Vision, functional and cognitive determinants of motor vehicle incidents in older drivers

Background: The proportion of older individuals in the driving population is predicted to increase in the next 50 years. This has important implications for driving safety as abilities which are important for safe driving, such as vision (which accounts for the majority of the sensory input required for driving), processing ability and cognition have been shown to decline with age. The current methods employed for screening older drivers upon re-licensure are also vision based. This study, which investigated social, behavioural and professional aspects involved with older drivers, aimed to determine: (i) if the current visual standards in place for testing upon re-licensure are effective in reducing the older driver fatality rate in Australia; (ii) if the recommended visual standards are actually implemented as part of the testing procedures by Australian optometrists; and (iii) if there are other non-standardised tests which may be better at predicting the on-road incident-risk (including near misses and minor incidents) in older drivers than those tests recommended in the standards. Methods: For the first phase of the study, state-based age- and gender-stratified numbers of older driver fatalities for 2000-2003 were obtained from the Australian Transportation Safety Bureau database. Poisson regression analyses of fatality rates were considered by renewal frequency and jurisdiction (as separate models), adjusting for possible confounding variables of age, gender and year. For the second phase, all practising optometrists in Australia were surveyed on the vision tests they conduct in consultations relating to driving and their knowledge of vision requirements for older drivers. Finally, for the third phase of the study to investigate determinants of on-road incident risk, a stratified random sample of 600 Brisbane residents aged 60 years and were selected and invited to participate using an introductory letter explaining the project requirements. In order to capture the number and type of road incidents which occurred for each participant over 12 months (including near misses and minor incidents), an important component of the prospective research study was the development and validation of a driving diary. The diary was a tool in which incidents that occurred could be logged at that time (or very close in time to which they occurred) and thus, in comparison with relying on participant memory over time, recall bias of incident occurrence was minimised. Association between all visual tests, cognition and scores obtained for non-standard functional tests with retrospective and prospective incident occurrence was investigated. Results: In the first phase,rivers aged 60-69 years had a 33% lower fatality risk (Rate Ratio [RR] = 0.75, 95% CI 0.32-1.77) in states with vision testing upon re-licensure compared with states with no vision testing upon re-licensure, however, because the CIs are wide, crossing 1.00, this result should be regarded with caution. However, overall fatality rates and fatality rates for those aged 70 years and older (RR=1.17, CI 0.64-2.13) did not differ between states with and without license renewal procedures, indicating no apparent benefit in vision testing legislation. For the second phase of the study, nearly all optometrists measured visual acuity (VA) as part of a vision assessment for re-licensing, however, 20% of optometrists did not perform any visual field (VF) testing and only 20% routinely performed automated VF on older drivers, despite the standards for licensing advocating automated VF as part of the vision standard. This demonstrates the need for more effective communication between the policy makers and those responsible for carrying out the standards. It may also indicate that the overall higher driver fatality rate in jurisdictions with vision testing requirements is resultant as the tests recommended by the standards are only partially being conducted by optometrists. Hence a standardised protocol for the screening of older drivers for re-licensure across the nation must be established. The opinions of Australian optometrists with regard to the responsibility of reporting older drivers who fail to meet the licensing standards highlighted the conflict between maintaining patient confidentiality or upholding public safety. Mandatory reporting requirements of those drivers who fail to reach the standards necessary for driving would minimise potential conflict between the patient and their practitioner, and help maintain patient trust and goodwill. The final phase of the PhD program investigated the efficacy of vision, functional and cognitive tests to discriminate between at-risk and safe older drivers. Nearly 80% of the participants experienced an incident of some form over the prospective 12 months, with the total incident rate being 4.65/10 000 km. Sixty-three percent reported having a near miss and 28% had a minor incident. The results from the prospective diary study indicate that the current vision screening tests (VA and VF) used for re-licensure do not accurately predict older drivers who are at increased odds of having an on-road incident. However, the variation in visual measurements of the cohort was narrow, also affecting the results seen with the visual functon questionnaires. Hence a larger cohort with greater variability should be considered for a future study. A slightly lower cognitive level (as measured with the Mini-Mental State Examination [MMSE]) did show an association with incident involvement as did slower reaction time (RT), however the Useful-Field-of-View (UFOV) provided the most compelling results of the study. Cut-off values of UFOV processing (>23.3ms), divided attention (>113ms), selective attention (>258ms) and overall score (moderate/ high/ very high risk) were effective in determining older drivers at increased odds of having any on-road incident and the occurrence of minor incidents. Discussion: The results have shown that for the 60-69 year age-group, there is a potential benefit in testing vision upon licence renewal. However, overall fatality rates and fatality rates for those aged 70 years and older indicated no benefit in vision testing legislation and suggests a need for inclusion of screening tests which better predict on-road incidents. Although VA is routinely performed by Australian optometrists on older drivers renewing their licence, VF is not. Therefore there is a need for a protocol to be developed and administered which would result in standardised methods conducted throughout the nation for the screening of older drivers upon re-licensure. Communication between the community, policy makers and those conducting the protocol should be maximised. By implementing a standardised screening protocol which incorporates a level of mandatory reporting by the practitioner, the ethical dilemma of breaching patient confidentiality would also be resolved. The tests which should be included in this screening protocol, however, cannot solely be ones which have been implemented in the past. In this investigation, RT, MMSE and UFOV were shown to be better determinants of on-road incidents in older drivers than VA and VF, however, as previously mentioned, there was a lack of variability in visual status within the cohort. Nevertheless, it is the recommendation from this investigation, that subject to appropriate sensitivity and specificity being demonstrated in the future using a cohort with wider variation in vision, functional performance and cognition, these tests of cognition and information processing should be added to the current protocol for the screening of older drivers which may be conducted at licensing centres across the nation.

