Education and driver training
ALLAN F. WILLIAMS
THIS paper on traffic safety is prepared from the perspective of countries with mature systems of motorization, in particular the United States. However, countries in all stages of motorization face similar problems in trying to reduce injuries on the roads. Countries with long histories of dealing with the injury problem have sometimes gone in wrong directions, but have also introduced sophisticated and effective approaches. This experience provides some perspective and guidelines for countries in earlier stages of motor vehicle introduction on productive paths to be taken in protecting their citizens, and pitfalls to avoid.
Societies benefit greatly from the mobility provided by vehicle travel. However, the by-product of enhanced mobility – injuries to humans – constitutes a major health problem in all motorized countries. In discussing ways to reduce injuries on the roads, it is important to recognize that this is a problem of our own making. We know the aetiology of injuries, that they occur when the energy released in collisions exceeds the human injury threshold. With this knowledge we can substantially control, or even eliminate the injury problem, if we chose to do so. Unfortunately, in most cases we have been overly indulgent of the injury burden associated with motor vehicle travel, treating it as part of the fabric – unfortunate but acceptable collateral damage. In most societies, highway safety has been a low priority issue. Apathy about the injury toll has resulted in scarce resources available to reduce it, and those resources have not always been used wisely. Approaches to controlling the problem have been limited and sometimes misdirected.
Education and training have been mainstays in attempts to deal with the injury problem. Indeed, in the early years of highway safety efforts in the United States and other motorized countries, they were used almost exclusively. Education and training programmes have many important benefits. Increased knowledge about a health issue can result in a more informed public and shape attitudes. This is important in that it can help set the public agenda, establishing the problem as one of concern, and providing support for laws and other means for addressing the problem. Education and training programmes can help people understand crash risk factors, safe travel practices, and to learn basic driving skills and rules of the road. It is especially important that legislators and others who make policy decisions be educated as to scientifically established ways to reduce the problem. Safety advocates, who play an important role in promoting highway safety, also need to understand the scientific underpinnings of effective countermeasures.
However, the aim of most educational and training programmes is to change individual behaviour. When used alone, they largely fail to do so. Programmes have been implemented on the naïve assumption that skilled drivers are necessarily safe drivers, and that merely urging people to adopt health enhancing behaviour for their own good will lead them to do so. They enjoy huge public popularity, are firmly entrenched, and most often are stand-alone efforts. Before reviewing the use of and effects of these programmes, it is important to understand this popularity and why it is so difficult to change individual behaviour.
It is readily apparent that driver behaviour is usually a contributing factor in crashes. The link between driver behaviour and crash events is clear and immediate, unlike other health areas, for example, tobacco use, where the relationship between the behaviour and unwanted health consequences is more remote.
The focus on driver error is what has led to emphasis on educational strategies to fix the problem. It is not ourselves who need to be educated, however. From an individual perspective, the emphasis is on the ‘other’ driver with whom we share the roads. We blame other people for driving poorly and getting into crashes and we do not want their misbehaviour to harm us. They need to be educated to be better drivers. Tobacco users largely harm themselves; ‘bad’ drivers can cause serious harm to others.
This perspective is encouraged by the tendency of people to think that they themselves are less likely than others to encounter negative events, and this is particularly so in the case of driving. People underestimate risks that are supposed to be under their own control, creating ‘illusory zones of immunity’ around routine, everyday activities.1 This sense of immunity is bolstered by most people’s belief that their driving and crash avoidance skills are above average. Surveys around the world have revealed this tendency. In one study conducted in the United States, 20% thought their skills were far above average, 52% that they were above average, and the other 28% that their skills were average.2 This leads people to think that they can control their own crash involvement.
In another survey, 82% said they thought they either had almost total control or a lot of control in preventing their own involvement in motor vehicle crashes. If they were to be in a crash, only 6% said it would be because they were at fault; 59% said it would be the fault of the other driver, or just bad luck (17%) or some defect in the road or vehicle.3 Crashes happen, but they happen to other drivers who are not so skilled or careful, and need to be brought under control because they threaten us. Educational programmes are supposed to do this job.
