title: Evaluating medically at-risk drivers: a survey of assessment practices in Canada.
abstract: BACKGROUND
  Assessing medical fitness to drive (FTD) can include both off- and on-road testing, although consistency of practice is unclear.
  
  
  OBJECTIVE
  To examine actual practices being used to assess FTD at driver assessment centres (DACs) across Canada.
  
  
  METHODS
  Surveys e-mailed to 90 DACs were returned by 47 assessors.
  
  
  RESULTS
  The majority of respondents (89%) were occupational therapists. Assessors reported doing an average of eight FTD assessments per month (range = I to 40) at an average cost of $366 (SD = $225; range = $40 to $985). Referrals came from physicians (96%), other health professionals (70%), and licensing authorities (66%). Clients with stroke, dementia, traumatic brain injury, mild cognitive impairment, and multiple sclerosis composed 62% of estimated caseloads. Assessments took 3 hr on average (range = 1.24 to 4.5 hr); 64% reported they always took clients on road regardless of clinic results.
  
  
  CONCLUSIONS
  Evidence-based guidelines for training and assessment are clearly needed given the inconsistency in practice.
authors.forename: Brenda H
authors.initials: BH
authors.lastname: Vrkljan
authors.forename: Anita M
authors.initials: AM
authors.lastname: Myers
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Crizzle
authors.forename: Robin A
authors.initials: RA
authors.lastname: Blanchard
authors.forename: Shawn C
authors.initials: SC
authors.lastname: Marshall
mesh_terms: D001259:Ataxia; D001333:Automobile Driver Examination; D001334:Automobile Driving; D002170:Canada; D006304:Health Status; D006801:Humans; D008603:Mental Health; D053580:Muscle Strength; D009788:Occupational Therapy / Q000379:methods*; D016059:Range of Motion, Articular; D012017:Referral and Consultation; D012307:Risk Factors; D014785:Vision, Ocular