APPENDIX FOR "DRIVING SIMULATOR FOR PERSONS WITH IMPAIRED COGNITION", PI WILLIAM K DURFEE

Transcription

1 APPENDIX FOR "DRIVING SIMULATOR FOR PERSONS WITH IMPAIRED COGNITION", PI WILLIAM K DURFEE Contents 1. Drive Log (simulation run): Used by researcher to record events that took place during a simulator session. There is a similar form for the on-road session. This is the version used in Phase I. The Phase II version will be simplified. Also note that in Phase II, driving instructions are given by STISIM Drive via automated prompting. (pp 2-10) 2. Driver Rating Form: Used by researcher to record overall driving behavior and the global driving form. (p 11) 3. Simulator Sickness Questionnaire (SSQ): Used to check for sickness in both simulator and on-road tests. (p12) 4. Driver Face Validity Questionnaire: Used to collect data for the face validity study. (pp13-15) 5. Self Awareness of Deficits Interview (SADI): Used for the self-awareness study. (pp 16-18) Appendix Page 1

2 Subject: Date: Data collector: DRIVE LOG Simulation run Instruct Subject: Please begin at speed of 45 mph, please maintain posted speed unless unsafe or your choice, and stay in the right lane, return to the right lane Instruction given yes no (Starting Point - Gas station on right) W NW FC A, R, U SS Right turn SI Execution GA P (45mph) [6200] 1. Left turn (did S let car pass B4 turn? yes no) Golden Valley Rd. SI Set-up (Barrels) Execution GA P (Road markings yellow lines no pass) [7900] 2. Right turn response to Right on red opportunity: TL at Noble SI Set-up Execution GA P (Speed 35mph) (Road narrows) [10400] 4 way SS straight Observe the people? Culver Rd. (Hot dog stand) TL straight 36 th Ave. (Car & truck) W NW FC A, R, U Appendix Page 2

3 (Stream of oncoming cars) Path Any lane deviation when attending to other cars? [13000] 4 way SS straight Hubbard Ave. balkack car approach) L Hill memory / manage speed (45 mph)? SP (apply brake?) (Stream of oncoming cars) ) Path Any lane deviation when attending to other cars? (Pedestrian crossing sign) ped and cross walk follow OB SP C (Lime green car pulls out) OB Path C [17000] 3. turn left West Broadway SI Set-up Execution Stream of oncoming cars GA P OB Path [19000] 4 way SS straight 41.5 Ave. (allow cross traffic first) nothing for awhile OB (evidence / impact of boredom? ) SP C [21800[ SL straight 42nd Ave. (2 gas stations) Road widens (Move to right lane) OB SP C Memory of instruction to stay right (Speed posted 45mph) Appendix Page 3

4 TL straight Douglas Dr. (Green) W NW FC A, R, U TL straight 55 th Ave. (Green) [25,000] (Car passes subject) PA C [26,000] (Management of curve to left (35 mph)) Path (45 mph) 4. TL turn Left Bass Lake Rd. SI Set-up Execution left) TL straight Jersey Ave. (factory bldgs) GA P (cars approach from left and right) [28600] SL straight St. Raphael s Long stretch of roadway evidence of boredom? PA [30,400]5. turn Left Winnetka SI Set-up Execution GA (wait for cars to pass first) 2 black cars P [31900] TL straight 49 th Ave. (green) [33,400] TL straight 47 th Ave. Appendix Page 4

5 (Green) (Response to car pass opportunity) OB SP Con G A Path W NW FC A, R, U [36000] TL straight 42nd Ave. (green) (speed limit 35) (response to car pass opportunity) OB SP Conf Gap Acceptance Path [38900] TL straight 36 th Ave. [40,000](Notice the speeder pulled over?) OB Long stretch of roadway evidence of boredom? PA [43000] TL straight 32nd Ave. (Green) X-roads) (Response to being passed by Jeep) [46000] (45mph) Curve to Right Straight-a-way 45 mph [48000] 6. turn Right Medicine Lake SI Set-up (red)execution (cars in X-roads) GA P [50400] TL straight (car from R) Boone Ave. Appendix Page 5

