Nurses driving change to improve access to education and quality in lcinical teaching : A partnership between Australia and Viet Nam

In Viet Nam, standards of nursing care fail to meet international competency standards. This increases risks to patient safety (eg. hospital acquired infection), consequently the Ministry of Health identified the need to strengthen nurse education in Viet Nam. This paper presents experiences of a piloted clinical teaching model developed in Ha Noi, to strengthen nurse led institutional capacity for in-service education and clinical teaching. Historically 90% of nursing education was conducted by physicians and professional development in hospitals for nurses was limited. There was minimal communication between hospitals and nursing schools about expectations of students and assessment and quality of the learning experience. As a result when students came to the clinical sites, no-one understood how to plan their learning objectives and utilise teaching and learning approaches appropriate to their level. Therefore student learning outcomes were variable. They focussed on procedures and techniques and “learning how to do” rather than learning how to plan, implement and evaluate patient care. This project is part of a multi-component capacity building program designed to improve nurse education in Viet Nam. The project was funded jointly by Queensland University of Technology (QUT) and the Australian Agency for International Development. Its aim was to develop a collaborative clinically-based model of teaching to create an environment that encourages evidence-based, student-centred clinical learning. Accordingly, strategies introduced promoted clinical teaching of competency based nursing practice utilising the regionally endorsed nurse core competency standards. Thirty nurse teachers from Viet Duc University Hospital and Hanoi Medical College participated in the program. These nurses and nurse teachers undertook face to face education in three workshops, and completed three assessment items. Assessment was applied, where participants integrated the concepts learned in each workshop and completed assessment tasks related to planning, implementing and evaluating teaching in the clinical area. Twenty of these participants were then selected to undertake a two week study tour in Brisbane, Australia where the clinical teaching model was refined and an action plan developed to integrate into both organisations with possible implementation across Viet Nam. Participants on this study tour also experienced clinical teaching and learning at QUT by attending classes held at the university, and were able to visit selected hospitals to experience clinical teaching in these settings as well. Effectiveness of the project was measured throughout the implementation phase and in follow up visits to the clinical site. To date changes have been noted on an individual and organisational level. There is also significant planning underway to incorporate the clinical teaching model developed across the organisation and how this may be implemented in other regions. Two participants have also been involved in disseminating aspects of this approach to clinical teaching in Ho Chi Minh, with further plans for more in-depth dissemination to occur throughout the country.

Chronological age and age-related cognitive deficits are associated with an increase in multiple types of driving errors in late life

Objective: Older driver research has mostly focused on identifying that small proportion of older drivers who are unsafe. Little is known about how normal cognitive changes in aging affect driving in the wider population of adults who drive regularly. We evaluated the association of cognitive function and age, with driving errors. Method: A sample of 266 drivers aged 70 to 88 years were assessed on abilities that decline in normal aging (visual attention, processing speed, inhibition, reaction time, task switching) and the UFOV® which is a validated screening instrument for older drivers. Participants completed an on-road driving test. Generalized linear models were used to estimate the associations of cognitive factor with specific driving errors and number of errors in self-directed and instructor navigated conditions. Results: All errors types increased with chronological age. Reaction time was not associated with driving errors in multivariate analyses. A cognitive factor measuring Speeded Selective Attention and Switching was uniquely associated with the most errors types. The UFOV predicted blindspot errors and errors on dual carriageways. After adjusting for age, education and gender the cognitive factors explained 7% of variance in the total number of errors in the instructor navigated condition and 4% of variance in the self-navigated condition. Conclusion: We conclude that among older drivers errors increase with age and are associated with speeded selective attention particularly when that requires attending to the stimuli in the periphery of the visual field, task switching, errors inhibiting responses and visual discrimination. These abilities should be the target of cognitive training.

Driving speed is altered by monocular Neutral Density filters : the Enright phenomenon

Introduction: An observer, looking sideways from a moving vehicle, while wearing a neutral density filter over one eye, can have a distorted perception of speed, known as the Enright phenomenon. The purpose of this study was to determine how the Enright phenomenon influences driving behaviour. Methods: A geometric model of the Enright phenomenon was developed. Ten young, visually normal, participants (mean age = 25.4 years) were tested on a straight section of a closed driving circuit and instructed to look out of the right side of the vehicle and drive at either 40 Km/h or 60 Km/h under the following binocular viewing conditions: with a 0.9 ND filter over the left eye (leading eye); 0.9 ND filter over the right eye (trailing eye); 0.9 ND filters over both eyes, and with no filters over either eye. The order of filter conditions was randomised and the speed driven recorded for each condition. Results: Speed judgments did not differ significantly between the two baseline conditions (no filters and both eyes filtered) for either speed tested. For the baseline conditions, when subjects were asked to drive at 60 Km/h they matched this speed well (61 ± 10.2 Km/h) but drove significantly faster than requested (51.6 ± 9.4 Km/h) when asked to drive at 40 Km/h. Subjects significantly exceeded baseline speeds by 8.7± 5.0 Km/h, when the trailing eye was filtered and travelled slower than baseline speeds by 3.7± 4.6 Km/h when the leading eye was filtered. Conclusions: This is the first quantitative study demonstrating how the Enright effect can influence perceptions of driving speed, and demonstrates that monocular filtering of an eye can significantly impact driving speeds, albeit to a lesser extent than predicted by geometric models of the phenomenon.