Yet educating people in a way that changes their highway safety behaviour is not an easy task. First, safe travel practices have to be done on each trip, so programmes that have only a one-time or short-term effect are essentially worthless. Second, most people know what they are supposed to do on the roads in terms of safe practices (paying attention, obeying traffic laws, driving or walking ‘defensively’, not being on the roads when fatigued or impaired, protecting oneself from injury through restraint and helmet use). It is not a matter of knowledge; highway crashes are more likely to result from failure to apply what is known. What people actually do on the roads is guided by attitudes, motivations, lifestyle factors, and assumptions about risk. Veteran drivers have well developed habits that pose a challenge to change. In addition, it is generally the case that those who contribute the most to a problem and whom one would therefore most like to influence, have traits, values, and peer associations that make them least susceptible to behaviour change through educational programmes.4
Asecond issue in effecting behaviour change is the emphasis on the ‘other’ driver as the source of the highway safety problem. People hear the messages, agree with them, but think they are for those ‘other’ drivers who need them, not themselves. Not surprisingly, in a number of health realms what has been called the ‘third-person effect’ is encountered, people viewing the message and believing it is intended for others.5 This is likely to be even more of a factor in regard to highway safety, given the psychological tendency of people to self-protect by minimizing the possibility of harm to themselves resulting from the everyday act of driving. Finally, crashes, especially those producing serious injury, are relatively rare events. Speeding, jaywalking, driving while impaired, and other dangerous and illegal behaviours generally have no downside. In this sense, drivers are rewarded every time they complete a trip involving these actions.
There is a huge variation among existing education and training programmes. Some, more aptly referred to as public information or mass media programmes, involve safety messages conveyed primarily through television, radio, roadway signs, the Internet, and print media (newspapers, brochures, pamphlets). Education programmes often involve direct, face-to-face contact with a specific audience, delivered in lecture format, or interactively, conveying information only, or using fear or other influence techniques in attempts to motivate behaviour change. Some might better be called persuasion programmes; others have used techniques based on theoretical models of behaviour change, or methods to teach skills to resist social influences through role playing, behavioural rehearsal and group discussion.6 Training programmes most typically include driver education for beginning drivers of cars or motorcycles (classroom and on-road), and group sessions designed to rehabilitate problem drivers, or to coach senior drivers on how to compensate for age-related impairments.
Programmes thus range from the simplistic (passive messaging) to the sophisticated, involving interactive methods and theory based persuasion techniques. A major problem in assessing programme effects is that formal evaluations are rare, and competent evaluations based on appropriate research design principles even more so. It is possible to find education programmes that work by themselves. Often these are programmes that communicate health knowledge not previously well known. A classic example is the dramatic shift of children to rear seats in the United States to avoid air bag inflation dangers, largely the result of public information/education efforts. There are, unfortunately, also examples of education programmes that have caused harm. For example, a school based bicyclist education programme in Australia increased crash incidents among 5-14 year olds, probably by inadvertently encouraging risk taking.
In general, even high quality education programmes have rarely worked by themselves in changing individual behaviour. Their contribution has been greater when combined with other prevention efforts as part of broader based programmes, generally at the community level. For example, a multifaceted programme that addressed booster seat use for children included many community elements in addition to education and public information, plus discounts for booster seat purchase. Use rates doubled from 13 to 26%, but this was a demonstration programme limited to one community and was a one-time effort, which greatly limits its effects.
Educational efforts to support laws and law enforcement is a better example of where education can contribute. Laws have been an essential component of efforts to encourage safe behaviour and discourage unsafe actions on the roads. Most of the demonstrable gains in changing individual behaviour in ways that will reduce motor vehicle related injuries in the United States and elsewhere have come through federal or state laws and their application. And, once in place, laws have permanent effects on a broad populace, unlike educational programmes that are often short-term efforts in one locale.