Redundancy in interface design and its impact on intuitive use of a product in older users

Many older adults have difficulty using modern consumer products due to their complexity both in terms of functionality and interface design. It has been observed that older people also have more problems learning new systems. It was hypothesised that designing technological products that are more intuitive for older people to use can solve this problem. An intuitive interface allows a user’s to employ prior knowledge, thus minimizing the learning needed for effective interaction. This paper discusses an experiment investigating the effectiveness of redundancy in interface design. The primary objective of this experiment was to find out if using more than one modality for a product’s interface improves the speed and intuitiveness of interactions for older adults. Preliminary analysis showed strong correlation between technology familiarity and time on tasks, but redundancy in interface design improved speed and accuracy of use only for participants with moderate to high technology familiarity.

Nursing students’ knowledge and practice of infection control precautions : an educational intervention

Aim. This paper is a report of the effectiveness of a purpose-designed education program in improving undergraduate nursing students’ understanding and practice of infection control precautions. Background. The severe acute respiratory syndrome outbreak in 2003 highlighted that healthcare workers were under-prepared for such an epidemic. While many in-service education sessions were arranged by institutions in response to the outbreak, preservice nursing education has overlooked preparation for handling such infectious disease epidemics. Method. A quasi-experimental design was used and a 16-hour, purpose-designed infection control education programme was implemented for preservice nursing students in southern Taiwan. Self-administered questionnaires were distributed at three time points during the period September 2005 to April 2006 to examine the sustainability and effectiveness of the intervention. Results. A total of 175 preservice nursing students participated in the study. Following the education programme, students in the intervention group showed a statistically significant improvement across time in their knowledge of these precautions [F(2, 180) = 13Æ53, P < 0Æ001] and confidence in resolving infectionrelated issues [F(1Æ79, 168Æ95) = 3Æ24] when compared with those in the control group. Conclusion. To improve nursing students’ capacity in responding to infectious epidemics, an educational programme that integrates the theme of infection precautions, learning theory and teaching strategies is recommended for all nursing institutes.