The role of cognitive and visual abilities as predictors in the Multifactorial Model of Driving Safety

Objective The current study evaluated part of the Multifactorial Model of Driving Safety to elucidate the relative importance of cognitive function and a limited range of standard measures of visual function in relation to the Capacity to Drive Safely. Capacity to Drive Safely was operationalized using three validated screening measures for older drivers. These included an adaptation of the well validated Useful Field of View (UFOV) and two newer measures, namely a Hazard Perception Test (HPT), and a Hazard Change Detection Task (HCDT). Method Community dwelling drivers (n = 297) aged 65–96 were assessed using a battery of measures of cognitive and visual function. Results Factor analysis of these predictor variables yielded factors including Executive/Speed, Vision (measured by visual acuity and contrast sensitivity), Spatial, Visual Closure, and Working Memory. Cognitive and Vision factors explained 83–95% of age-related variance in the Capacity to Drive Safely. Spatial and Working Memory were associated with UFOV, HPT and HCDT, Executive/Speed was associated with UFOV and HCDT and Vision was associated with HPT. Conclusion The Capacity to Drive Safely declines with chronological age, and this decline is associated with age-related declines in several higher order cognitive abilities involving manipulation and storage of visuospatial information under speeded conditions. There are also age-independent effects of cognitive function and vision that determine driving safety.

Volatile properties of particles emitted by compressed natural gas and diesel buses during steady state and transient driving modes

Volatile properties of particle emissions from four compressed natural gas (CNG) and four diesel buses were investigated under steady state and transient driving modes on a chassis dynamometer. The exhaust was diluted utilising a full-flow continuous volume sampling system and passed through a thermodenuder at controlled temperature. Particle number concentration and size distribution were measured with a condensation particle counter and a scanning mobility particle sizer, respectively. We show that, while almost all the particles emitted by the CNG buses were in the nanoparticle size range, at least 85% and 98% were removed at 100ºC and 250ºC, respectively. Closer analysis of the volatility of particles emitted during transient cycles showed that volatilisation began at around 40°C with the majority occurring by 80°C. Particles produced during hard acceleration from rest exhibited lower volatility than that produced during other times of the cycle. Based on our results and the observation of ash deposits on the walls of the tailpipes, we suggest that these non-volatile particles were composed mostly of ash from lubricating oil. Heating the diesel bus emissions to 100ºC removed ultrafine particle numbers by 69% to 82% when a nucleation mode was present and just 18% when it was not.

Occupational driver safety : conceptualising a leadership-based intervention to improve safe driving performance

Occupational driving crashes are the most common cause of death and injury in the workplace. The physical and psychological outcomes following injury are also very costly to organizations. Thus, safe driving poses a managerial challenge. Some research has attempted to address this issue through modifying discrete and often simple target behaviors (e.g., driver training programs). However, current intervention approaches in the occupational driving field generally do not consider the role of organizational factors in workplace safety. This study adopts the A-B-C framework to identify the contingencies associated with an effective exchange of safety information within the occupational driving context. Utilizing a sample of occupational drivers and their supervisors, this multi-level study examines the contingencies associated with the exchange of safety information within the supervisor-driver relationship. Safety values are identified as an antecedent of the safety information exchange, and the quality of the leader-member exchange relationship and safe driving performance is identified as the behavioral consequences. We also examine the function of role overload as a factor influencing the relationship between safety values and the safety information exchange. Hierarchical Linear Modelling found that role overload moderated the relationship between supervisors’ perceptions of the value given to safety and the safety information exchange. A significant relationship was also found between the safety information exchange and the subsequent quality of the leader-member exchange relationship. Finally, the quality of the leader-member exchange relationship was found to be significantly associated with safe driving performance. Theoretical and practical implications of these results are discussed.