Seat belt use provides a good example of the interplay between education, laws, and the combination of the two in maximizing law related effects. Seat belt use is of obvious importance since belts are highly effective in preventing deaths and serious injuries. However, voluntary belt use rates are typically low and attempts to convince people to use belts through education and persuasion programmes have had little success. One exception was an intensive public information/education programme in Greece, which increased seat belt use, but only from 5% to 10%, at an estimated cost of three million US dollars. This gain was found right after the programme and the likelihood is that it dissipated over time.
In surveys, even most non-users say they think belts are protective and that it is advisable to wear them, yet they did not, often saying that they forgot, or were lazy, or were in a hurry. These surface responses may simply mask more basic reasons for non-use, the combination of self-assessment as a skilled driver and minimization of risks thought to be under individual control. It is true, of course, that the likelihood of being in a crash on any one trip is extremely low. In any case, convincing drivers to use belts through educational efforts proved difficult because most already believed they should do so, but did not believe, or did not want to believe they would need them.
In the United States, seat belt laws alone had positive but limited effects. However, when combined with extensive enforcement, publicity about the enforcement, and education about the importance of belt use that provides political and public support for heavy enforcement, dramatic increases in seat belt use have been the result.
Educational programmes for children, generally dealing with walking or cycling behaviour, are available in many countries, and compulsory in some. The concept of educating children about proper road use is generally assumed to be important, a way of providing lifelong societal benefits. It is routinely recommended as a central feature of safety programmes in developing countries where adults have had little experience or instruction in safe travel practices. Children are generally assumed to be more reachable than adults through this route, since they initially lack knowledge about how to manage the roads. Research evidence on this point is, however, scant, as evaluations of programmes are typically not done or are done poorly. In some cases this has led to contradictory findings. For example, Elvik and Vaa7 describe one study of members of a child safety club in Norway that found highly positive results on crashes, whereas a study of a safety club in Sweden reported a 67% increased risk of being injured in traffic. Both studies had methods problems and no conclusions are possible from existing research on child safety clubs.
A review of 14 randomized trials of safety education programmes for child pedestrians found that some programmes could improve children’s knowledge of the road crossing task and can change observed road crossing behaviour.8 However, the authors noted that ‘…there is no evidence supporting the effectiveness of pedestrian education for preventing injuries to children, and inconsistent evidence that it might improve their behaviour, attitudes, and knowledge.’ They concluded that ‘…environmental modification and the enforcement of appropriate speed limits may be more effective strategies to protect children from road traffic.’
In regard to educational programmes addressing cycling behaviour, Elvik and Vaa, summarizing the limited information available, noted that in contrast to street crossing drills, cycling proficiency training teaches more general skills, some of which may be more difficult to apply in everyday cycling. In one skills training programme that was competently evaluated, the programme was not effective in improving safe cycling behaviour, knowledge, or attitudes among grade IV children. As discussed earlier, a bicycle safety programme consisting of safe riding skills, traffic knowledge and skills and basic bicycle mechanics did not reduce subsequent collisions. In fact, 36% of those taking the programme were in crashes compared with 25% of controls.9 The authors speculate that the programme may have inadvertently encouraged risk taking, and note that there is little evidence in the literature that education alone can reduce bicycle crashes and injuries. In general there is very limited evidence that safety education and training of children can provide safety benefits, and there is also the possibility of unintended negative outcomes.
