Handbook of Driving Simulation for Engineering, Medicine, and Psychology

Understanding and Changing the Younger Driver Problem: A Review of the Randomized Controlled Trials Conducted with Driving Simulation

Authors
Marie Claude Ouimet, University of Sherbrooke
Caitlin W. Duffy, Northwestern University
Bruce G. Simons-Morton, National Institutes of Health
Thomas G. Brown, Douglas Mental Health Research Institute
Donald L. Fisher, University of Massachusetts

Abstract
The Problem. Younger drivers, from newly licensed teenagers to drivers in their early twenties, often lack driving skills and engage in driving behavior that may increase their crash risk. Clarification of the mechanisms underlying risk in young drivers and the development of new effective countermeasures to complement existing ones are needed. Role of Driving Simulation. Driving simulation can play a role in safely identifying factors associated with young drivers’ crash risk and evaluating intervention programs to mitigate risk. It also offers the experimental control required for randomized control trials (RCTs), the gold standard for causal inference. The main goals of this chapter are to evaluate the present state of research in this area and to stimulate future research with young drivers combining RCTs and driving simulation. Scenarios and Dependent Variables. This chapter reviews RCTs with either parallel or factorial designs, organized with respect to their research topics, driving-related outcomes, and issues related to the internal and external validity of findings. Studies (N = 37) were identified using PsychINFO and MEDLINE (1950–2008), as well as other literature search methods. A systematic review was conducted on the studies’ main topic (i.e., interventions to increase skills, chiefly risk or hazard perception; n = 11) and main driving-related outcome (i.e., speed; n = 22). Results indicated that interventions could increase short-term skill acquisition but left many other key issues unanswered, such as the long-term effects of these interventions on skill acquisition and crash reduction. Most studies (82%) reported significant results on speed in the hypothesized direction. Appraisal of study methodology and interpretation of results revealed widespread shortcomings in reporting practices with regards to randomization and blinding, as well as a frequent failure to adequately address the generalizability of results. This chapter also examines promising avenues for future research and the relevance of RCT guidelines from the Consolidated Standards of Reporting Trials (CONSORT) Statement to this research area. Platform Specificity and Equipment Limitations. Platforms varied greatly across studies, but there was no evidence that results in any study reviewed here were limited to the specific equipment used.

Keywords
Systematic Review, Randomized Controlled Trial, Random Assignment Experiment, Prevention, Driving Skill,
Risky Behavior, Driving Simulation, Young Adult, Novice Driver, Adolescent

Key Points
• Young drivers are over-represented in motor vehicle crashes and many factors have been associated with their increased crash risk including inadequate driving skills, engaging in risky driving behavior, and driving in risky conditions.
• Randomized controlled trials (RCTs) are generally considered the best design for establishing causal relationships. Implementing them in a safe and controlled driving simulation environment can help clarify the mechanisms underlying teenage drivers’ risks and test the efficacy of interventions. To stimulate and guide future research with young drivers employing RCTs and driving simulation, a systematic review of selected studies was performed in addition to a consideration of potential threats to the internal and external validity of findings.
• Interventions to increase driving skills, especially risk or hazard perception, represent the only major body of research focusing on young drivers using the RCT design and driving simulation. Both RCT design and driving simulation could be utilized to address key research questions regarding the mechanisms that underlie young drivers’ increased risk in dangerous driving conditions (e.g., the effect of driving at night, with passengers) and possible interventions to mitigate these risks (e.g., improving driving skills other than risk or hazard perception, reducing risk when driving with young passengers).
• All but one of the selected studies failed to document essential details of RCTs, especially randomization and blinding procedures that are vital to the appraisal of internal validity. Also, many studies did not adequately report demographic information, such as the mean and distribution of age and driving experience, so the specific relevance of the findings to either teenage or young drivers was sometimes unclear.

Key Readings
Altman, D. G., Schulz, K. F., Moher, D., Egger, M., Davidoff, F., Elbourne, D., . . . Lang, T. (2001). The revised CONSORT Statement for reporting randomized trials: Explanation and elaboration. Annals of Internal Medicine, 134, 663–694.

Hunton, J., and Rose, J. M. (2005). Cellular telephones and driving performance: The effects of attentional demands on motor vehicle crash risk. Risk Analysis, 25, 855–866.

McKenna, F. P., Horswill, M. S., and Alexander, J. L. (2006). Does anticipation training affect drivers’ risk-taking? Journal of Experimental Psychology, 12, 1–10.

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Taubman Ben-Ari, O., Florian, V., and Mikulincer, M. (1999). The impact of mortality salience on reckless driving: A test of terror management mechanisms. Journal of Personality and Social Psychology, 76, 35–45.