The Brisbane media map : participatory design and authentic learning to link students and industry

The Brisbane Media Map is both an online resource and a tertiary-level authentic learning project. The Brisbane Media Map is an online database which provides a detailed overview of about 600 media industry organisations in Brisbane, Australia. In addition to providing contact details and synopses for each organisation’s profile, the Brisbane Media Map also includes supplementary information on current issues, trends, and individuals in the media and communication industry sectors. This resource is produced and updated annually by final-year undergraduate Media and Communication students. This article introduces the Brisbane Media Map, its functionality and systems design approach, as well as its alignment with key learning infrastructures. It examines authentic learning as the pedagogical framework underpinning the ongoing development work of the resource and highlights some synergies of this framework with participatory design principles. The Brisbane Media Map is a useful example of an authentic learning approach that successfully engages students of non-traditional and non-design areas of study in human-computer interaction, usability, and participatory design activities.

Engaging students in programming

Poor student engagement and high failure rates in first year units were addressed at the Queensland University of Technology (QUT) with a course restructure involving a fresh approach to introducing programming. Students’ first taste of programming in the new course focused less on the language and syntax, and more on problem solving and design, and the role of programming in relation to other technologies they are likely to encounter in their studies. In effect, several technologies that have historically been compartmentalised and taught in isolation have been brought together as a breadth-first introduction to IT. Incorporating databases and Web development technologies into what used to be a purely programming unit gave students a very short introduction to each technology, with programming acting as the glue between each of them. As a result, students not only had a clearer understanding of the application of programming in the real world, but were able to determine their preference or otherwise for each of the technologies introduced, which will help them when the time comes for choosing a course major. Students engaged well in an intensely collaborative learning environment for this unit which was designed to both support the needs of students and meet industry expectations. Attrition from the unit was low, with computer laboratory practical attendance rates for the first time remaining high throughout semester, and the failure rate falling to a single figure percentage.

Multidisciplinary students on Property core units : comparative analysis of introductory and advanced units

The composition of many professional services firms in the Urban Development area has moved away from a discipline specific ‘silo’ structure to a more multidisciplinary environment. The benefits of multidisciplinarity have been seen in industry by providing synergies across many of the related disciplines. Similarly, the Queensland University of Technology, Bachelor of Urban Development degree has sought to broaden the knowledge base of students and achieve a greater level of synergy between related urban development disciplines through the introduction of generic and multidisciplinary units. This study aims to evaluate the effectiveness of delivering core property units in a multidisciplinary context. A comparative analysis has been undertaken between core property units and more generic units offered in a multidisciplinary context from introductory, intermediate and advanced years within the property program. This analysis was based on data collected from course performance surveys, student performance results, a student focus group and was informed by a reflective process from the student perspective and lecturer/ tutor feedback. The study showed that there are many benefits associated with multidisciplinary unit offerings across the QUT Urban Development program particularly in the more generic units. However, these units require a greater degree of management. It is more difficult to organise, teach and coordinate multidisciplinary student cohorts due to a difference in prior knowledge and experience between each of the discipline groups. In addition, the interaction between lecturers/ tutors and the students frequently becomes more limited. A perception exists within the student body that this more limited face to face contact with academic staff is not valuable which may be exacerbated by the quality of complimentary online teaching materials. For many academics, non-attendance at lectures was coupled with an increase in email communication. From the limited data collected during the study there appears to be no clear correlation between large multidisciplinary student classes and student academic performance or satisfaction.

Is implementing criterion-referenced assessment worth the effort with gen Y?

