Driver Training for Reducing Car Accidents

(DRIVER Trial)

Overseen By Jamillah T Millner, MPH

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Children's Hospital of Philadelphia

Disqualifiers: Non-Pennsylvania resident, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

1300 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests different types of driver training to determine which best reduces car accidents among young new drivers. Participants will either receive in-person behind-the-wheel driver training or take online courses focused on driver skills or vehicle safety. The trial seeks Pennsylvania teens who have a learner's permit, plan to get their license soon, and have limited driving practice. The goal is to identify the most effective method to make new drivers safer on the road. As an unphased trial, it offers participants the opportunity to contribute to important research that could enhance road safety for new drivers.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these driver training interventions are safe?

Research shows that driver education, including hands-on driving practice, improves driving skills. However, it does not significantly reduce accidents or injuries. Studies suggest that this training might only slightly lower crash rates. For online driver skills training, strong evidence does not support its effectiveness in preventing accidents. These programs aim to teach new drivers important skills, but their effect on actual crash rates remains unclear.

Both types of training are generally considered safe. They focus on education rather than introducing new medications or medical procedures, so typical side effects like those seen in drug trials do not occur. Participants can expect to learn in a safe, structured environment, whether online or in a car. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to improve driver safety and reduce car accidents. Unlike traditional methods that often involve standard classroom instruction, this trial examines the impact of online and behind-the-wheel training. The Online Driver Skills Training offers a flexible, accessible way to improve skills with its ACCEL program, which can be completed from any computer. Meanwhile, the Behind-the-Wheel Driver Training provides hands-on experience with professional instructors, offering real-world practice that no online course can replicate. By comparing these different approaches, researchers hope to identify the most effective strategies for teaching novice drivers and ultimately making roads safer.

What evidence suggests that this trial's driver training interventions could be effective for reducing young new driver crash risk?

Research shows that driver training programs can have varying levels of success. In this trial, participants will experience different training methods. For instance, one study found that behind-the-wheel training, which participants in this trial may receive, initially reduced crashes by up to 16.4% and by 8.3% after two years. However, another study found no clear evidence that driver education reduces crashes. Participants in another arm of this trial will receive online driver skills training, which past research has shown to have positive results; one study demonstrated a 70% drop in traffic violations. These mixed results suggest that while some driver training methods can be effective, their success may depend on implementation. ^{1 2 6 7 8}

Who Is on the Research Team?

Elizabeth A Walshe, PhD

Principal Investigator

Children's Hospital of Philadelphia

Flaura Winston, MD, PhD

Principal Investigator

Children's Hospital of Philadelphia

Dan Romer, PhD

Principal Investigator

Children's Hospital of Philadelphia/University of Pennsylvania

Are You a Good Fit for This Trial?

This trial is for Pennsylvania teens aged 16-17 who plan to get a driver's license within the next year, have less than 30 hours of driving practice, and have never taken an on-road licensing exam. Participants must have access to a vehicle post-licensure, their own cell phone, and internet access via smartphone/tablet/computer.

Inclusion Criteria

Have <30 hours of driving practice during permit phase

I am 16 or 17 years old and live in Pennsylvania.

I have an active Pennsylvania learner's permit.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Learner Phase

Participants are monitored through the learner phase with a smartphone app and monthly surveys. They receive one of three driver training interventions.

6-12 months

Monthly surveys (virtual)

Licensure Examination

Participants take the state license examination after completing the learner phase.

1 day

1 visit (in-person)

Post-Licensure Follow-up

Participants are monitored for crash risk and driving behavior for 6 months after licensure using a smartphone app and online surveys.

6 months

Surveys at 2, 4, and 6 months (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Behind-the-Wheel Driver Training
• Online Driver Skills Training
• Online Vehicle and Driver Safety Training

Trial Overview The study is evaluating three types of driver training: online safety training, online skills training, and behind-the-wheel training. It aims to see which method best reduces crash risks for new drivers shortly after they get their licenses.

How Is the Trial Designed?

Group I: Online Driver Skills Training Experimental Treatment 1 Intervention

Participants in the Online Driver Skills Training arm will complete an online driver skill training program known as Accelerated Curriculum to Create Effective Learning (ACCEL) for novice drivers. It requires up to two hours to complete and can be done from any internet-connected computer (at home, at school, etc.).

Group II: Behind-the-Wheel Driver Training Experimental Treatment 1 Intervention

Participants in the Behind-the-Wheel training arm will receive professional behind-the-wheel training course delivered in-person on the road by a local driving school instructor through our partnership with a local driving school Coastline Academy.

Group III: Active Control: Online Vehicle and Driver Safety Education Active Control 1 Intervention

Participants in this arm will receive care as usual, and also complete an online video training module on vehicle and driver safety, with a short quiz at the end to determine compliance. The training content will not teach driving skills, as in the other online driver training arm. It requires up to two hours to complete and can be done from any internet-connected computer (at home, at school, etc.).

