Occupational Therapy In Health Care, 28(2):169–175, 2014 C 2014 by Informa Healthcare USA, Inc. Available online at http://informahealthcare.com/othc DOI: 10.3109/07380577.2014.904536
ARTICLE
Consensus Statements on Occupational Therapy Education and Professional Development Related to Driving and Community Mobility Wendy B. Stav Department of Occupational Therapy, Nova Southeastern University, Ft. Lauderdale, FL, USA
ABSTRACT. Professional and postprofessional education for occupational therapy practitioners in the area of driving and community mobility has been inconsistent and not sufficient to meet the growing community mobility needs of the aging population. This article reviews the current expectations of entry-level occupational therapy education, the postprofessional credentialing opportunities, and the professional development path for occupational therapy practitioners. Finally, consensus statements are presented to move both entry-level and professional education forward in the area of driving and community mobility. KEYWORDS.
Community mobility, Driving, Education, Professional development
Occupational therapy practice in the area of driving and community mobility has been identified as a unique specialty area for over a decade since it was identified as one of the top 10 emerging practice areas (Johansson, 2000). Since 2002 when the Older Driver Initiative was initiated, the American Occupational Therapy Association (AOTA) has invested a considerable amount of resources and attention to the practice area through the formalization of an Older Driver Initiative, two systematic reviews of the evidence (Arbesman et al., in press; Stav et al., 2008) and subsequent practice guidelines (Stav, in press; Stav et al., 2006), creation of official documents including a Statement (AOTA, 2005, 2010b), and several fact sheets including one defining the role of occupational therapy in the practice area (AOTA, 2012). Driving and community mobility practice has received priority attention apart from general occupational therapy practice and from other specialty practice areas from AOTA for several reasons. Older driver safety was initially identified as a public health issue in the 1990s due to the aging of the population in the United States combined with disproportionately high automobile crash and fatality rates Address correspondence to: Wendy Stav, Department of Occupational Therapy, Nova Southeastern University, 3200 S. University Drive, Ft. Lauderdale, FL 33328, USA (E-mail: [email protected]). (Received 6 February 2014; accepted 11 March 2014)
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among mature drivers. Consequently, the public health issue sparked the attention of several Federal agencies which offered grant funding for research and programming specific to older drivers. During the time of growing attention to older driver issues, researchers were finding negatives effects of driving cessation including increased depressive symptoms (Marottoli et al., 1997). Through an occupational therapy lens, the older driver safety issue and implications of driving cessation took on an occupational perspective. It became clear that while driving and community mobility existed as an instrumental activity of daily living as defined in the Occupational Therapy Practice Framework 2nd ed. (AOTA, 2008), it also served as a conduit for engagement in many other community-based occupations such as shopping, health management, social participation, education, work, and leisure. As such, driving and community mobility became more than just an instrumental activity of daily living; it became recognized as an occupation enabler (Stav & Lieberman, 2008). Given the involvement of driving and community mobility in so many other areas of occupational engagement, the priority attention from AOTA was warranted. The additional attention to driving and community mobility from AOTA has resulted in the development of public and professional awareness materials and focused scholarly investigations about the practice area. The emphasis of the published research has been specific to assessment of driving performance, driving intervention approaches, and community mobility beyond driving. However, there is a paucity of literature on occupational therapy education specific to practice in this area which needs to be addressed. EDUCATION REQUIREMENTS Individuals embarking on a career in occupational therapy must earn the appropriate academic degree at an educational institution through a curriculum accredited by the Accreditation Council on Occupational Therapy Education (ACOTE). In an effort to ensure each academic program offers a curriculum satisfying a minimum standard, ACOTE outlines educational standards required for inclusion in all entry level curricula. Since the ACOTE educational standards are grounded in the Occupational Therapy Practice Framework (2nd ed.) (AOTA, 2008), the standards are inclusive of content related to driving and community mobility as an instrumental activity of daily living. Specifically, academic curricula are required to address community mobility which is defined as, “moving around in the community and using public or private transportation, such as driving, walking, bicycling, or accessing and riding in buses, taxi cabs, or other transportation systems” (AOTA, 2008, p. 631). Engaging in driving and community mobility is inherently complex due to the required simultaneous use of several performance skills to meets multiple activity demands within dynamic and unpredictable contexts. Therefore, content related to driving and community mobility should be intentionally coordinated and delivered. The standards are slightly different depending on the level of education (e.g., associates, masters, or doctoral education) but represent the same skill areas, including several items either directly or indirectly related to practice in the area of driving and community mobility. For the purposes of this article, master’s level educational standards are identified as they represent the median academic
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TABLE 1. ACOTE Educational Standards Related to Driving and Community Mobility Standard A.6.1.