Well implemented criterion-referenced assessment (CRA) requires dedicated time and effort, especially in describing realistic expectations of evidence of achievement to students in the form of criteria sheets (or grading rubrics). It is also takes time out of delivering content to teach students how to judge their own work using criteria sheets. In 2007, to engage third year Microbiology students in using criteria sheets for the first time in their degree, we devised an innovative assessment tutorial supported by online resources. We were sceptical of much of the literature that reported ‘agreed’ characteristics of our predominantly gen Y cohort, because of the older ages of the majority of authors. These authors claim gen Y has a propensity for digital media, overconfidence in their own abilities and a collaborative orientation. We rejected this stereotype when developing the tutorial. Evaluations by students were positive and there was no dramatic change to grades for the unit. These results are similar to those in the literature for non gen Y cohorts. This lends support to our claim that giving students control over their own learning, irrespective of their generational label, is worth the time and effort.

Property and valuation education : an analysis of UWS property students from 1994 to 2006

The valuation and property is an evolving industry and the participants within the industry are also changing. This change is due to improved technology and construction, global nature of business today, professional standards, legal and accounting issues and environmental matters. Throughout this change in the property industry, there has also been significant change in the structure and content of tertiary property courses in Australia. Over the past thirteen years each first year cohort commencing study in the property program at the University of Western Sydney have been surveyed in relation to their background, reasons for course selection and job expectations. This paper will review this annual survey and the profile of all first year students who commenced their studies in the Bachelor of Business (Property) degree [formerly Bachelor of Commerce (Property Economics) and Bachelor of Commerce (Land Economy)] for years commencing 1994 to 2006. The paper will also provide a detailed analysis of the type of student entering the property industry and their exposure to the valuation and property sectors prior to commencing their studies.

Changing face of property students : an analysis of UWS property students from 1994 to 2003

Property is an evolving industry and the participants within the industry are also changing. This change is due to improved technology and construction, global nature of business today, professional standards, legal and accounting issues and environmental matters. Throughout this change in the property industry, there has also been significant change in the structure and content of tertiary property courses in Australia. Over the past ten years each first year cohort commencing study in the property program at the University of Western Sydney have been surveyed in relation to their background, reasons for course selection and job expectations. This paper will review the annual survey and the profile of all first year students who commenced their studies in the Bachelor of Business (Property Economics) degree [formerly Bachelor of Commerce (Property Economics) and Bachelor of Commerce (Land Economy)] for years commencing 1994 to 2003.

Mainstreamed students with learning difficulties : failing and underachieving in the secondary school

Despite the rhetoric that students with learning difficulties are adequately supported within schools, the evidence suggests that they continue to experience school failure with devastating consequences. Students with learning difficulties are disproportionately represented as juvenile delinquents, as the unemployed and in mental health statistics. However, the defining of this group remains confused and imprecise and has not been a national priority. This has repercussions for both secondary schools and for the students themselves. This paper highlights research related to teaching practices, policies and school structure and their effects on the academic outcomes and emotional well being of students with learning difficulties. Finally, it makes a number of recommendations to change the status quo for these students.

Attitudes and interests towards biotechnology: The mismatch between students and teachers

Increasing the scientific literacy of Australians has become an educational priority in recent times. The ‘Science State – Smart State’ initiative of the Queensland Government involves an action plan for improving science education that includes a Science for Life action. A desired outcome is for an increased understanding of the natural world so that responsible decisions concerning our future wellbeing can be made in an age of science and technology. Biotechnology is a technology that is having profound impact on our lives. This paper describes how 15-16 year old students and biology teachers revealed a mismatch in both attitudes and interests towards biotechnology between the students and teachers. The findings are of interest as the teachers are writing biotechnology into their work programs in response to new syllabus documents. The teacher’s areas of interest did not match those of the students, possibly resulting in a curriculum the teachers want to teach, but the students do not want to learn.