Young and unlicensed : risky driving before entering the licensing system

Objective: On-road driving before gaining a valid licence (pre-Licence driving) represents a risk for all road users. Pre-Licence driving among young people who obtained a Provisional licence within an enhanced graduated driver licensing program in Queensland, Australia, was investigated. Methods: Recently-licensed drivers (n = 1032) aged 17-19 years (M = 17.54) completed a survey exploring their driving experiences while on their Learners licence. Six months later, 355 of these drivers completed the same survey exploring their experiences on their Provisional (intermediate) licence. Results: Twelve percent of participants reported pre-Licence driving. Pre-Licence drivers reported significantly more risky driving as Learners and Provisional drivers. Conclusions: Pre-Licence drivers not only place themselves and other road users at risk at the time but also continue to do so through their subsequent risky driving. Pre-licence driving should be discouraged, and parents should be encouraged to monitor car use and the driving behaviour of their children.

In search of the antecendents for risky driving at railway level crossings

This paper discusses human factors issues of low cost railway level crossings in Australia. Several issues are discussed in this paper including safety at passive level railway crossings, human factors considerations associated with unavailability of a warning device, and a conceptual model for how safety could be compromised at railway level crossings following prolonged or frequent unavailability. The research plans to quantify safety risk to motorists at level crossings using a Human Reliability Assessment (HRA) method, supported by data collected using an advanced driving simulator. This method aims to identify human error within tasks and task units identified as part of the task analysis process. It is anticipated that by modelling driver behaviour the current study will be able to quantify meaningful task variability including temporal parameters, between participants and within participants. The process of complex tasks such as driving through a level crossing is fundamentally context-bound. Therefore this study also aims to quantify those performance-shaping factors that contribute to vehicle train collisions by highlighting changes in the task units and driver physiology. Finally we will also consider a number of variables germane to ensuring external validity of our results. Without this inclusion, such an analysis could seriously underestimate the probabilistic risk assessment.

Music selection using a touch screen interface : effect of auditory and visual feedback on driving and usability

This study aimed to examine the effects on driving, usability and subjective workload of performing music selection tasks using a touch screen interface. Additionally, to explore whether the provision of visual and/or auditory feedback offers any performance and usability benefits. Thirty participants performed music selection tasks with a touch screen interface while driving. The interface provided four forms of feedback: no feedback, auditory feedback, visual feedback, and a combination of auditory and visual feedback. Performance on the music selection tasks significantly increased subjective workload and degraded performance on a range of driving measures including lane keeping variation and number of lane excursions. The provision of any form of feedback on the touch screen interface did not significantly affect driving performance, usability or subjective workload, but was preferred by users over no feedback. Overall, the results suggest that touch screens may not be a suitable input device for navigating scrollable lists.

Driving for work : a series of organisational audit results

Previous research has indicated that road crashes are the most common form of work related fatalities (Haworth et al., 2000). Historically, industry has often taken a “silver bullet” approach developing and implementing a single countermeasure to address all their work related road safety issues, despite legislative requirements to discharge obligations through minimising risk and enhancing safety. This paper describes the results and implications from a series of work related road safety audits that were undertaken across five organisations to determine deficiencies in each organisation‟s safe driving management and practice. Researchers conducted a series of structured interviews, reviewed documentation relating to work related driving, and analysed vehicle related crash and incident records to determine each organisation‟s current situation in the management of work related road safety and driver behaviour. A number of consistent themes and issues across each organisation were identified relating to managing driver behaviour, organisational policies, incident recording and reporting, communication and education, and formalisation of key work related road safety strategies. Although organisations are required to undertake risk reduction strategies for all work related driving, the results of the research suggest that many organisations fail to systematically manage driver behaviour and mitigate work related road safety risk. Future improvements in work related road safety will require organisations to firstly acknowledge the high risk associated with drivers driving for work and secondly adopt comprehensive risk mitigation strategies in a similar manner to managing other workplace hazards.

Driving Ge island ordering on nanostructured Si surfaces

Semiconductor epitaxial nanostructures have been recently proposed as the key building blocks of many innovative applications in materials science and technology. To bring their tremendous potential to fruition, a fine control of nanostructure size and placement is necessary. We present a detailed investigation of the self-ordering process in the prototype case of Ge/Si heteroepitaxy. Starting from a bottom-up strategy (step-bunching instabilities), our analysis moves to lithographic techniques (scanning tunneling lithography, nanomechanical stamping, focused ion beam patterning) with the aim of developing a hybrid approach in which the exogenous intervention is specifically designed to suit and harness the natural self-organization dynamics of the system.