B.5.5. B.5.13.
B.5.17.
Accreditation Standards for a Master’s Level Educational Program for Occupational Therapist The curriculum must include preparation for practice as a generalist with a broad exposure to current practice settings (e.g., school, hospital, community, long-term care) and emerging practice areas (as defined by the program). The curriculum must prepare students to work with a variety of populations including, but not limited to, children, adolescents, adults, and elderly persons in areas of physical and mental health. Provide training in self-care, self-management, health management and maintenance, home management, and community and work integration. Provide recommendations and training in techniques to enhance community mobility, including public transportation, community access, and issues related to driver rehabilitation. Develop and promote the use of appropriate home and community programming to support performance in the client’s natural environment and participation in all contexts relevant to the client.
Note: Select educational standards (Accreditation Council for Occupational Therapy Education, 2011).
requirements of all accredited curricula. The ACOTE standards listed in Table 1 are the best examples where relevance and applicability to driving rehabilitation and community mobility practice are required in occupational therapy curricula. While there are ample opportunities to infuse content related to driving and community mobility into occupational therapy curricula through these and other educational standards, the extent to which this content is included in curricula is at the discretion of the individual curriculum or faculty member. As a result, there is a high level of variability in the driving and community mobility content, quantity, and depth of focus across programs. Yuen and Burik (2011) confirm the presence of this variability through their exploration of content on driving in occupational therapy curricula. Of the 90 respondent professional entry-level programs, nine required a course specific to driving, 80 including driving content in required courses, and 16 offered an elective course related to driving (Yuen & Burik, 2011). The respondents also shared the variety of ways in which the content is taught ranging from lectures, laboratory experiences, field trips, and level I fieldwork experiences. The results of this study are promising in that it suggests a growing attention to driving in entry-level curricula, but concerns still exist due to the inconsistency of content, depth, and quality across programs as well as the unknown attention to driving in the 54 nonresponding programs. PROFESSIONAL DEVELOPMENT As a highly valued instrumental activity of daily living, all occupational therapy practitioners should address driving and community mobility. In fact, recent work has shown that with continuing education for occupational therapists in general practice will increase the competence and confidence of therapists working with their clients to meet their driving and community needs (Dickerson, Chew, Schold Davis, & Touchinsky, 2013). However, if an occupational therapist wishes to specialize in the area of driving and community mobility or driver rehabilitation, he or she must engage in specialized professional development since the practice area is considered to require skills beyond entry-level education. AOTA specifically
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Stav
“asserts that occupational therapists and occupational therapy assistants require advanced education prior to working directly in specialized driving rehabilitation services” (2010b, p. S113). The requirement for additional education and advanced training for driving practice is not unusual. In Australia, driving rehabilitation is considered an elite practice area and therapists must become certified through completion of an intensive didactic and practical course including assignments, examinations, and competency checks equivalent to a four-credit graduate course in the United States (University of Sydney, 2014). In the United States, there is no required educational curriculum for practitioners, but there are credentialing options which require experience for eligibility and continued professional development to retain the credential. The first credential developed was the certified driver rehabilitation specialist (CDRS) awarded by the Association of Driver Rehabilitation Specialists (ADED). The organization defines a driver rehabilitation specialist as one who “‘plans, develops, coordinates and implements driver rehabilitation services for individuals with disabilities” (ADED, 2014, para. 1). The CDRS credential was initiated in 1995 and developed to protect the public by ensuring current knowledge and professional development among certificants (ADED, 2014). Both occupational therapists and occupational therapy assistants are eligible for this exam-based