Exit Menu

Development of a web-based decision aid to assist occupational therapists to make optimal fitness-to-drive decisions for disabled and older drivers


Project description

The number of older people or those with disabilities, who want to drive, is growing. Occupational Therapist Driver Assessors (OTDAs), with their combined health and performance expertise, are well equipped to conduct clinic-based and on-road driving assessments of older people and those with disabilities. However, there is a lack of OTDAs internationally. Recognising this, we undertook a project to develop a web-based decision-training aid to enhance novice Occupational Therapists’ (OTs) capacity to make optimal fitness-to-drive decisions. For this, we generated a set of driver scenarios, and asked a sample of experienced OTDAs to make decisions on the scenarios. We statistically modelled the experts’ decisions to obtain an optimal consensus judgement policy, and then used this policy to explain how driver information provided in referrals should be used when making fitness-to-drive decisions. The case scenarios and consensus policy were incorporated into a web-based decision-training aid. A randomised controlled trial (n=166) was conducted to test the effectiveness of the decision aid on novices’ decision making capacity. Trained novices were able to identify more not fit-to-drive cases as compared untrained novices.

The training aid developed has the potential to improve fitness-to-drive decision making skills and increase the occupational therapy workforce for fitness-to-drive assessments. These mean improved quality and effectiveness of service delivery, and improved road safety for users.


  • Unsworth, C. , Harries, P. and Davies, M. (2015) 'Using Social Judgment Theory method to examine how experienced occupational therapy driver assessors use information to make fitness-to-drive recommendations'. British Journal of Occupational Therapy, 2 pp. 71 - 72. doi: 10.1177/0308022614562396 Download publication 
  • Harries, PA. and Unsworth, CU. (2015) 'Driving and community mobility (I): clinical assessment of fitness to drive'. British Journal of Occupational Therapy. pp. 71 - 72. doi: 10.1177/0308022614564670 
  • Unsworth, CA. and Harries, PA. (2015) 'Special Issue: Driving and community mobility (II) - interventions to enable driving'. BRITISH JOURNAL OF OCCUPATIONAL THERAPY, 78 (6). pp. 337 - 338. doi: 10.1177/0308022614566859 
  • Harries, PA. and Unsworth, CA. (2013) 'Clinical assessment of fitness-to-drive: positioning occupational therapy for workforce development'. BRITISH JOURNAL OF OCCUPATIONAL THERAPY, 76 (7). pp. 299 - 299. doi: 10.4276/030802213X13729279114852