Older driver training programs: A systematic review of evidence aimed at improving behind-the-wheel performance

IntroductionAge- and health-related changes, alongside declines in driving confidence and on-road exposure, have been implicated in crashes involving older drivers. Interventions aimed at improving behind-the-wheel behavior are diverse and their associated impact remains unclear. This systematic review examined evidence on older driver training with respect to (1) road safety knowledge; (2) self-perceived changes in driving abilities; and (3) behind-the-wheel performance. Method Nine databases were searched for English-language articles describing randomized controlled trials (RCTs) and non-RCTs of driver training interventions aimed at those aged 55+ who did not have medical or other impairments that precluded licensure. Quality appraisals were conducted using Cochrane’s Risk of Bias Tool (RoB) and Risk Of Bias In Non-randomized Studies – of Interventions tool (ROBINS – I). [PROSPERO; registration no. CRD42018087366]. Results Twenty-five RCTs and eight non-RCTs met the inclusion criteria. Interventions varied in their design and delivery where classroom-based education, or a combination of classroom-based education with on-road feedback, improved road safety knowledge. Training tailored to individual participants was found to improve self-perceived and behind-the-wheel outcomes, including crashes. Conclusions Interventions comprised of tailored training can improve knowledge of road safety, changes to self-perception of driving abilities, and improved behind-the-wheel performance of older drivers. Future research should compare modes of training delivery for this driver population to determine the optimal combinations of off- and/or on-road training. Practical applications Training programs aimed at older drivers should be supported by theory and research evidence. By conducting comparative trials with a sufficient sample size alongside well-defined outcomes that are designed in accordance with reporting guidelines, the most effective approaches for training older drivers will be identified.     

On-road and simulated driving: concurrent and discriminant validation

Introduction

A converging pair of studies investigated the validity of a simulator for measuring driving performance/skill.

Study 1

A concurrent validity study compared novice driver performance during an on-road driving test with their performance on a comparable simulated driving test.

Results

Results showed a reasonable degree of concordance in terms of the distribution of driving errors on-road and errors on the simulator. Moreover, there was a significant relationship between the two when driver performance was rank ordered according to errors, further establishing the relative validity of the simulator. However, specific driving errors on the two tasks were not closely related suggesting that absolute validity could not be established and that overall performance is needed to establish the level of skill.

Study 2

A discriminant validity study compared driving performance on the simulator across three groups of drivers who differ in their level of experience - a group of true beginners who had no driving experience, a group of novice drivers who had completed driver education and had a learner's permit, and a group of fully licensed, experienced drivers.

Results

The findings showed significant differences among the groups in the expected direction -- the various measures of driving errors showed that beginners performed worse than novice drivers and that experienced drivers had the fewest errors. Collectively, the results of the concurrent and discriminant validity studies support the use of the simulator as a valid measure of driving performance for research purposes.

Impact on industry

These findings support the use of a driving simulator as a valid measure of driving performance for research purposes. Future research should continue to examine validity between on-road driving performance and performance on a driving simulator and the use of simulated driving tests in the evaluation of driver education/training programs.     

Comparison of young male and female drivers' attitude and self-reported traffic behaviour in Finland in 1978 and 2001

Problem: This study evaluates how the traffic behaviors of young drivers and their attitudes toward traffic regulations have changed over the last 23 years, and particularly, whether the differences in attitudes and behavior between male and female drivers have changed. Method: The study was conducted in 2001, and it replicated a traffic attitude survey administered in 1978. The same survey was used, enabling comparison between the years. The number of respondents was 3,158 in 1978 and 2,759 in 2001. Results: The comparison revealed several differences regarding the background factors, attitudes, and driving style of novice drivers. Most obvious changes in the drivers' background were the changes in education level (higher today), driver training (more private training today), and exposure/experience in terms of kilometers (more today). The summary variable measured that the young drivers showed more negative attitudes toward traffic rules and safe driving in 2001 compared to 1978. Female drivers drove less than males and evaluated their driving skill lower. Female drivers were less involved in accidents and they committed less traffic offenses than males (kilometrage controlled). Female drivers showed a more positive attitude toward traffic safety and rules than males. The difference in traffic attitudes and behavior between males and females in 1978 compared to 2001 remained the same or even increased somewhat.     