credential which requires a formal health or traffic related education and/or experience working in the field of driver rehabilitation (ADED, 2014). The second credential in the practice area was created by the AOTA. This portfolio-based certification is based on practice criteria and grounded in the Occupational Therapy Practice Framework (OTPF, 2nd edition) (2008) as well as the Standards for Continuing Competence (AOTA, 2010a). The certification encompasses the entire scope of community mobility defined in the OTPF and therefore is appropriate for practitioners working in the area of driving or specifically focused on community mobility such as transit, pedestrian, or bicycle travel. There are two levels of credential for occupational therapy practitioners, the Specialty Certification in Driving and Community Mobility (SCDCM) for occupational therapists and the Specialty Certified Assistant in Driving and Community Mobility (SCADCM) for occupational therapy assistants. The final credentialing option is the certified driving instructor (CDI) which is awarded by different state agencies depending on the state but oftentimes the Department of Transportation, Department of Motor Vehicles, or the Department of Highway Safety. The process and requirement for this credential varies significantly from state to state. The criteria for earning the credential ranges from completion of a weekend course through graduate coursework. While most states do not require either of the previously mentioned credentials, many states do require certification as a driving instructor to ensure safety of the public on the roadways. As with all professional development, there are stages when entering a new or specialty practice area such as driving and community mobility. Alsop (2013) presents the stages of professional development as starting at the novice level and progressing through advanced beginner, competent, proficient, and finally culminating at expert. Occupational therapy practice is likely to be executed differently across the stages of professional development, particularly in a complex practice area such as driving and community mobility. Table 2 illustrates an examples of
173
• Capable of administering driving-related assessments and executing intervention plans according to guidelines, but are not yet able to interpret performance • Very objective in practice
Stage 1 Novice
• Views driving performance “in a vacuum,” but may also consider the client’s home driving environments and implications of the population density • May recognize unsafe driving behavior but not be able to identify the cause of the difficulty
Stage 2 Advanced Beginner
Stage 5 Expert • Intuition about services and client potential is based on thorough understanding of the situation and reflections of past experiences • Could work with almost any client and effectively manage the case because of the vast array of knowledge and experiences from which to draw.
Stage 4 Proficient • Able to recognize and manage unfamiliar diagnostic or contextual situations • Has a repertoire of vehicle adaptation options for clients but can also can think outside of the typical protocol if circumstances are not typical
Stage 3 Competent • Able to distinguish which facts are relevant to driving • Able to manage a larger, more complex client caseload while “feeling” a sense of mastery. • Can formulate hypotheses such as, providing travel training will likely result in independent transit use versus no intervention will require supported travel using paratransit.
TABLE 2. Examples of Driving and Community Mobility Practice at Stages of Professional Development
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how this progression might be described with driving and community mobility. Advancement through the stages of professional development is dependent on time, experience, and engagement in professional development activities to enhance one’s knowledge and skills.
SUMMARY AND CONSENSUS STATEMENTS The process of developing consensus statements involved a review of the professional resources, available evidence, professional education guidelines, and professional development options related to driving and community mobility practice. Due to the complexity and importance of driving and community mobility as both an occupation and occupation enabler for occupational therapy clients, practitioners at all levels of professional development (entry-level student through expert) should engage in education with intention and direction prior to practicing in the area. Within entry-level occupational therapy programs, the review of the materials revealed inconsistencies in content, quantity, depth, and experiences related to driving and community mobility across entry-level educational curricula. The following consensus statements were developed and affirmed based on clinical judgment by the Expert Panel (see Dickerson & Schold Davis, this issue).