Biotechnology education : topics of interest to students and teachers

This paper presents the findings of a survey that investigates the biotechnology topics of interest according to students and teachers for inclusion in biology lessons and reports on the similarities and differences in teachers’ and students’ biotechnology topics of interest. The study is of significance as biotechnology has been identified as a key area of technological and economic importance worldwide yet there is scant literature relating to teachers’ and students’ interests concerning biotechnology education topics. 500 students and their 15 teachers completed the survey. Interviews were conducted with 3 teachers and 60 students. Responses indicate there is a mismatch in the interests of students and teachers, and what they perceive as being possible topics for inclusion in biology and biotechnology lessons. Where teachers are provided with the freedom to design and assess their own units of work, this mismatch of interests causes problems. The study found students withdrawing from biology courses in post compulsory settings due to lack of interest, and perceived lack of relevance of the course. It is possible that this lack of agreement on topics of interest is a factor in the world wide decline of enrolments in the sciences.

Writing together, learning together : the value and effectiveness of a research writing group for doctoral students

The high level of scholarly writing required for a doctoral thesis is a challenge for many research students. However, formal academic writing training is not a core component of many doctoral programs. Informal writing groups for doctoral students may be one method of contributing to the improvement of scholarly writing. In this paper, we report on a writing group that was initiated by an experienced writer and higher degree research supervisor to support and improve her doctoral students’ writing capabilities. Over time, this group developed a workable model to suit their varying needs and circumstances. The model comprised group sessions, an email group, and individual writing. Here, we use a narrative approach to explore the effectiveness and value of our research writing group model in improving scholarly writing. The data consisted of doctoral students’ reflections to stimulus questions about their writing progress and experiences. The stimulus questions sought to probe individual concerns about their own writing, what they had learned in the research writing group, the benefits of the group, and the disadvantages and challenges to participation. These reflections were analysed using thematic analysis. Following this analysis, the supervisor provided her perspective on the key themes that emerged. Results revealed that, through the writing group, members learned technical elements (e.g., paragraph structure), non-technical elements (e.g., working within limited timeframes), conceptual elements (e.g., constructing a cohesive arguments), collaborative writing processes, and how to edit and respond to feedback. In addition to improved writing quality, other benefits were opportunities for shared writing experiences, peer support, and increased confidence and motivation. The writing group provides a unique social learning environment with opportunities for: professional dialogue about writing, peer learning and review, and developing a supportive peer network. Thus our research writing group has proved an effective avenue for building doctoral students’ capability in scholarly writing. The proposed model for a research writing group could be applicable to any context, regardless of the type and location of the university, university faculty, doctoral program structure, or number of postgraduate students. It could also be used within a group of students with diverse research abilities, needs, topics and methodologies. However, it requires a group facilitator with sufficient expertise in scholarly writing and experience in doctoral supervision who can both engage the group in planned writing activities and also capitalise on fruitful lines of discussion related to students’ concerns as they arise. The research writing group is not intended to replace traditional supervision processes nor existing training. However it has clear benefits for improving scholarly writing in doctoral research programs particularly in an era of rapidly increasing student load.

Scaffolding students’ thinking in mathematical investigations

This article describes some of the issues that teachers might encounter when scaffolding students’ thinking during mathematical investigations. It describes four episodes where a teacher’s scaffolding failed to support students’ mathematical thinking and explores the reasons why the scaffolding was ineffective. Understanding what is ineffective and why is one way to improve pedagogical practice. As a background to these episodes, we first provide an overview of the mathematical investigation. Our paper concludes with some recommendations for judicious scaffolding during investigations.

Serious playground : using Second Life to engage high school students in urban planning

Virtual world platforms such as Second Life have been successfully used in educational contexts to motivate and engage learners. This article reports on an exploratory workshop involving a group of high school students using Second Life for an urban planning project. Young people are traditionally an under-represented demographic when it comes to participating in urban planning and decision making processes. The research team developed activities that combined technology with a constructivist approach to learning. Real world experiences and purposes ensured that the workshop enabled students to see the relevance of their learning. Our design also ensured that play remained an important part of the learning. By conceiving of the workshop as a ‘serious playground’ we investigated the ludic potential of learning in a virtual world.