Reducing aggression on our roads : testing a comprehensive model of aggressive driving

Background: Trauma resulting from traffic crashes poses a significant problem in highly motorised countries. Over a million people worldwide are killed annually and 50 million are critically injured as a result of traffic collisions. In Australia, road crashes cost an average of $17 billion annually in personal loss of income and quality of life, organisational losses in productivity and workplace quality, and health care costs. Driver aggression has been identified as a key factor contributing to crashes, and many motorists report experiencing mild forms of aggression (e.g., rude gestures, horn honking). However despite this concern, driver aggression has received relatively little attention in empirical research, and existing research has been hampered by a number of methodological and conceptual shortcomings. Specifically, there has been substantial disagreement regarding what constitutes aggressive driving and a failure to examine both the situational factors and the emotional and cognitive processes underlying driver aggression. To enhance current understanding of aggressive driving, a model of driver aggression that highlights the cognitive and emotional processes at play in aggressive driving incidents is proposed. Aims: The research aims to improve current understanding of the complex nature of driver aggression by testing and refining a model of aggressive driving that incorporates the person-related and situational factors and the cognitive and emotional appraisal processes fundamental to driver aggression. In doing so, the research will assist to provide a clear definition of what constitutes aggressive driving, assist to identify on-road incidents that trigger driver aggression, and identify the emotional and cognitive appraisal processes that underlie driver aggression. Methods: The research involves three studies. Firstly, to contextualise the model and explore the cognitive and emotional aspects of driver aggression, a diary-based study using self-reports of aggressive driving events will be conducted with a general population of drivers. This data will be supplemented by in-depth follow-up interviews with a sub-sample of participants. Secondly, to test generalisability of the model, a large sample of drivers will be asked to respond to video-based scenarios depicting driving contexts derived from incidents identified in Study 1 as inciting aggression. Finally, to further operationalise and test the model an advanced driving simulator will be used with sample of drivers. These drivers will be exposed to various driving scenarios that would be expected to trigger negative emotional responses. Results: Work on the project has commenced and progress on the first study will be reported.

Opinions, attitudes and driving experiences of car and racing "enthusiasts" : results of the Ontario Car and Racing Club Survey

In recent years, car club and racing websites and forums have become an increasingly popular way for car enthusiasts to access racing and car club news, chat-rooms and message boards. However, no North American research has been found that has examined opinions and driving experiences of car and racing enthusiasts. The purpose of this study was to examine car club members’ opinions about and experiences with various aspects of driving, road safety and traffic legislation, with a particular focus on street racing. A web-based questionnaire (Survey Monkey) was developed using the expert panel method and was primarily based on validated instruments or questions that were developed from other surveys. The questionnaire included: 1) driver concerns regarding traffic safety issues and legislation; 2) attitudes regarding various driving activities; 3) leisure-time activities, including club activities; 4) driving experiences, including offences and collisions; and 5) socio-demographic questions. The survey was pre- tested and piloted. Electronic information letters were sent out to an identified list of car clubs and forums situated in southern Ontario. Car club participants were invited to fill out the questionnaire. This survey found that members of car clubs share similar concerns regarding various road safety issues with samples of Canadian drivers, although a smaller percentage of car club members are concerned about speeding-related driving. Car club members had varied opinions regarding Ontario’s Street Racers, Stunt and Aggressive Drivers Legislation. The respondents agreed the most with the new offences regarding not sitting in the driver’s seat, having a person in the trunk, or driving as close as possible to another vehicle, pedestrian or object on or near the highway without a reason. The majority disagreed with police powers of impoundment and on-the-spot licence suspensions. About three quarters of respondents reported no collisions or police stops for traffic offences in the past five years. Of those who had been stopped, the most common offence was reported as speeding. This study is the first in Canada to examine car club members’ opinions about and experiences with various aspects of driving, road safety and traffic legislation. Given the ubiquity of car clubs and fora in Canada, insights on members’ opinions and practices provide important information to road safety researchers.

Useful field of view predicts driving in the presence of distracters

Purpose. The Useful Field of View (UFOV(R)) test has been shown to be highly effective in predicting crash risk among older adults. An important question which we examined in this study is whether this association is due to the ability of the UFOV to predict difficulties in attention-demanding driving situations that involve either visual or auditory distracters. Methods. Participants included 92 community-living adults (mean age 73.6 +/- 5.4 years; range 65-88 years) who completed all three subtests of the UFOV involving assessment of visual processing speed (subtest 1), divided attention (subtest 2), and selective attention (subtest 3); driving safety risk was also classified using the UFOV scoring system. Driving performance was assessed separately on a closed-road circuit while driving under three conditions: no distracters, visual distracters, and auditory distracters. Driving outcome measures included road sign recognition, hazard detection, gap perception, time to complete the course, and performance on the distracter tasks. Results. Those rated as safe on the UFOV (safety rating categories 1 and 2), as well as those responding faster than the recommended cut-off on the selective attention subtest (350 msec), performed significantly better in terms of overall driving performance and also experienced less interference from distracters. Of the three UFOV subtests, the selective attention subtest best predicted overall driving performance in the presence of distracters. Conclusions. Older adults who were rated as higher risk on the UFOV, particularly on the selective attention subtest, demonstrated poorest driving performance in the presence of distracters. This finding suggests that the selective attention subtest of the UFOV may be differentially more effective in predicting driving difficulties in situations of divided attention which are commonly associated with crashes.