6 [52000] TL straight Hillsboro Ave. (yellow to red) Entering freeway: [53000] (narrows to 2 lanes) Path (35 mph) [54000] (25 mph) Manage curve SP OB police car PAth (road widens to 3 lanes) Memory (did S move to right lane) yes instruction repeated 1X other Enter highway and (speed increases to 65mph) [59,500] Opportunity to pass OB (car coming up from behind) GA Confidence Subject returns to right lane, behind white car? Memory to return to right other: GA Second opportunity to pass: passing car boxes you in OB GA (Speed 35) Manage curve to right OB Path Speed [65,000] Reduce speed to 45 (after curve) Response to situation (the 2 cars passed subject), one pulls in front of S at TL OB SP [69200] TL straight Boone Ave. (red light) (S behind maroon car) (opportunity to pass car in front) OB Appendix Page 6

7 SP GA (45 mph) [71300] SL straight St. Raphael s (green) [73,000] * (*DEMAND: jeep from L thru light) OB TL straight SP Jersey Ave. [74,400] (*ROAD NARROWS marked by sign) (** Give right turn instruction at appearance of road narrows sign) W NW FC A, R, U [75000] 8. SS Right turn West Broadway SI Set-up Execution GA P [72,200] Reduce to 35 mph LEFT CURVE Response to approaching/ passing car on curve OB SP Path Response to oncoming car passing a bus OB [77,000] SP Path Response to slower car in front: Recognition of no pass zone? [79000] SS straight OB SP Path [79,800] No PASS ZONE ENDS Did subject eventually Pass? OB SP Describe braking behavior: Path [81,000] (Vehicle spun out on left side of road) OB Appendix Page 7

8 [82,500] road widens [83,000] (Increase to 45 mph) [83,790] RESPONSE- lime green car pulls out OB Unexpected Safety Awareness SP Describe braking behavior: Path W NW FC A, R, U [86,400] 9. TL Left turn Golden Valley Rd SI Set-up Execution GA (stream of oncoming cars) P (45 mph) [87000] Go Straight past Barrels *CONFLICT [88,000] (Road narrows) OB Unexpected SP Describe steering/ braking behavior: Path (35 mph) (25 mph) (stream of oncoming traffic) Path Approaching village with pedestrians Sign warning of intersection [91000] 10. Right Turn Wait for pedestrian to cross? (2 way SS, THRU) SI Set-up Execution Safety Awareness GA (Response to peds) P (Stream of cars) [91,200] (Increase to 45 mph) [92,200] Appendix Page 8

9 (Road widens to 4 lane) OB Path Memory (stay right) (Stream of traffic) Path [95,000] (Black car passes subject from behind) PA C [98,000] INSTRUCT: to pull into gas station as if to park by pump, but continue forward motion until computer stops CONFLICT- must allow car to pass, move safely into left lane and execute left turn) OB SP Describe braking behavior: GA Awareness of traffic cond. Path Subject pulls up to gas pump PA C Memory of instruction [99000] END General observations: Terms Defined (A) overall Awareness of traffic conditions in that event (U) Subject response to the Unexpected (Observe it, Speed change, Path, Safety awareness) (C) Confidence Did the driver approach the turn in an overall confident and safe manner? (D) Distractibility (FC) Following Car (I) Impulsivity (PJ) Poor Judgment (SA) Safety Awareness Demonstrated observations: (GA) Gap Acceptance Did the driver, in merging into traffic, accept a gap of a safe size, as opposed to accepting a gap too short? (LL) Limit Line Did the driver position himself (herself) correctly at a stop sign, yield sign, or traffic signal? (OB) Observation Did the driver make the necessary observations (directly or via a mirror) at a stop or yield sign, prior to a requested change of lanes, on turns, and at major railroad crossings? (P) Path Did the driver stay within his/her lane without unsafe deviations from the intended directions? (R) Repeated Instructions repeated (SI) Signal Indicator Did the driver appropriately use proper signals to inform other drivers of intention to turn? (SP) Speed Did the driver stay within +/- 5 mph of the speed limit? Did the driver maintain a smooth speed profile in turns and during acceleration? Environment Abbreviations: Appendix Page 9