Driver education and training, in particular for beginning drivers, enjoys immense public acceptance and approval. A survey in the United States found that 86% considered driver education courses very important, and only 2% said not important.10 It is reasonable to expect that safety messages and instruction received through driver education can be overwhelmed by ongoing parental, peer, personal, and other social influences that shape driving styles and crash involvement. Several comprehensive international reviews of driver education programmes all come to the conclusion that there is no difference in the crash records of driver education graduates compared with equivalent groups of beginners without formal education and training. The latest review of driver education covered programmes for learner drivers, young/recently licensed drivers, and experienced drivers, concluding that, ‘Overall, the research evidence suggests that most driver education/training contributes little to reductions in accident involvement or crash risk among drivers of all ages and experience groups.’11
Notably, driver education can have a negative effect on safety because virtually all evaluations have found that it encourages earlier licensing, which leads to additional crashes and injuries. Another type of driver education – skid control training using test tracks – has been found to increase rather than reduce crash risk, particularly among young males. It seems likely that the course creates overconfidence, or young people may create extra opportunities to try out these manoeuvres. This is another example of how skills learned through driver education can interact with developmental and lifestyle factors of young people to produce unintended results. There is some evidence from Europe that advanced driver training courses can be modified so as not to have harmful effects, teaching drivers about self-assessment and anticipation of risk, rather than emphasis on skill acquisition. This trend has not happened in the United States, where skill training courses are very popular.
Driver education evaluations have consistently indicated that skill and knowledge are important but not necessarily correlated with safe on-road driving, and in some instances can increase exposure to risk. The limitations of driving skill are illustrated in the landmark DeKalb County study in the United States in which the group that was provided with driver education and training considered to be state of the art scored higher on the Southern California on-road performance test than did those in a control group or a minimum training group. Yet, the highest scorers also had more crashes subsequent to the training. In earlier work, a study of race car drivers who had special advanced training in crash avoidance techniques in order to qualify for off-highway racing had more crashes per driver and per mile than ordinary drivers.
A review of motorcycle programmes concluded that the few evaluations that have been undertaken have generally produced discouraging findings and led many to question the value of formal motorcycle rider education and training as an effective loss reduction measure. A more recent review of the international research also failed to find a link between motorcycle training and crash risk.12 None of the evaluations of older driver improvement courses has found a decrease in subsequent crash risk among participants relative to comparison groups, and this is the case also for drivers with traffic violations on their records that lead to their participation in improvement courses. A meta-analysis of post-license education programmes based on multiple trials of driver improvement programmes for those who had committed traffic offences found no significant reductions in total crashes or injury crashes.
This bleak assessment does not necessarily mean that some combination of education and training will not eventually be found that will change behaviour. However, the current evidence is strong that traditional forms of driver education and training that have been scientifically evaluated have not reduced crashes, and in some cases have increased them.
There is no doubt that great advances have been made in the highway safety field through a public health, or safe systems approach. However, advances that come through engineering/ environmental changes always seem to be accompanied by pleas to get back to the real source of the problem, irresponsible drivers. It is as though we are letting them off the hook by not addressing them directly. Drivers themselves are psychologically primed to think of the motor vehicle crash and injury problem in terms of themselves as the good driver and the ‘other’ driver as the bad actor who must be controlled. The belief that most crashes involve blameworthy behaviour is reinforced by criminal justice systems, by fault based insurance systems, and by newspaper reportage. Newspaper reports have tended to present fatal crashes as dramas, with victims and villains, focusing disproportionately on crashes in which at-fault drivers survived to take the blame.
Driver education for beginning drivers has proven to be particularly popular, despite the overwhelmingly negative evidence and indications that it can be counterproductive. In 2000, the British government launched its road safety plan, which included a large component of driver education. After reviewing the literature the Cochrane Review Group13 unsuccessfully protested this development because of the concern that the government’s road safety strategy included an intervention that would increase teenage road traffic crashes. Skid control training, despite research from Europe and the US that it can have unintended negative effects, is currently very popular in the United States, and training is widely available from police agencies, car manufacturers, and private organizations.