• Driving rehabilitation is a multitiered complex practice area that requires advanced knowledge, skills and experience. • Scientific evidence should be prominent in the education and professional development of driving rehabilitation specialists while individuals with higher levels of scholarship expertise should generate evidence that is useful to practitioners for integration for practice. • The consensus statements will hopefully serve as a standard upon which to base both professional and postprofessional education in the area of driving and community mobility. Declaration of interest: The author reports no conflicts of interest related to this publication. The authors alone are responsible for the content and writing of the paper.
ABOUT THE AUTHOR Wendy Stav, Department of Occupational Therapy, Nova Southeastern University, 3200 S. University Drive, Ft. Lauderdale, FL 33328, USA. REFERENCES Alsop A. (2013). Continuing professional development in health and social care. West Sussex, UK: Wiley-Blackwell. American Occupational Therapy Association. (2005). Statement: Driving and community mobility. American Journal of Occupational Therapy, 59, 666–670. American Occupational Therapy Association. (2008). Occupational therapy practice framework: Domain and process, 2nd edition. American Journal of Occupational Therapy, 62(6), 625–683.
Education and Professional Development Related to Driving
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American Occupational Therapy Association. (2010a). Standards for continuing competence. American Journal of Occupational Therapy, 64, S103–S105. doi: doi:10.5014/ajot.2010.64S103 American Occupational Therapy Association. (2010b). Statement: Driving and community mobility. American Journal of Occupational Therapy, 64(6), S112–S124 doi: 10.5014/ajot.2010. 64S112 American Occupational Therapy Association. (2012). The occupational therapy role in driving and community mobility across the lifespan. Retrieved from http://www.aota.org/AboutOccupational-Therapy/Professionals/PA/Facts/Driving-Community-Mobility.aspx Arbesman M, Lieberman D, & Berlanstein DR. (in press). Method for the systematic reviews on occupational therapy and driving and community mobility for older adults. American Journal of Occupational Therapy. In press. Association for Driver Rehabilitation Specialists. (2014). Certification. Retrieved from http://www.driver-ed.org/i4a/pages/index.cfm?pageid=507 Dickerson AE, Chew F, Touchinsky S, & Schold Davis E. (November 21, 2013). Evidence for a Successful Focused Education Program to Meet the Needs of the Older Driver in Medical Settings. Paper presented at Gerontological Society of America Annual Conference, New Orleans, LA. Johansson C. (2000). Top 10 emerging practice areas to watch in the new millennium. OT Practice, 5, 7–8. Marottoli RA, Mendes de Leon CF, Glass TA, Williams CS, Jr. LMC, Berkman LF, & Tinetti ME. (1997). Driving cessation and increased depressive symptoms: Prospective evidence from the New Haven EPESE. Journal of the American Geriatrics Society, 45, 202–206. Stav WB. (in press). Driving and community mobility for older adults: Occupational therapy practice guidelines (2nd ed.). Bethesda, MD: American Occupational Therapy Association. Stav WB, Arbesman M, & Lieberman D. (2008). Background and methodology of the older driver evidence-based literature review. American Journal of Occupational Therapy, 62(2), 130–135. Stav WB, Hunt L, & Arbesman M. (2006). Driving and community mobility for older adults: Occupational therapy practice guidelines. Bethesda, MD: American Occupational Therapy Association. Stav WB, & Lieberman D. (2008). From the desk of the editor. American Journal of Occupational Therapy, 62(2), 127–129. University of Sydney. (2014). Driving assessment & training course for occupational therapists. Retrieved from http://cce.sydney.edu.au/course/DATO Yuen HK, & Burik JK. (2011). Brief Report—Survey of driving evaluation and rehabilitation curricula in occupational therapy programs. American Journal of Occupational Therapy, 65, 217–220. doi: 10.5014/ajot.2011.000810
Copyright of Occupational Therapy in Health Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
ARTICLE
Consensus Statements on Occupational Therapy Education and Professional Development Related to Driving and Community Mobility Wendy B. Stav Department of Occupational Therapy, Nova Southeastern University, Ft. Lauderdale, FL, USA
ABSTRACT. Professional and postprofessional education for occupational therapy practitioners in the area of driving and community mobility has been inconsistent and not sufficient to meet the growing community mobility needs of the aging population. This article reviews the current expectations of entry-level occupational therapy education, the postprofessional credentialing opportunities, and the professional development path for occupational therapy practitioners. Finally, consensus statements are presented to move both entry-level and professional education forward in the area of driving and community mobility. KEYWORDS.
