Ontario s 80 and Over Licence Renewal Program: Measuring Safety Impact
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1 Ontario s 80 and Over Licence Renewal Program: Measuring Safety Impact CARSP Conference, June 2017 Maryam Haya, Tracey Ma, Frances Ilari, Erin Dessau and Yoassry Elzohairy Road Safety Research Office Ministry of Transportation of Ontario 1
2 Ontario s 80+ Population 1,800,000 1,600,000 1,400,000 1,200, Licenced Drivers Projected 80+ Licenced Drivers 80+ Population Projected 80+ Population 1,527,658 1,000, , , , , , , , ,352 Licence data from MTO Driver Annual Statistics 2014 Population projections from Ministry of Finance 2016 (using 2011 Census) 2
3 Evolution of the Senior Driver Renewal Program Program Introduction Vision, knowledge and road test required annually Program Changes Group Education Session (GES) Vision and knowledge test Road test referral at the discretion of Driver Improvement counsellor (DIC) Program Changes Knowledge test replaced with cognitive screens Road test referral based on objective criteria 1936 October 1996 April 21,
4 4 Evaluation of Ontario s 80 and Over Senior Driver Renewal Program Knowledge test performance is not a strong predictor of road safety outcomes Good indicators of road safety outcomes: Demerit points Failing first road test attempt
5 5 A Meta-Analysis of Cognitive Screening Tools of Drivers Aged 80 and Over 2 tools prioritized 6 tools piloted 42 tools selected 446 peer reviewed articles
6 Cognitive Screening Tests Clock Drawing Test Single Letter Cancellation Test (letter H) Measures visuo-spatial ability Measures psycho-motor speed COGNITIVE SCREEN PASS MODERATE FAIL EXTREME FAIL Clock Drawing Test Letter Cancellation Test
7 Cognitive Screening Tests Clock Drawing Test Single Letter Cancellation Test (letter H) Measures visuo-spatial ability Measures psycho-motor speed Clock Drawing Test Letter Cancellation Test 90% 91% 92% 93% 94% 95% 96% 97% 98% 99% 100% Pass Moderate Fail Extreme Fail 7
8 GES Results Road Test (6%) Medical Review (0.1%) Pass (94%) 8
9 Road Tests Results New Program Previous Program 18% 41% Fail Pass Fail Pass 59% 82%
10 Road Tests Results New Program Previous Program 41% Fail Pass 59% 2.3 X More Effective 18% Fail Pass 82%
11 Number of Senior Drivers Road Test Results Overall, 41% of all road test attempts resulted in failure Senior Driver Number of Road Test Attempts 62% Pass Fail (41%) Fail Pass % (59%) % 49% 42% 58% Road Test Attempt
12 Quantitative Data Group Education Session Road Test Medical Review Driver Record Clock Drawing Test raw score Letter Cancellation Test raw score 500 types of operational, observational, or rules of the road errors Cognitive Assessment results Functional Assessment results Licence information Collision involvement Suspension history Number of demerit points Decision (pass, road test, medical review) Classified as major or minor errors Conviction history 12
13 Evaluation questions 1. Who are Ontario s 80 and over drivers? 13
14 Evaluation questions 1. Who are Ontario s 80 and over drivers? 2. Road safety outcomes of new program vs. road safety outcomes of old program. 14
15 Evaluation questions 1. Who are Ontario s 80 and over drivers? 2. Road safety outcomes of new program vs. road safety outcomes of old program. 3. Can cognitive screening tools predict future driving events? 15
16 Evaluation questions 1. Who are Ontario s 80 and over drivers? 2. Road safety outcomes of new program vs. road safety outcomes of old program. 3. Can cognitive screening tools predict future driving events? 4. Cognitive screening tools, road tests, and driver performance errors. 16
17 Evaluation questions 1. Who are Ontario s 80 and over drivers? 2. Road safety outcomes of new program vs. road safety outcomes of old program. 3. Can cognitive screening tools predict future driving events? 4. Cognitive screening tools, road tests, and driver performance errors. 5. Cognitive screening tools vs. road test. 17
18 Evaluation questions 1. Who are Ontario s 80 and over drivers? 2. Road safety outcomes of new program vs. road safety outcomes of old program. 3. Can cognitive screening tools predict future driving events? 4. Cognitive screening tools, road tests, and driver performance errors. 5. Cognitive screening tools vs. road test. 6. Cognitive screening tools vs. medical review. 18
19 Evaluation questions 1. Who are Ontario s 80 and over drivers? 2. Road safety outcomes of new program vs. road safety outcomes of old program. 3. Can cognitive screening tools predict future driving events? 4. Cognitive screening tools, road tests, and driver performance errors. 5. Cognitive screening tools vs. road test. 6. Cognitive screening tools vs. medical review. 7. Multiple road test attempts and road safety outcomes. 19
20 Evaluation questions 1. Who are Ontario s 80 and over drivers? 2. Road safety outcomes of new program vs. road safety outcomes of old program. 3. Can cognitive screening tools predict future driving events? 4. Cognitive screening tools, road tests, and driver performance errors. 5. Cognitive screening tools vs. road test. 6. Cognitive screening tools vs. medical review. 7. Multiple road test attempts and road safety outcomes. 20
21 Conclusions and Next Steps Monitor & Evaluate Research & Develop Ontario s unique, multi-faceted approach to senior driver licence renewal is unlike any other licensing renewal program internationally. Preliminary results demonstrate that the new program is 2.3 times more effective in identifying drivers who may be unfit to drive. Results of the complete evaluation will inform future program and policy changes. 21
22 Acknowledgements We are grateful to the expert advisory committee who helped guide our evaluation framework. Michel Bedard, Ph.D. Ezra Hauer, Ph.D. Shawn Marshall, MD Gary Naglie, MD Mark Rapoport, MD Tom Schweizer, Ph.D. Brenda Vrkljan, Ph.D 22
23 THANK YOU 23
24 APPENDICES 24
25 Test Scoring & Thresholds Clock Drawing Test Instructions: Draw a large circle, put all the numbers in to make it look like the face of a clock, and then draw the hands of the clock to show ten minutes after eleven. Stop when completed. Scoring: For a total of 7 points, award 3 points for time, 2 points for numbers, 2 points for spacing. Thresholds: 3-7 points = pass 1-2 points = moderate fail 0 points = extreme fail Letter Cancellation Test Instructions: Look at the letters below. Whenever you see an H, place a mark with a pencil through it. Stop when completed. Scoring: Calculating the number of omissions (i.e., H s that were not crossed out). Thresholds: 0-5 omissions = pass 6-10 omissions = moderate fail 11+ omissions = extreme fail 25
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Nanaimo Region John Howard Society 200-1585 Bowen Road V9S 1G4 Nanaimo, BC 250-754-1266 www.johnhowardnanaimo.org RESTORATIVE JUSTICE YOUTH MENTORING PROGRAM: VOLUNTEER MENTOR APPLICATION Name: Address:
Assessment of Fitness to Drive to be completed by medical practitioner
COMMERCIAL VEHICLE DRIVER MEDICAL ASSESSMENT This Medical Assessment meets the requirements of the following Western Australian Government Authorities; Department of Commerce, WorkSafe - Occupational Safety