Although used across North America, many on-road studies do not explicitly document the content and metrics of on-road courses and accompanying assessments. This article discusses the development of the University of Western Ontario’s on-road course, and elucidates the validity of its accompanying on-road assessment. We identified main components for developing an on-road course and used measurement theory to establish face, content, and initial construct validity. Five adult volunteer drivers and 30 drivers with multiple sclerosis participated in the study. The road course had face and content validity, representing 100% of roadway components determined through a content validity matrix and index. The known-groups method showed that debilitated drivers (vs. not debilitated), made more driving errors (W = 463.50, p = .03), and failed the on-road course, indicating preliminary construct validity of the on-road assessment. This research guides and empirically supports a process for developing a road course and its assessment.
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1-S48.
2.
BarcoP. P.CarrD. B.RutkoskiK.XiongC.RoeC. M. (2015). Interrater reliability of the Record of Driving Errors (RODE). American Journal of Occupational Therapy, 69(2), 21-26. doi:10.5014/ajot.2015.013128
CarrD. B.OttB. R. (2010). The older adult driver with cognitive impairment. The Journal of the American Medical Association, 303, 1632-1641. doi:10.1001/jama.2010.481
5.
ClassenS. (2010). Special issue on older driver safety and community mobility. The American Journal of Occupational Therapy, 64, 211-214. doi:10.5014/ajot.64.2.211
6.
ClassenS.DickersonA. E.JustissM. D. (2012). Occupational therapy driving evaluation: Using evidence-based screening and assessment tools. In McGuireM. J.Schold-DavisE. (Eds.), Driving and community mobility: Occupational therapy across the lifespan (pp. 221-277). Bethesda, MD: AOTA Press.
7.
ClassenS.KrasniukS.KnottM.AlvarezL.MonahanM.MorrowS.A.DanterT. (in press). Inter-rater reliability of Western University’s On-Road Assessment. The Canadian Journal of Occupational Therapy.
8.
ClassenS.LanfordD. N. (2012). Clinical reasoning process in the comprehensive driving evaluation. In McGuireM. J.Schold-DavisE. (Eds.), Driving and community mobility: Occupational therapy strategies across the lifespan (pp. 321-344). Bethesda, MD: AOTA Press.
9.
ClassenS.MonahanM.AutenB.YarneyA. (2014). Evidence-based review of interventions for medically at-risk older drivers. The American Journal of Occupational Therapy, 68, e107-e114. doi:10.5014/ajot.2014.010975
10.
DavisJ.ConlonE.OwnsworthT.MorrisseyS. (2016). Measuring situational avoidance in older drivers: An application of Rasch analysis. Accident Analysis & Prevention, 87, 68-77. doi:10.1016/j.aap.2015.11.018
11.
DawsonJ. D.UcE. Y.AndersonS. W.JohnsonA. M.RizzoM. (2010). Neuropsychological predictors of driving errors in older adults. Journal of the American Geriatrics Society, 58, 1090-1096. doi:10.1111/j.1532-5415.2010.02872.x
DevosH.RanchetM.AkinwuntanA. E.UcE. Y. (2015). Establishing an evidence-based framework for driving rehabilitation in Parkinson’s disease: A systematic review of on-road driving studies. NeuroRehabilitation, 37, 35-52. doi:10.3233/NRE-151239
14.
DickersonA. E. (2014). Screening and assessment tools for determining fitness to drive: A review of the literature for the pathways project. Occupational Therapy in Health Care, 28, 82-121. doi:10.3109/07380577.2014.904535
15.
DickersonA. E.MolnarL. J.EbyD. W.AdlerG.BedardM.Berg-WegerM.. . . TrujilloL. (2007). Transportation and aging: A research agenda for advancing safe mobility. Gerontologist, 47, 578-590. doi:10.1093/geront/47.5.578
16.
DickersonA. E.ReisletterT.Schold DavisE.MonahanM. (2011). Evaluating driving as a valued instrumental activity of daily living. American Journal of Occupational Therapy, 65, 64-75. doi:10.5014/ajot.2011.09052
17.
DickersonA. E.StresselD.JustissM. D.Luther-KrugM. (2012). Behind the wheel: Driver rehabilitation intervention. In McGuireM. J.Schold-DavisE. (Eds.), Driving and community mobility: Occupational therapy strategies across the lifespan (pp. 345-382). Bethesda, MD: AOTA Press.
18.
Di StefanoM.MacdonaldW. (2003). Assessment of older drivers: Relationships among on-road errors, medical conditions and test outcome. Journal of Safety Research, 34, 415-429. doi:10.1016/j/jsr.2003.09.010
19.
Di StefanoM.MacdonaldW. (2005). On-the-road evaluation of driving performance. In PelleritoJ. M. (Ed.), Driver rehabilitation and community principles and practice (pp. 255-274). St Louis, MO: Elsevier Mosby.
20.
Di StefanoM.MacdonaldW. (2012). Design of occupational therapy on-road test routes and related validity issues. Australian Occupational Therapy Journal, 59, 37-46. doi:10.1111/j.1440-1630.2011.00990.x
HuntL. A.MurphyC. F.CarrD. B.DuchekJ. M.BucklesV.MorrisJ. C. (1997b). Reliability of the Washington University Road Test. A performance-based assessment for drivers with dementia of the Alzheimer type. Archives of Neurology, 54, 707-712. doi:10.1001/archneur.1997.00550180029008
23.