10 (SL) Stop Light (SS) Stop Sign Overall Performance Observed by Evaluator as: (W) Well Executed (NW) Not Well Executed General evaluators observations and impressions of Attitude as in: Problem? Comments: Awareness of traffic conditions Safety awareness Hostility Confusion Inattention to detail Difficulty following directions Poor judgment Inadequate problem solving Summary 3. Improvements for Phase II Appendix Page 10

11 DRIVER RATING FORM Subject Number: Date: Type of test: On-Road Simulator Overall Comments/observations: Driving Behavior Ratings: COGNITIVE Vigilance (scanning/blindspot checks of pedestrians, traffic) Use of turn signals Modifies speed appropriately for other traffic (yields right of way, following distance) Modifies speed appropriately for road postings/signals (yellow lights, signs) Modifies speed appropriately for commanded actions (merges, turns, hill) Decision/Judgement (gap for turn; gap for merge) Observes posted laws (speed limit) Observes non-posted laws/rules (stays right, right on red?) MOTOR Lane positioning (straight) Path on curves Brake control Speed limit OK Marginal Unacceptable Comments OK Marginal Unacceptable Comments GLOBAL DRIVING SCORE How well did the patient do during the drive? (Circle 1) Unsafe Safe to drive to drive Appendix Page 11

12 Simulator Sickness Questionnaire (SSQ) Instructions: Circle the items that apply to you at this time SYMPTOM RATING General Discomfort None Slight Moderate Severe Fatigue None Slight Moderate Severe Headache None Slight Moderate Severe Eye Strain None Slight Moderate Severe Difficulty Focusing None Slight Moderate Severe Increased Salivation None Slight Moderate Severe Sweating None Slight Moderate Severe Nausea None Slight Moderate Severe Difficulty Concentrating None Slight Moderate Severe Fullness of the Head None Slight Moderate Severe Blurred Vision None Slight Moderate Severe Dizzy (eyes open) None Slight Moderate Severe Dizzy (eyes closed) None Slight Moderate Severe Vertigo None Slight Moderate Severe Stomach Awareness None Slight Moderate Severe Burping None Slight Moderate Severe Other. (describe) ** Stomach Awareness is usually used to indicate a feeling of discomfort, which is just short of nausea. Appendix Page 12

13 DRIVER FACE VALIDITY QUESTIONNAIRE Subject number After on road / / After simulator / / VIEW 1 How well were you able to see the road and other cars during this drive? DRIVING SITUATIONS 2. How well did this drive show your ability to handle difficult driving situations? FATIGUE 3. How tiring was this drive compared to a typical one for the same amount of time? Was it: A lot more tiring than a typical drive A little more tiring than a typical drive The same as a typical drive A little less tiring than a typical drive A lot less tiring than a typical drive THROTTLE: 4. How was the feel of the accelerator? 5. How well did this drive show your ability to control a car s speed? Appendix Page 13

14 STEERING: 6. How was the feel of the steering wheel? 7. How well did this drive show your ability to control a car in a turn? BRAKE: 8. How was the feel of the brake? 9. How well did this drive show your ability to brake? TURN SIGNAL 10. How was the feel of the turn signal? 11. How well did this drive show your ability to signal your turns and lane changes? Appendix Page 14

15 GENERAL/OVERALL: 12. In general, how well did this drive show your ability to drive a car? 13. Do you think you made any mistakes or showed any bad driving habits during this drive? yes no What? Did you try to correct it? yes no How? Did your effort to correct it work? 14. Did you do anything during your drive that you think was dangerous or improper? yes no What? When did you realize that you d done that? Did you try to correct it? How? Did your effort to correct it work? Appendix Page 15