Community mobility, Driving, Education, Professional development
Occupational therapy practice in the area of driving and community mobility has been identified as a unique specialty area for over a decade since it was identified as one of the top 10 emerging practice areas (Johansson, 2000). Since 2002 when the Older Driver Initiative was initiated, the American Occupational Therapy Association (AOTA) has invested a considerable amount of resources and attention to the practice area through the formalization of an Older Driver Initiative, two systematic reviews of the evidence (Arbesman et al., in press; Stav et al., 2008) and subsequent practice guidelines (Stav, in press; Stav et al., 2006), creation of official documents including a Statement (AOTA, 2005, 2010b), and several fact sheets including one defining the role of occupational therapy in the practice area (AOTA, 2012). Driving and community mobility practice has received priority attention apart from general occupational therapy practice and from other specialty practice areas from AOTA for several reasons. Older driver safety was initially identified as a public health issue in the 1990s due to the aging of the population in the United States combined with disproportionately high automobile crash and fatality rates Address correspondence to: Wendy Stav, Department of Occupational Therapy, Nova Southeastern University, 3200 S. University Drive, Ft. Lauderdale, FL 33328, USA (E-mail: [email protected]). (Received 6 February 2014; accepted 11 March 2014)
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among mature drivers. Consequently, the public health issue sparked the attention of several Federal agencies which offered grant funding for research and programming specific to older drivers. During the time of growing attention to older driver issues, researchers were finding negatives effects of driving cessation including increased depressive symptoms (Marottoli et al., 1997). Through an occupational therapy lens, the older driver safety issue and implications of driving cessation took on an occupational perspective. It became clear that while driving and community mobility existed as an instrumental activity of daily living as defined in the Occupational Therapy Practice Framework 2nd ed. (AOTA, 2008), it also served as a conduit for engagement in many other community-based occupations such as shopping, health management, social participation, education, work, and leisure. As such, driving and community mobility became more than just an instrumental activity of daily living; it became recognized as an occupation enabler (Stav & Lieberman, 2008). Given the involvement of driving and community mobility in so many other areas of occupational engagement, the priority attention from AOTA was warranted. The additional attention to driving and community mobility from AOTA has resulted in the development of public and professional awareness materials and focused scholarly investigations about the practice area. The emphasis of the published research has been specific to assessment of driving performance, driving intervention approaches, and community mobility beyond driving. However, there is a paucity of literature on occupational therapy education specific to practice in this area which needs to be addressed. EDUCATION REQUIREMENTS Individuals embarking on a career in occupational therapy must earn the appropriate academic degree at an educational institution through a curriculum accredited by the Accreditation Council on Occupational Therapy Education (ACOTE). In an effort to ensure each academic program offers a curriculum satisfying a minimum standard, ACOTE outlines educational standards required for inclusion in all entry level curricula. Since the ACOTE educational standards are grounded in the Occupational Therapy Practice Framework (2nd ed.) (AOTA, 2008), the standards are inclusive of content related to driving and community mobility as an instrumental activity of daily living. Specifically, academic curricula are required to address community mobility which is defined as, “moving around in the community and using public or private transportation, such as driving, walking, bicycling, or accessing and riding in buses, taxi cabs, or other transportation systems” (AOTA, 2008, p. 631). Engaging in driving and community mobility is inherently complex due to the required simultaneous use of several performance skills to meets multiple activity demands within dynamic and unpredictable contexts. Therefore, content related to driving and community mobility should be intentionally coordinated and delivered. The standards are slightly different depending on the level of education (e.g., associates, masters, or doctoral education) but represent the same skill areas, including several items either directly or indirectly related to practice in the area of driving and community mobility. For the purposes of this article, master’s level educational standards are identified as they represent the median academic
Education and Professional Development Related to Driving
171
TABLE 1. ACOTE Educational Standards Related to Driving and Community Mobility Standard A.6.1.
