ABSTRACT

The decision to return to driving is both complex and difficult. It is often made with clinician support, perhaps on the basis of results from standardized paper and pencil tests, and less frequently an assessment of on-road driving. However, the resources required and inherent reliability and validity challenges suggest that greater use of computerization and driving simulation may play a useful role in the assessment process. In this study, thirty-six age-matched healthy and post-stroke drivers completed standard psychometric assessments (including NART, MMSE, BADS, IADL), computer delivered cognitive assessments (including SART, N-Back, Simple Reaction Time), as well as simulated and on-road assessments of driving. While significantly different in terms of psychometric and computer-based assessments, the healthy and post-stroke drivers who completed the on-road test did not differ. In contrast, driving in the portable simulator showed impaired driving, on some but not all driving manoeuvres, for those who failed the on-road test or had voluntarily ceased to drive. These results are discussed in terms of the implications they have for the multi-faceted nature of driving as a skill, and the need to involve simulation when assessing fitness to drive.

摘要

重返驾驶的决定既复杂又困难。它通常是在临床医生的支持下进行的，可能是基于标准化纸笔测试的结果，而不是对道路驾驶的评估。然而，所需的资源和固有的可靠性和有效性挑战表明，更多地使用计算机化和驾驶模拟可能在评估过程中发挥有用的作用。在这项研究中，36 名年龄匹配的健康和中风后驾驶员完成了标准的心理测量评估（包括 NART、MMSE、BADS、IADL）、计算机交付的认知评估（包括 SART、N-Back、简单反应时间），以及作为模拟和道路驾驶评估。虽然在心理测量和基于计算机的评估方面存在显着差异，完成道路测试的健康和中风后驾驶员没有差异。相比之下，在便携式模拟器中驾驶显示，对于那些未通过道路测试或自愿停止驾驶的人，在一些但不是所有驾驶技巧上驾驶受损。这些结果是根据它们对作为一项技能的驾驶的多方面性质的影响以及在评估驾驶适应性时涉及模拟的必要性来讨论的。