On-road driving evaluations: a potential tool for helping older adults drive safely longer

PROBLEM: This paper explores the potential use of on-road driving evaluations as a tool for helping older adults extend their safe driving years. METHOD: Three separate research activities were carried out. The first was a national telephone survey of current and former older drivers. The results of this survey provide information relevant to the potential market for on-road driving evaluations. The second was a series of focus groups with potential stakeholders in the process: driver educators, occupational therapists, and physicians. These groups explored the feasibility and requirements of offering on-road driving evaluations to the wider public. Supplemental data were also collected from a mail survey of driving schools nationwide. RESULTS: Based on the results of these efforts, a number of recommendations are presented for expanding the availability of on-road driving evaluations, specifically to help older adults make more responsible decisions about continuing or stopping driving, and more generally to help them drive safely longer.     

Driving safety improves after individualized training: An RCT involving older drivers in an urban area

Objective: This study aimed to reproduce the results of a previous investigation on the safety benefits of individualized training for older drivers. We modified our method to address validity and generalizability issues.

Methods: Older drivers were randomly assigned to one of the 3 arms: (1) education alone, (2) education?+?on road training, and (3) education?+?on road?+?simulator training. Older drivers were recruited from a larger urban community. At the pre- and posttests (separated by 4 to 8 weeks) participants followed driving directions using a Global Positioning System (GPS) navigation system.

Results: Our findings support the positive influence of individualized on-road training for urban-dwelling older drivers. Overall, driving safety improved among drivers who received on-road training over those who were only exposed to an education session, F(1, 40) = 11.66, P = .001 (26% reduction in total unsafe driving actions [UDAs]). Statistically significant improvements were observed on observation UDAs (e.g., scanning at intersections, etc.), compliance UDAs (e.g., incomplete stop), and procedural UDAs (e.g., position in lane).

Conclusion: This study adds to the growing evidence base in support of individualized older driver training to optimize older drivers’ safety and promote continued safe driving.     

Associations between driver training, determinants of risky driving behaviour and crash involvement

The core aim of the study is to examine associations between formal and informal practical driver training as well as driving experience on the one hand and young drivers’ safety attitudes, self-assessment of driving ability and self-reported driver behaviour on the other hand. An additional aim is to examine the associations between attitudes, self-assessment and behaviour on the one hand and crash involvement on the other hand. The results are based on a self-completion questionnaire survey conducted among a representative sample of Norwegian drivers aged 18–20 years (n = 1419). The results showed that there were small yet significant associations between driver training, on the one hand and traffic safety attitudes and risky driving behaviour on the other hand. The amount of formal driver training was negatively associated with the respondents’ evaluation of their driving skills; although the amount of lay instruction was positively associated with such self-evaluation. The results also showed that attitudes as well as self-assessment of driving ability were significantly associated with self-reported risk behaviour. This was especially true for attitudes related to rule violations. There was a strong association between crash involvement and exposure (measured as months holding a licence). Young novice drivers’ crash involvement seems stronger associated with driving skills (manifested as self-assessment of driving ability) than safety attitudes and self-reported driver behaviour. The consequences of the results for driver training and accident prevention are discussed.     

Practicing for and performance on drivers license tests in relation to gender differences in crash involvement among novice drivers