B.5.5. B.5.13.
B.5.17.
Accreditation Standards for a Master’s Level Educational Program for Occupational Therapist The curriculum must include preparation for practice as a generalist with a broad exposure to current practice settings (e.g., school, hospital, community, long-term care) and emerging practice areas (as defined by the program). The curriculum must prepare students to work with a variety of populations including, but not limited to, children, adolescents, adults, and elderly persons in areas of physical and mental health. Provide training in self-care, self-management, health management and maintenance, home management, and community and work integration. Provide recommendations and training in techniques to enhance community mobility, including public transportation, community access, and issues related to driver rehabilitation. Develop and promote the use of appropriate home and community programming to support performance in the client’s natural environment and participation in all contexts relevant to the client.
Note: Select educational standards (Accreditation Council for Occupational Therapy Education, 2011).
requirements of all accredited curricula. The ACOTE standards listed in Table 1 are the best examples where relevance and applicability to driving rehabilitation and community mobility practice are required in occupational therapy curricula. While there are ample opportunities to infuse content related to driving and community mobility into occupational therapy curricula through these and other educational standards, the extent to which this content is included in curricula is at the discretion of the individual curriculum or faculty member. As a result, there is a high level of variability in the driving and community mobility content, quantity, and depth of focus across programs. Yuen and Burik (2011) confirm the presence of this variability through their exploration of content on driving in occupational therapy curricula. Of the 90 respondent professional entry-level programs, nine required a course specific to driving, 80 including driving content in required courses, and 16 offered an elective course related to driving (Yuen & Burik, 2011). The respondents also shared the variety of ways in which the content is taught ranging from lectures, laboratory experiences, field trips, and level I fieldwork experiences. The results of this study are promising in that it suggests a growing attention to driving in entry-level curricula, but concerns still exist due to the inconsistency of content, depth, and quality across programs as well as the unknown attention to driving in the 54 nonresponding programs. PROFESSIONAL DEVELOPMENT As a highly valued instrumental activity of daily living, all occupational therapy practitioners should address driving and community mobility. In fact, recent work has shown that with continuing education for occupational therapists in general practice will increase the competence and confidence of therapists working with their clients to meet their driving and community needs (Dickerson, Chew, Schold Davis, & Touchinsky, 2013). However, if an occupational therapist wishes to specialize in the area of driving and community mobility or driver rehabilitation, he or she must engage in specialized professional development since the practice area is considered to require skills beyond entry-level education. AOTA specifically
172
Stav
“asserts that occupational therapists and occupational therapy assistants require advanced education prior to working directly in specialized driving rehabilitation services” (2010b, p. S113). The requirement for additional education and advanced training for driving practice is not unusual. In Australia, driving rehabilitation is considered an elite practice area and therapists must become certified through completion of an intensive didactic and practical course including assignments, examinations, and competency checks equivalent to a four-credit graduate course in the United States (University of Sydney, 2014). In the United States, there is no required educational curriculum for practitioners, but there are credentialing options which require experience for eligibility and continued professional development to retain the credential. The first credential developed was the certified driver rehabilitation specialist (CDRS) awarded by the Association of Driver Rehabilitation Specialists (ADED). The organization defines a driver rehabilitation specialist as one who “‘plans, develops, coordinates and implements driver rehabilitation services for individuals with disabilities” (ADED, 2014, para. 1). The CDRS credential was initiated in 1995 and developed to protect the public by ensuring current knowledge and professional development among certificants (ADED, 2014). Both occupational therapists and occupational therapy assistants are eligible for this exam-based