All countries are dealing with the same basic issues – how to reduce crashes and injuries involving primarily motor vehicles, pedestrians, and cyclists. The one difference is that in countries in the early stages of motorization, consideration of how to protect vulnerable road users – pedestrians and cyclists – needs to take centre stage. Much can be learned from countries with longer histories of trying to deal with the highway safety problem, not only in terms of what has worked well, but what has not, and where imbalances in the approach to the problem have been created and sustained. Certainly, countries have learned and borrowed from one another.
In this regard, the United States, no longer a world leader in highway safety progress, has systematically investigated what can be learned from other countries. It was concluded that successful national safety programmes are more distinguished by their management than the particular interventions, and that essential management elements include: a systems perspective that integrates engineering design, traffic control, regulatory enforcement, and public health methods to identify and reduce risks; a plan that specifies goals and milestones, methods, and resource requirements and that constitutes a commitment for which the government agencies responsible for delivery may be held accountable; and regular monitoring to identify problems and measure progress toward goals and ongoing evaluation to determine effectiveness of the actions taken. Good data systems and good research are clearly important in supporting these guidelines.
Most importantly, countries need to keep the role of human behaviour in proper perspective, using education and training programmes to supplement other counter measures, and not going astray by succumbing to what will always be strong efforts to move education/training strategies to the forefront to the exclusion or minimization of more effective measures. Politicians, policy makers, and the general public have placed great emphasis on educational and training approaches. However, as indicated in this paper, their potential for changing individual behaviour is limited. Much greater progress is possible through application of a systems approach emphasizing engineering, environmental, and vehicle design changes.
1. S. Jasanoff, ‘The Political Science of Risk Perception’, Reliability Engineering and System Safety 59, 1998, pp. 91-99.
2. A.F. Williams, N.N. Paek and A.K. Lund, ‘Factors That Drivers Say Motivate Safe Driving Practices’, Journal of Safety Research 26, 1995, pp. 119-124.
3. Teknekron Research, Inc., 1979 Survey of Public Perceptions on Highway Safety. Report no. DOT HS 805 165. National Highway Traffic Safety Administration, Washington DC, 1979.
4. A.F. Williams, ‘The Contribution of Education and Public Information to Reducing Alcohol-impaired Driving’, Alcohol, Drugs and Driving 10, 1994, pp. 197-205.
5. W.P. Davison, ‘The Third-person Effect in Communication’, Public Opinion Quarterly 47, 1983, pp. 1-15.
6. A.F. Williams, ‘Public Information and Education in the Promotion of Highway Safety. National Cooperative Highway Research Program’, Research Results Digest 322. Transportation Research Board, Washington DC, 2007.
7. R. Elvik and T. Vaa, The Handbook of Road Safety Measures. Elsevier, Amsterdam, 2004.
8. O. Duperrex, F. Bunn and I. Roberts, ‘Safety Education of Pedestrians for Injury Prevention: a Systematic Review of Randomized Controlled Trials’, British Medical Journal 324, 2002, pp. 1-5.
9. J.B. Carlin, P. Taylor and T. Nolan, ‘School Based Bicycle Education and Bicycle Injuries in Children: A Case-control Study’, Injury Prevention 4(1), 1998, pp. 22-27.
10. National Highway Traffic Safety Administration, 1995 Customer Satisfaction Survey. US Department of Transportation, Washington DC, 1996.
11. Royal Automobile Club of Victoria, The Effectiveness of Driver Training/Education as a Road Safety Measure. RACV, Victoria, Australia, 2011.
12. K. Kardamanidis, A. Martiniuk, R.Q. Ivers, M.R. Stevenson and K. Thistlehwaite, ‘Motorcycle Rider Training for the Prevention of Road Traffic Crashes’, Cochrane Data Base of Systematic Reviews, Issue 10. Art. No. CD005240. The Cochrane Collection, Devonshire, England, 2010.
13. Cochrane Injuries Group Driver Education Reviewers, ‘Evidence Based Road Safety: The Driver Standards Agency’s Schools Programme’, Lancet 358, 2001, pp. 230-232.