PROBLEM: Young male novice drivers are overrepresented in injury motor-vehicle crashes compared to females in the same category. This difference in crash involvement is often assumed to include factors such as overestimation, risk acceptance, and sensation seeking, but it can also be related to acquisition of knowledge, skills, insight, and driving experience. Therefore, this study explored possible gender differences among 18-24-year-olds in Sweden regarding practicing as learners, outcome of the driver's tests, and crash involvement during the first year after licensure. METHOD: Data for 2005 from different sources (e.g., questionnaires, license test, and crash statistics) were examined. It was not possible to follow individual subjects through all stages or in all analyses. Nevertheless, the study design did enable scrutinization and discussion of gender differences between younger inexperienced drivers with respect to education and training, license test results, and initial period of licensure. RESULTS: Males and females assimilated tuition in different ways. Females studied more theory, pursued training in a more structured manner, practiced more elements of driving in several different environments, and participated more extensively in driving school instruction. National statistics showed that females did better on the written test but not on the driving test. Males were involved in 1.9 more injury crashes per 1,000 drivers than females during their first year of licensed driving. The proportional distribution of crash types was the same for both sexes during the first period as novice drivers, but the circumstances surrounding the accidents varied (e.g., males were involved in more night crashes). IMPACT ON TRAFFIC SAFETY: More structured training while learning appears to be one of the reasons why females initially do better than males as novice drivers. Therefore, in the future, driver education should focus not only on matters such as the amount of time spent on training and preconditioning, but also on the importance of the organization and content of the learning process.     

Traffic climate and driver behaviors: The moderating role of driving skills in Turkey and China

Introduction: While road traffic accidents and fatalities are a worldwide problem, the rates of road traffic accidents and fatalities show differences among countries. Similarly, driver behaviors, traffic climate, and their relationships also show differences among countries. The aim of the current study is to investigate the moderating effect of driving skills on the relationship between traffic climate and driver behaviors by country. (Turkey and China). Method: There were 294 Turkish drivers and 292 Chinese drivers, and they completed the Traffic Climate Scale, the Driving Skills Inventory, and the Driver Behavior Questionnaire. The moderated moderation analyses were conducted with Hayes PROCESS tool on SPSS. Results: The results showed that safety skills moderated the relationship between internal requirements and violations both in Turkey and China. Safety skills also moderated the relationship between internal requirements and errors only in China and the relationship between functionality and violations in Turkey. Perceptual-motor skills moderated the relationships between external affective demands and errors, and also the relationship between internal requirements and positive driver behaviors in Turkey. It can be inferred that driving skills has different influences on traffic climate-driver behaviors relationship in different cultures and there might be cultural differences in the evaluation of drivers’ own driving skills. Practical Applications: Among driving skills, safety skills have a more critical role to increase road safety by decreasing number of violations. Interventions to increase safety skills of drivers might be promising for road safety.     

Driver education and graduated licensing in North America: past, present, and future

PROBLEM: A stated objective of driver education in North America is to produce safer drivers, typically defined as drivers less likely to crash. This paper examines the extent to which driver education has achieved this objective independently as well as the extent to which such programs can support the success of graduated licensing in reducing young driver crashes. In so doing, it discusses past experiences, recent developments, and the future direction of driver education and training in relation to graduated driver licensing. METHOD: Literature review and synthesis. RESULTS: Driver education programs have yet to demonstrate consistent attainment of their safety objectives. Moreover, they have not been found to enhance the safety effectiveness of graduated licensing programs--indeed, some practices, for example, "time discounts" for driver education have actually had a detrimental effect on teen safety. DISCUSSION: Despite its disappointing safety record to date, it is important not to abandon driver education. In particular, there are opportunities to improve driver education so that it achieves its safety objectives, and ensure that programs in the future complement graduated driver licensing and contribute to its overall safety benefits. Current and future efforts to improve driver education and better integrate it with graduated licensing programs, however, need to be rigorously evaluated to determine what does and does not work to reduce young driver crashes, and as importantly, to understand why this is the case. IMPACT ON INDUSTRY: Improved driver education integrated with graduated driver licensing has potential safety benefits.     