Behind-the-Wheel Driver Training is already approved in United States, Canada, European Union for the following indications:

Approved in United States as Behind-the-Wheel Driver Training for:

• Driver Education
• Young New Driver Crash Risk Reduction

Approved in Canada as Behind-the-Wheel Instruction for:

• Driver Training
• New Driver Safety

Approved in European Union as Practical Driving Lessons for:

• Driver Education
• Road Safety

Who Is Running the Clinical Trial?

Children's Hospital of Philadelphia

Lead Sponsor

Trials

749

Recruited

11,400,000+

National Institutes of Health (NIH)

Collaborator

Trials

2,896

Recruited

8,053,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

University of Michigan

Collaborator

Trials

1,891

Recruited

6,458,000+

University of Pennsylvania

Collaborator

Trials

2,118

Recruited

45,270,000+

Published Research Related to This Trial

A study involving over 1,300 students found that home-study driver education programs (CD ROM, workbook, and Internet/workbook) are as effective as traditional classroom courses in teaching driver education, with some home-study formats showing slightly better knowledge and attitude scores.

The results suggest that home-study courses could be more widely adopted, potentially making driver education more accessible and affordable, especially when integrated into a two-stage driver education system.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of home-study driver education compared to classroom instruction: the impact on student knowledge and attitudes. Masten, SV., Chapman, EA.[2019]

In Ohio, novice drivers aged 16 and 17 who underwent comprehensive licensing requirements, including behind-the-wheel training, had significantly lower crash rates in the first year after getting their licenses compared to those licensed at age 18, with a 27% lower crash rate in the first 2 months for 16-year-olds and 14% lower for 17-year-olds.

The study suggests that implementing mandatory driver education and training could enhance safety for young drivers, as those who received this training showed better performance on licensing exams and lower crash rates, indicating the potential benefits of comprehensive licensing policies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Licensing Examination and Crash Outcomes Postlicensure in Young Drivers. Walshe, EA., Romer, D., Wyner, AJ., et al.[2022]

The introduction of compulsory skid training in Finnish driver education in 1990 did not lead to a reduction in accidents during slippery road conditions, as shown by a study involving 41,000 novice drivers.

Drivers who received the new skid training reported higher confidence in their driving skills and felt less fear when driving in slippery conditions, suggesting that while confidence increased, it did not translate into improved safety outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does increased confidence among novice drivers imply a decrease in safety? The effects of skid training on slippery road accidents. Katila, A., Keskinen, E., Hatakka, M., et al.[2019]

A study involving 78 older drivers showed that combining basic in-class training with on-road training and driving simulator practice significantly reduced driving errors by about 30% compared to basic training alone.

The findings support the effectiveness of individualized driver training programs in enhancing safe driving performance among older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The combined effects of on-road and simulator training with feedback on older drivers' on-road performance: Evidence from a randomized controlled trial. Sawula, E., Polgar, J., Porter, MM., et al.[2019]

Asynchronous online training (AOT) can effectively improve mental health practitioners' knowledge for at least six months, even without the need for classroom training or supervision.

However, the impact of online training on skill acquisition remains unclear due to mixed results, indicating a need for further research to evaluate the effectiveness of different training methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Using Technology to Optimize the Training of Mental Health Providers in Evidence-Based Treatment: State of Knowledge]. Bond, S., Binet, É., Pudelko, B.[2021]

A study involving 43 postgraduate health professionals showed that online training for Cognitive Behavior Therapy (CBT) was as effective as traditional in-person training in terms of content satisfaction and didactic quality.

While online training was generally well-received, there was a slight preference for in-person training regarding professional benefit and active participation, suggesting that online methods can be effectively integrated into CBT education even after social distancing measures are lifted.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teaching Cognitive Behavior Therapy to Postgraduate Health Care Professionals in Times of COVID 19 - An Asynchronous Blended Learning Environment Proved to Be Non-inferior to In-Person Training. Soll, D., Fuchs, R., Mehl, S.[2021]

Integrating an 8-hour medication-assisted treatment (MAT) waiver training into the Internal Medicine clerkship curriculum at Wayne State University significantly improved medical students' comfort and knowledge regarding opioid use disorders (OUD), as evidenced by pre- and post-survey results from 141 students.

The training, which was provided for free online, resulted in increased familiarity with MAT and a higher likelihood of students feeling prepared to utilize MAT in their future practice, indicating a promising approach to addressing the physician shortage in OUD treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Eight-hour medication-assisted treatment waiver training for opioid use disorder: integration into medical school curriculum. Lien, IC., Seaton, R., Szpytman, A., et al.[2021]

A study involving 191 patients who completed the Alcohol Change Course (ACC) showed that 69.6% were satisfied with the program, indicating its efficacy as an Internet-delivered cognitive behavior therapy for alcohol misuse.

Patients found skills like coping with cravings and managing risky situations particularly helpful, but many suggested increasing personal interaction and providing more information to enhance the course experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving internet-delivered cognitive behaviour therapy for alcohol misuse: Patient perspectives following program completion. Hadjistavropoulos, HD., Chadwick, C., Beck, CD., et al.[2021]

An online learning course on traumatic dental injury (TDI) was developed for medical students, highlighting the importance of cross-disciplinary education in enhancing their knowledge of dental trauma.

