The contribution of cognitive and psychomotor evaluation tools to the assessment of driving potential

Israeli law requires physicians to report to the authorities all patients, 16 years old and older, who suffer from medical conditions that could possibly impact their ability to drive safely in order not to endanger themselves or others. Despite this clearly defined ruling, in the year 2000 the Israel State Comptroller, reported that only 5% of the physicians reported patients whom they identified as suffering from a deterioration of skills that could result in dangerous and incompetent driving. A mere 1.5% of the total number of referrals to the Medical Institute for Traffic Safety were made by physicians and half of those who were referred were ultimately found to be incompetent for driving by the authorities. Due to the lax reporting, it is entirely probable that there are drivers suffering from medical conditions that could severely impair their ability to drive safely. Physicians, as a rule, must perform their duties confronted by an ethical dilemma. They have been trained to maintain the patient's independence and well-being and keep their medical history confidential. On the other hand, they also have an obligation to society. In addition, the physician may be uncertain how the patient's disability may affect his driving skills. The objective of this paper is to increase the physician's awareness of these issues and introduce evaluation tools for assessing driving competency. This would enhance the physician's professional ability to make decisions based on current valid and reliable practice. The occupational therapy departments of Israel's hospitals that specialize in driver rehabilitation utilize a variety of evaluation tools for assessing driving skills, which include the evaluation of motor, sensory, visual, cognitive and behavioral abilities. This paper focuses on cognitive and psychomotor tools that have been psychometrically tested and found to be reliable for assessing driving skills. They are currently in use in Israel's driving rehabilitation centers and abroad. All of the tools reviewed in this article have already appeared in peer-reviewed articles.