Understanding adolescent development: implications for driving safety

PROBLEM: The implementation of Graduated Driver Licensing (GDL) programs has significantly improved the crash and fatality rates of novice teen drivers, but these rates remain unacceptably high. METHOD: A review of adolescent development research was undertaken to identify potential areas of improvement. RESULTS: Research support for GDL was found to be strong, particularly regarding early acquisition of expertise in driving safety (beyond driving skill), and to limitations that reduce opportunities for distraction. GDL regimes are highly variable, and no US jurisdictions have implemented optimal regimes. SUMMARY: Expanding and improving GDL to enhance acquisition of expertise and self-regulation are indicated for implementation and for applied research. Driver training that effectively incorporates safety goals along with driving skill is another target. IMPACT ON INDUSTRY: The insurance industry will benefit from further GDL enhancements. Benefits may accrue to improved driver training, improved simulation devices during training, and automated safety feedback instrumentation.     

Cycle Aware: Piloting a module for novice drivers

Introduction: In low-cycling countries, motor-vehicle traffic and driver behavior are well known barriers to the uptake of bicycles, particularly for utility cycling. Lack of separation between cyclists and faster-moving traffic is one key issue, while attitudes of drivers toward and/or harassment of cyclists is another. Cyclist-related driver education has been recommended as a means to improve driver-cyclist interactions. Methods: The driver licensing process provides an opportunity for such education. The Cycle Aware module was developed to test and enhance novice drivers’ knowledge of interacting safely with cyclists. It was piloted across three Australian jurisdictions targeting both novice and experienced drivers. Participants were asked to complete the Cycle Aware module and an accompanying survey. A total of 134 novice and 97 experienced drivers completed the survey with 42 novice and 50 experienced drivers going on to complete the module. Results: Both groups of drivers scored equally well in the module but the very youngest and very oldest participants were more likely to have some incorrect responses. We did not find any relationship between correct module scores and attitudes toward cyclists. Survey results showed both novice and experienced drivers had somewhat positive attitudes toward cyclists. The two cohorts differed on several attitude questions. Sixty percent (60%) of novices compared to 30% of experienced drivers reported feeling concerned when sharing the road with cyclists, and novices were less likely to agree that cyclists had a right to use the roads. Conclusions and practical applications: The analysis suggests novices need to be better equipped to share roads confidently with cyclists and to recognize cyclists as legitimate traffic participants.     

Probationary and non-probationary drivers' nighttime crashes in Western Australia, 1996-2000

INTRODUCTION: This study was designed to explore the temporal aspects of crashes for probationary and non-probationary drivers. METHODS: Data from the West Australian Road Injury Database from 1996-2000 were used to calculate age-sex-specific crash rates per 100,000 person-days and to plot proportions of fatal and hospital crashes by time for probationary and non-probationary drivers. The population attributable risk was used to estimate the potential number of lives saved by nighttime driving restriction in the probationary period. RESULTS: Probationary drivers were seven times more likely to crash than non-probationary drivers. While the highest number of crashes was in the daytime, probationary drivers had a higher proportion of fatal or hospitalization crashes at night than non-probationary drivers. CONCLUSION: Restrictions on driving at night could form part of graduated driver training. Even if some probationary drivers disobeyed the restriction, a substantial reduction in car occupant fatalities and hospitalizations could result.     

Introducing a multi-variate classification method: Risky driving acceptance among different heterogeneous driver sub-cultures

Introduction: Heterogeneous driving populations with many different origins are likely to have various sub-cultures that comprise of drivers with shared driver characteristics, most likely with dissimilar traffic safety cultures. An innovative methodology in traffic safety research is introduced which is beneficial for large datasets with multiple variables, making it useful for the multi-variate classification of drivers, driving attitudes and/or (risky) driving behaviours. Method: With the application of multidimensional scaling analysis (MDS), this study explores traffic safety culture in the State of Qatar using a questionnaire and investigates the similarity patterns between the questionnaire items, aiming to classify attitudes towards risky driving behaviours into themes. MDS is subsequently applied to classify drivers within a heterogeneous driving sample into sub-cultures with shared driver characteristics and different risky driving attitudes. Results: Results show that acceptance of speeding is highest among the young Arabic students and acceptance of distraction and drivers’ negligence such as phone use and not wearing a seatbelt is highest among male Arab drivers. Acceptance of extreme risk-taking like intoxicated driving and red-light running is highest among South-Asian business drivers. Conclusion: It is important and practical to understand risky behavioural habits among sub-cultures and thereby focussing on groups of drivers instead of individuals, because groups are easier to approach and drivers within sub-cultures are found to influence each other. By indicating which groups of drivers are most likely to perform specific risky driving themes, it is possible to target these groups and effectively emphasise certain subsets of risky driving behaviours during training or traffic safety education. Practical Applications: This study provides guidance for the improvement of driver education and targeted traffic safety awareness campaigns, intending to make changes to attitudes and habits within specific driver sub-cultures with the aim to improve traffic safety on the longer term.     