credential which requires a formal health or traffic related education and/or experience working in the field of driver rehabilitation (ADED, 2014). The second credential in the practice area was created by the AOTA. This portfolio-based certification is based on practice criteria and grounded in the Occupational Therapy Practice Framework (OTPF, 2nd edition) (2008) as well as the Standards for Continuing Competence (AOTA, 2010a). The certification encompasses the entire scope of community mobility defined in the OTPF and therefore is appropriate for practitioners working in the area of driving or specifically focused on community mobility such as transit, pedestrian, or bicycle travel. There are two levels of credential for occupational therapy practitioners, the Specialty Certification in Driving and Community Mobility (SCDCM) for occupational therapists and the Specialty Certified Assistant in Driving and Community Mobility (SCADCM) for occupational therapy assistants. The final credentialing option is the certified driving instructor (CDI) which is awarded by different state agencies depending on the state but oftentimes the Department of Transportation, Department of Motor Vehicles, or the Department of Highway Safety. The process and requirement for this credential varies significantly from state to state. The criteria for earning the credential ranges from completion of a weekend course through graduate coursework. While most states do not require either of the previously mentioned credentials, many states do require certification as a driving instructor to ensure safety of the public on the roadways. As with all professional development, there are stages when entering a new or specialty practice area such as driving and community mobility. Alsop (2013) presents the stages of professional development as starting at the novice level and progressing through advanced beginner, competent, proficient, and finally culminating at expert. Occupational therapy practice is likely to be executed differently across the stages of professional development, particularly in a complex practice area such as driving and community mobility. Table 2 illustrates an examples of
173
• Capable of administering driving-related assessments and executing intervention plans according to guidelines, but are not yet able to interpret performance • Very objective in practice
Stage 1 Novice
• Views driving performance “in a vacuum,” but may also consider the client’s home driving environments and implications of the population density • May recognize unsafe driving behavior but not be able to identify the cause of the difficulty
Stage 2 Advanced Beginner
Stage 5 Expert • Intuition about services and client potential is based on thorough understanding of the situation and reflections of past experiences • Could work with almost any client and effectively manage the case because of the vast array of knowledge and experiences from which to draw.
Stage 4 Proficient • Able to recognize and manage unfamiliar diagnostic or contextual situations • Has a repertoire of vehicle adaptation options for clients but can also can think outside of the typical protocol if circumstances are not typical
Stage 3 Competent • Able to distinguish which facts are relevant to driving • Able to manage a larger, more complex client caseload while “feeling” a sense of mastery. • Can formulate hypotheses such as, providing travel training will likely result in independent transit use versus no intervention will require supported travel using paratransit.
TABLE 2. Examples of Driving and Community Mobility Practice at Stages of Professional Development
174
Stav
how this progression might be described with driving and community mobility. Advancement through the stages of professional development is dependent on time, experience, and engagement in professional development activities to enhance one’s knowledge and skills.
SUMMARY AND CONSENSUS STATEMENTS The process of developing consensus statements involved a review of the professional resources, available evidence, professional education guidelines, and professional development options related to driving and community mobility practice. Due to the complexity and importance of driving and community mobility as both an occupation and occupation enabler for occupational therapy clients, practitioners at all levels of professional development (entry-level student through expert) should engage in education with intention and direction prior to practicing in the area. Within entry-level occupational therapy programs, the review of the materials revealed inconsistencies in content, quantity, depth, and experiences related to driving and community mobility across entry-level educational curricula. The following consensus statements were developed and affirmed based on clinical judgment by the Expert Panel (see Dickerson & Schold Davis, this issue).