16 SELF AWARENESS OF DEFICITS INTERVIEW (SADI) SUBJECT NUMER: Tape number / / Before the first experience / / after the first experience / / Before the second experience / / after the second experience Section I: Self-awareness of deficits 1) Are you any different now, compared to what you were like before your accident? 2) FOLLOWING INITIAL RESPONSE, In what way? 3) Then, well, how about in terms of your memory a) avoid leading - Is your memory bad b) avoid pointed - c) avoid directive How about that time you were unable to concentrate? 4) Clarify SLOW a) And in what other ways are you slow. Avoid leading b) 1. Do you feel that anything about you, or your abilities has changed? How about in terms of your Memory/confusion? Concentration? Problem-solving, decision making, organizing and planning things? Controlling behavior? Communication? Getting along with other people? Personality? Physical abilities (e.g. movement of arms, legs, balance, vision, endurance?) 2. For further clarification, clarify with Do people who know you well notice that anything is different about you since the accident? 3. What might they notice? Physical abilities (e.g. movement of arms, legs, balance, vision, endurance?) Memory/confusion? Concentration? Problem-solving, decision making, organizing and planning things? Controlling behavior? Communication? Getting along with other people? Personality? 4. Lastly, for further clarification, go into problems: Appendix Page 16

17 5. What do you see as your problems, if any, resulting from your injury? What is the main thing you would like to get better? Physical abilities (e.g. movement of arms, legs, balance, vision, endurance?) Memory/confusion? Concentration? Problem-solving, decision making, organizing and planning things? Controlling behavior? Communication? Getting along with other people? Personality? Section II: Self-awareness of functional implications of deficits 1) Does your cognitive impairment have any affect on your functional abilities a) In what way? 2) Are you driving now? 3) Does your head injury or Stroke affect your ability to drive? In what way? a) (use their reports how do you think your difficulty controlling you temper might impact your driving) b) How would your memory, your confusion affect your driving? c) What do you think is getting in the way of your resuming driving 4) (POINT get to the reason, others or self) and the MAGNITUDE of the impact the problem / issue may have on driving 5) How much of a problem would you have driving a car, if you had to? Chose one: (a) Can't do, (b) Very difficult to do, (c) Can do with some difficulty, (d) Fairly easy to do, (e) Can do with ease. Section III: Ability to set realistic goals 1) What do you hope to achieve in the next 6 months? What are some of your goals? a) OR - In 6 months, what do you think you will be doing? Where do you think you will be? b) What do you think driving has to do with these goals? c) 2) Do you think your head injury will still be having an affect on your life in 6 months? a) If yes, how? b) If no, are you sure? Appendix Page 17

18 Scoring Section 1 0 Cognitive/psychological problems (where relevant) reported by the patient/client in response to general questioning, or readily acknowledged in response to specific questioning. 1 Some cognitive/psychological problems reported, but other denied or minimized. Patient/client may have a tendency to focus on relatively minor physical changes (e.g., scares), and acknowledge cognitive/psychological problems only on specific questioning about deficits. 2 Physical deficits only acknowledged; denies, minimizes, or is unsure of cognitive/psychological changes. Patient/client may recognize problems that occurred at an earlier stage but denies existence of persisting deficits, or may state that other people thing there are deficits, but s/he does not think so. 3 No acknowledgement of deficits (other than obvious physical deficits) can be obtained, or patient will only acknowledge problems that have been imposed on him/her (e.g., not allowed to drive, not allowed to drink alcohol). Section II 0 Patient accurately describes current functional DRIVING and specifies how his/her head injury problems limit DRIVING. 1 Some functional implications reported following questions or examples of problems in DRIVING. Patient may not be sure of other likely DRIVING problems, e.g., is unable to say because she has not tried an activity yet. 2 Patient may acknowledge some functional implications of deficits but minimizes the importance of identified problems. Other likely functional implications may be actively denied by the patient. 3 Little acknowledgement of functional consequences can be obtained; the patient will not acknowledge problems: except that s/he is not allowed to perform certain tasks. S/he may actively ignore medical advice and may engage in risk-taking behaviors (e.g., drinking, driving). Section III 0 Patient sets reasonably realistic goals and (where relevant) identifies that the head injury will probably continue to have an impact on some areas of functioning. 1 Patient sets goals which are somewhat unrealistic, or is unable to specify a goal, but recognizes that s/he may still have problems in some areas of function in the future, i.e. sees that goals for the future may need some modification, even if s/he as not yet done so. 2 Patient sets unrealistic goals, or is unable to specify a goal, and does not know how s/he will be functioning in 6 months time, but hopes s/he will return to pretrauma, i.e. no modification of goals has occurred. 3 Patient expects without uncertainty that in 6 months s/he will be functioning at pre-trauma level (or at a higher level). Appendix Page 18