Traffic safety culture and prosocial driver behavior for safer vehicle-bicyclist interactions

Introduction: Bicyclist safety is a growing concern as more adults use this form of transportation for recreation, exercise, and mobility. Most bicyclist fatalities result from a crash with a vehicle. Often, the behaviors of the driver are responsible for the crash. Method: This survey study of Montana and North Dakota residents (n = 938) examined the influence of traffic safety culture on driver behaviors that affect safe interactions with bicyclists. Results: Prosocial driver behavior was most common and appeared to be intentional. Intention was increased by positive attitudes, normative perceptions, and perceived control. However, normative perceptions appear to offer the most opportunity for change. Practical Application: Strategies that increase perceptions that prosocial driver behavior is normal may increase prosocial intentions, thereby increasing bicyclist safety.     

In-vehicle workload assessment: effects of traffic situations and cellular telephone use

PROBLEM: Assessment of drivers' on-road workload is an important traffic safety consideration. This study was conducted to examine the effects of cellular phone communication on driving performance, with particular emphasis on variations in task demand in different traffic situations. METHOD: Twelve participants were asked to drive on urban roads and motorways with or without concomitant mathematical-addition tests relayed via cellular phone. Measurements included task and driving performance, physiological responses, and compensatory behavior. RESULTS: Analysis of task performance revealed that mean response time was markedly increased (11.9%) for driving on urban roads compared to motorways. The mean driving speed only decreased 5.8% in the presence of phone tasks in comparison to normal driving without distractions. In addition, overall physiological workload increased through compensatory behavior in response to the phone tasks. CONCLUSIONS: Driving with phone use in different traffic environments induced measurable variations in driver workload. IMPACT ON INDUSTRY: When faced with heavy traffic, a greater safety margin is typically adopted, with more lowered driving speed and restricted phone use, and it can be assumed that there is a general trade-off between tasks to preserve driving safety.     

Older driver retraining: An updated systematic review of evidence of effectiveness

Problem and Objective

The number of older drivers who might benefit from driver retraining is growing. A previous review on the effectiveness of older driver retraining included intervention studies up to 2004. The objective was to perform an updated systematic review of the effectiveness of older driver retraining for improving driving-related skills and reducing crash rates.

Method

Articles published from 2004-2008 were grouped according to the intervention provided and outcome studied. Randomized clinical trials (RCTs) were appraised using the Physiotherapy Evidence Database (PEDro) Scale and scored for quality according to their internal validity. Each intervention's effectiveness was then rated and assigned a level of evidence by combining pre- and post- 2004 findings.

Results

Three RCTs and one matched-pairs cohort design met the inclusion criteria. There is strong evidence (Level 1a) that education combined with on-road training improves driving performance and moderate evidence (Level 1b) that it improves knowledge. There is moderate evidence (Level 1b) that physical retraining improves driving performance. There is moderate evidence (Level 1b) that an educational intervention curriculum alone is not effective in reducing crashes.

Summary

The updated evidence on the effectiveness of retraining aimed at older drivers is sufficiently encouraging to merit assertive health promotion actions regarding intervention and program planning.

Impact on Industry

These positive findings warrant a comprehensive plan that has both behavioral and monetary incentives encouraging older driver participation in programs aimed at driver safety.     