JankeM. K.EberhardJ. W. (1998). Assessing medically impaired older drivers in a licensing agency setting. Accident Analysis & Prevention, 30, 347-361. doi:10.1016/S0001-4575(97)00112-7
24.
JustissM. D.MannW. C.StavW. B.VelozoC. A. (2006). Development of a behind-the-wheel driving performance assessment for older adults. The older driver, Part 2. Topics in Geriatric Rehabilitation, 22, 121-128.
25.
KayL.BundyA.ClemsonL.JollyN. (2008). Validity and reliability of the on-road driving assessment with senior drivers. Accident Analysis & Prevention, 40, 751-759. doi:10.1016/j.aap.2007.09.012
26.
KayL. G.BundyA. C.ClemsonL. M. (2009). Predicting fitness to drive in people with cognitive impairments by using DriveSafe and DriveAware. Archives of Physical Medicine and Rehabilitation, 90, 1514-1522. doi:10.1016/j.apmr.2009.03.011
27.
KielhofnerG. (2006). Developing and evaluating quantitative data collection instruments. In KielhofnerG. (Ed.), Research in occupational therapy: Methods of inquiry for enhancing practice (pp. 155-176). Philadelphia, PA: F.A. Davis Company.
28.
Korner-BitenskyN.GélinasI.Man-Son-HingM.MarshallS. (2005). Recommendations of the Canadian Consensus Conference on driving evaluation in older drivers. In MannW. (Ed.), Community mobility: Driving and transportation alternatives for older persons (pp. 123-144). Binghamton, NY: Haworth Press.
29.
KurtzkeJ. F. (1983). Rating neurologic impairment in multiple sclerosis: An Expanded Disability Status Scale (EDSS). Neurology, 33, 1444-1452. doi:10.1212/WNL.33.11.1444
30.
LynnM. R. (1986). Determination and quantification of content validity. Nursing Research, 35, 382-385. doi:10.1097/00006199-198611000-00017
31.
MichonJ. A. (1985). A critical view of driver behavior models: What do we know, what should we do? In EvansE. L.SchwingR. (Eds.), Human behavior and traffic safety (pp. 485-520). New York, NY: Plenum.
32.
Ministry of Transportation Ontario. (2010). Basic medical standards. Available from www.mto.gov.on.ca
33.
Ministry of Transportation Ontario. (2014). The Official Ministry of Transportation handbook. Toronto, ON: Road User Safety Division of the Ministry of Transportation Ontario.
OdenheimerG. L.BeaudetM.JetteA. M.AlbertM. S.GrandeL.MinakerK. L. (1994). Performance-based driving evaluation of the elderly driver: Safety, reliability, and validity. Journal of Gerontology, 49, M153-M159. doi:10.1093/geronj/49.4.M153
36.
OttB. R.PapandonatosG. D.DavisJ. D.BarcoP. P. (2012). Naturalistic validation of an on-road driving test of older drivers. Human Factors, 54, 663-674. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22908688
37.
PatomellaA.-H.BundyA. (2015). P-Drive: Implementing an assessment of on-road driving in clinical settings and investigating its internal and predictive validity. American Journal of Occupational Therapy, 69(4), 1-8. doi:10.5014/ajot.2015.015131
38.
RanchetM.AkinwuntanA.TantM.NealE.DevosH. (2015). Agreement between physician’s recommendation and fitness-to-drive decision in multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 96, 1840-1844. doi:10.1016/j.apmr.2015.06.010
39.
Schold DavisE.DickersonA. (2012). The gaps and pathways project. OT Practice, 17(21), 9-13, 19.
40.
ShechtmanO.AwadziK. D.ClassenS.LanfordD. N.JooY. (2010). Validity and critical driving errors of on-road assessment for older drivers. American Journal of Occupational Therapy, 64, 242-251. doi:10.5014/ajot.64.2.242
41.
StavW. B.JustissM.BelchiorP.LanfordD. (2006). Clinical practice in driving. Topics in Geriatric Rehabilitation, 22, 153-161.
42.
StavW. B.JustissM. D.McCarthyD. P.MannW. C.LanfordD. N. (2008). Predictability of clinical assessments for driving performance. Journal of Safety Research, 39, 1-7. doi:10.1016/j.jsr.2007.10.004
43.
SwanepoelL.ClassenS.GoliathC. (2015). Validity of the Stellenbosch University on-road driving assessment. South African Journal of Occupational Therapy, 45(3), 9-15.
44.
Transportation Research Board Sub-Committee ANB 60. (2016). Taxonomy and terms for stakeholders in senior mobility (Transportation Research Circular No. E-C211). Washington, DC: Transportation Research Board.
45.
UcE. Y.RizzoM.JohnsonA. M.DastrupE.AndersonS. W.DawsonJ. D. (2009). Road safety in drivers with Parkinson disease. Neurology, 73, 2112-2119. doi:10.1212/WNL.0b013e3181c67b77
46.
VrkljanB. H.MyersA. M.BlanchardR. A.CrizzleA. M.MarshallS. (2015). Practices used by occupational therapists and others in driving assessment centers for determining fitness-to-drive: A case-based approach. Physical & Occupational Therapy in Geriatrics, 33, 163-174. doi:10.3109/02703181.2015.1016647
47.
WithaarF. K.BrouwerW. H.Van ZomerenA. H. (2000). Fitness to drive in older drivers with cognitive impairment. Journal of the Neuropsychological Society, 6, 480-490. doi:10.1017/S1355617700644065