The study identified ten key features essential for designing effective online courses, such as prioritizing relevant information, promoting self-confidence, and using visual aids to enhance understanding, which can improve the overall learning experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What is important to medical students' online learning of dental trauma in medical education. Yeng, T.[2023]

The transition to virtual training for intrauterine contraception during the COVID-19 pandemic allowed healthcare providers to continue their education without needing to travel, using online materials and livestreamed sessions.

Participants in the virtual training reported a high level of skill acquisition and positive impacts on their clinical practice, indicating that this method is effective for teaching essential clinical skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual Skills Training Format for Teaching Intrauterine Contraception Insertion During Coronavirus Disease 2019. Metcalf-Wilson, K., Bates, A., Webb, S., et al.[2022]

A pilot study involving 19 dietetics students revealed that while online training offered benefits like flexibility and reduced commute, it also presented challenges such as increased workload and communication issues with preceptors.

Despite 52.6% of students feeling they adequately acquired PDEP competencies, a significant 94.7% reported negative impacts on their mental health, indicating a need for improvements in online training methods to support both competency acquisition and mental well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of the COVID-19-induced shift to online dietetics training on PDEP competency acquisition and mental health. Van, K., Beauchamp, DM., Rachid, H., et al.[2022]

A study comparing online and in-person opioid overdose prevention training (OOPT) for first-year medical students found no meaningful differences in knowledge, attitudes, and preparedness, suggesting that online training is just as effective as in-person training.

The results indicate that online OOPT can be a viable alternative to traditional methods, but further research in a randomized controlled setting is needed to confirm these findings and explore the effectiveness of OOPT in broader populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of online opioid overdose prevention training for first-year medical students: A comparative analysis of online versus in-person training. Berland, N., Lugassy, D., Fox, A., et al.[2020]

The VINCENTweb course, a no-cost online training program focused on injury prevention and control, received positive feedback from participants, particularly those with lower education levels, indicating its accessibility and effectiveness.

Participants reported high levels of learning and satisfaction, suggesting that internet-based distance learning can be a valuable tool for continuing education in public health, especially in areas that are often underrepresented.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementation and evaluation of a Web-based continuing education course in injury prevention and control. Bernhardt, JM., Runyan, CW., Bou-Saada, I., et al.[2019]

In a study involving 54 older adults (ages 70-89), those who received video and GPS feedback during driving instruction significantly reduced their driving errors by 25%, while those in classroom-only or control groups showed no significant improvement.

The use of technology for direct feedback not only enhanced driving performance but also led to a 52% improvement in global safety ratings among participants who received the video feedback, compared to much lower rates in the other groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Older driver training using video and global positioning system technology--a randomized controlled trial. Porter, MM.[2013]

Error training in a driving simulator significantly improved participants' ability to transfer skills to real driving tests and enhanced their coping strategies for new driving situations, despite reducing their self-confidence in driving skills.

Guided error training showed only weak benefits over errorless learning and did not improve self-confidence or transfer skills to novel driving tests, suggesting that active engagement with errors may be more effective than passive observation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Learning from errors in a driving simulation: effects on driving skill and self-confidence. Ivancic, K., Hesketh, B.[2019]

Citations

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Is driver education contributing towards road safety? a ... There was no evidence that driver education is an effective approach to reducing crashes or injuries. This negative result might be due to ineffective teaching ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S0386111211000021

Do driver training programs reduce crashes and traffic ... The 16.4% crash reduction at period 1 and the 8.3% reduction after 24 months were significant at P ≤ .02 and P ≤ .03, respectively. Unfortunately, these ...

3. scirp.org scirp.org/journal/paperinformation?paperid=53146

The Effectiveness of Driver Education and Information ... Their results indicated that GDL regulations reduced traffic fatalities among 15 - 17 years olds by at least 5.6%. Shope [11] provided an overview of evaluation ...

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Teen Driver Safety Experimental studies that randomly assigned drivers to various training conditions and compared subsequent crash rates and other measures;. Quasi-experimental ...

5. media.nrspp.org.au media.nrspp.org.au/wp-content/uploads/2017/07/06021326/The-Effectiveness-Of-Driver-Training-As-A-Road-Safety-Measure-A-Review-Of-The-Literature.pdf

the effectiveness of driver training as a road safety measure An analysis, in terms of convictions, of a volunteer, behind the wheel, advanced driver training course. Unpublished report. Rosebery, NSW: Traffic Accident.

6. chop.edu chop.edu/news/study-suggests-policy-education-and-training-make-youngest-novice-drivers-better-prepared

Study Suggests Policy, Education and Training Make ... Compared with drivers licensed at 18, those licensed at age 17 had 19% lower crash rates over the first 2 months of licensure and 6% lower crash ...

7. researchgate.net researchgate.net/publication/348787496_Is_driver_education_contributing_towards_road_safety_a_systematic_review_of_systematic_reviews

(PDF) Is driver education contributing towards road safety? ... Conclusions: There was no evidence that driver education is an effective approach to reducing crashes or injuries. This negative result might be ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9039772/

Licensing Examination and Crash Outcomes Postlicensure ... Study findings suggest comprehensive license policy that mandates driver education including behind-the-wheel (BTW) training may reduce crashes ...