A comparison of the driving behavior between remunerated and volunteer drivers

IntroductionPast research suggests that some groups of work-related drivers practice more safe driving behavior than others. However, no research to date has compared the driving behavior of those remunerated for their services and volunteer work-related drivers. As such, based on a theoretical discussion of the organizational and social contexts in which work-related driving occurs, this study hypothesized that volunteers would report safer driving behavior compared with remunerated drivers.MethodsOne-hundred and ninety remunerated drivers and 59 volunteers completed a self-reported driving behavior questionnaire.ResultsSome support was found for the hypotheses, as volunteers reported more safe driving behavior than remunerated drivers. Specifically, volunteers reported less inattention and tiredness while driving compared to remunerated drivers.ConclusionsThe results suggested that organizations need to formalize the roles and responsibilities of the work-related driver, and better integrate driving within the wider occupational health and safety system.     

Impact of the Graduated Driver Licensing Program in Nova Scotia

A comprehensive evaluation of the Nova Scotia graduated licensing program was conducted. This program was implemented on October 1, 1994 and applies to all novice drivers, regardless of age. It spans 2 1/2 years in two stages: a 6-month learner phase, followed by a 24-month newly licensed driver phase. During both phases several driving restrictions apply, most notably a requirement for adult supervision at all times in the learner phase and a night driving restriction from midnight to 5 a.m. in the newly licensed driver phase. The evaluation of this program used a series of increasingly refined analyses that controlled for the influence of other explanatory variables. All the analyses showed that the graduated licensing program in Nova Scotia was associated with a significant reduction in crashes. For drivers age 16, there was a 24 percent decrease in total crashes during the first full year of the program and a 37 percent reduction during the first 3 years of the program. Comparable decreases occurred in injury crashes. Improvements also were observed for all novice drivers, not just those who are young - there was a 19 percent decrease in the crash rate for all novice drivers. Comparisons with results from other graduated licensing programs indicate the Nova Scotia program has been more effective than others in reducing crashes.     

Traffic rules and traffic safety

In the present paper the effects of traffic rules on driver behaviour and on traffic safety are discussed. The discussion is mainly based on research conerning driver’s use of safety equipment, their speed adjustment and drunken driving with respect to safety potential, effects of the rules, and effects of enforcement on driver behaviour. Factors influencing drivers’ decisions to comply with rules are also considered. It is concluded that only rules that are possible to enforce should be implemented and that police surveillance should be visible to the drivers. Also, the traffic system should be seen as a social system where drivers are interacting with other drivers and road users. Rules and regulations are important to help the actors of the system to function in a safe and effective way.     

The role of off-path glances: A quantitative analysis of rear-end conflicts involving Chinese professional truck drivers as the striking partners

Introduction: Rear-end crashes are one of the most frequent crash types in China, leading to significant economic and societal losses. The development of active safety systems – such as Automatic Emergency Braking System (AEBS) – could avoid or mitigate the consequences of these crashes in Chinese traffic situations. However, a clear understanding of the crash causation mechanisms is necessary for the design of these systems. Method: Manually coded variables were extracted from a naturalistic driving study conducted with commercial vehicles in Shanghai. Quantitative analyses of rear-end crashes and near crashes (CNC) were conducted to assess the prevalence, duration, and location of drivers’ off-path glances, the influence of lead vehicle brake lights on drivers’ last off-path glance, and driver brake onset, and the influence of off-path glances and kinematic criticality on drivers’ response to conflicts. Results: The results indicate that the Chinese truck drivers in our study rarely engage in distracting activities involving a phone or other handheld objects while driving. Instead, they direct their off-path glances mainly toward the mirrors, and the duration of off-path glances leading to critical situations are shorter compared to earlier analyses performed in Western countries. The drivers also often keep small margins. Conclusions: Overall, the combination of short time headway with off-path glances directed toward the mirror originates visual mismatches which, associated to a rapid change in the kinematic situation, cause the occurrence of rear-end CNC. When drivers look back toward the road after an off-path glance, a fast response seems to be triggered by lower values of looming compared to previous studies, possibly because of the short time headways. Practical Application: The results have practical implications for the development of driver models, for the design of active safety systems and automated driving, and for the design of campaigns promoting safe driving.