Examining the validity of an interactive driving simulator for determining fitness to drive for older adults with cognitive impairment

Abstract

Purpose: To examine the validity of the interactive driving simulator for determining fitness to drive for older adults with cognitive impairment. Method: This pretest/posttest design had ten older adults complete two "test" scenarios, receive additional experience, and then perform the same two scenarios plus a third scenario. Participants and four reviewers scored their performance. Performances were compared between the participants with cognitive impairment, physical impairment, and no diagnosis as well as between participants' and reviewers' scores. Results: There was no significant change in self-awareness or self-efficacy as a group. Driving performance in terms of safety and errors did not significantly improve after the simulator training intervention. Scores by the researchers were lower in terms of safety, especially for those with cognitive impairment. However, scores on the number of errors were more similar, that is, participants were more accurate in identifying the amount of errors they committed. Conclusion: Participants appeared to appreciate their mistakes made on simulator. However, although their perception of mistakes improves, the knowledge did not change their perception about their safety to drive. Only two participants changed their perception of his or her ability to drive, one improving and one decreasing in ability. For clients with cognitive impairments, the driving simulator may not be a useful tool for increasing self-awareness. However, unsafe driving behaviors were observed by clinicians, suggesting the interactive driving simulator may be an effective tool for assessment.