• Driving rehabilitation is a multitiered complex practice area that requires advanced knowledge, skills and experience. • Scientific evidence should be prominent in the education and professional development of driving rehabilitation specialists while individuals with higher levels of scholarship expertise should generate evidence that is useful to practitioners for integration for practice. • The consensus statements will hopefully serve as a standard upon which to base both professional and postprofessional education in the area of driving and community mobility. Declaration of interest: The author reports no conflicts of interest related to this publication. The authors alone are responsible for the content and writing of the paper.
ABOUT THE AUTHOR Wendy Stav, Department of Occupational Therapy, Nova Southeastern University, 3200 S. University Drive, Ft. Lauderdale, FL 33328, USA. REFERENCES Alsop A. (2013). Continuing professional development in health and social care. West Sussex, UK: Wiley-Blackwell. American Occupational Therapy Association. (2005). Statement: Driving and community mobility. American Journal of Occupational Therapy, 59, 666–670. American Occupational Therapy Association. (2008). Occupational therapy practice framework: Domain and process, 2nd edition. American Journal of Occupational Therapy, 62(6), 625–683.
Education and Professional Development Related to Driving
175
American Occupational Therapy Association. (2010a). Standards for continuing competence. American Journal of Occupational Therapy, 64, S103–S105. doi: doi:10.5014/ajot.2010.64S103 American Occupational Therapy Association. (2010b). Statement: Driving and community mobility. American Journal of Occupational Therapy, 64(6), S112–S124 doi: 10.5014/ajot.2010. 64S112 American Occupational Therapy Association. (2012). The occupational therapy role in driving and community mobility across the lifespan. Retrieved from http://www.aota.org/AboutOccupational-Therapy/Professionals/PA/Facts/Driving-Community-Mobility.aspx Arbesman M, Lieberman D, & Berlanstein DR. (in press). Method for the systematic reviews on occupational therapy and driving and community mobility for older adults. American Journal of Occupational Therapy. In press. Association for Driver Rehabilitation Specialists. (2014). Certification. Retrieved from http://www.driver-ed.org/i4a/pages/index.cfm?pageid=507 Dickerson AE, Chew F, Touchinsky S, & Schold Davis E. (November 21, 2013). Evidence for a Successful Focused Education Program to Meet the Needs of the Older Driver in Medical Settings. Paper presented at Gerontological Society of America Annual Conference, New Orleans, LA. Johansson C. (2000). Top 10 emerging practice areas to watch in the new millennium. OT Practice, 5, 7–8. Marottoli RA, Mendes de Leon CF, Glass TA, Williams CS, Jr. LMC, Berkman LF, & Tinetti ME. (1997). Driving cessation and increased depressive symptoms: Prospective evidence from the New Haven EPESE. Journal of the American Geriatrics Society, 45, 202–206. Stav WB. (in press). Driving and community mobility for older adults: Occupational therapy practice guidelines (2nd ed.). Bethesda, MD: American Occupational Therapy Association. Stav WB, Arbesman M, & Lieberman D. (2008). Background and methodology of the older driver evidence-based literature review. American Journal of Occupational Therapy, 62(2), 130–135. Stav WB, Hunt L, & Arbesman M. (2006). Driving and community mobility for older adults: Occupational therapy practice guidelines. Bethesda, MD: American Occupational Therapy Association. Stav WB, & Lieberman D. (2008). From the desk of the editor. American Journal of Occupational Therapy, 62(2), 127–129. University of Sydney. (2014). Driving assessment & training course for occupational therapists. Retrieved from http://cce.sydney.edu.au/course/DATO Yuen HK, & Burik JK. (2011). Brief Report—Survey of driving evaluation and rehabilitation curricula in occupational therapy programs. American Journal of Occupational Therapy, 65, 217–220. doi: 10.5014/ajot.2011.000810
Copyright of Occupational Therapy in Health Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
