Learning to Drive: CHOP Researchers Lead Largest Driver’s Ed Study Since 1983

By Lauren Ingeno

Researchers in the Center for Injury Research and Prevention (CIRP) at Children’s Hospital of Philadelphia have spent more than a decade studying the common crash risks that young drivers face and the skills they need to avoid them.

That’s critical, considering that motor vehicle crashes are a leading cause of death for U.S. teenagers, said Flaura Winston, MD, PhD, Professor of Pediatrics and CIRP founder.

Now, researchers from CHOP and the University of Pennsylvania are enrolling 1,000 teens into the first randomized controlled trial since 1983 to evaluate pre-licensure driver training on crash risk outcomes.

The study, funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, is led by Dr. Winston; Elizabeth Walshe, PhD, CIRP Senior Research Scientist; and Dan Romer, PhD, Research Director of the Annenberg Public Policy Center at Penn and an affiliate research scientist at CIRP.

“It’s not like you are born knowing how to drive — it’s a skill you need to learn,” Dr. Winston said. “We’re putting young people behind thousands of pounds of machinery without the skills to know how to manage it safely.”

The DRIVER study will not only test different types of driver training programs, but it will also measure how other factors — like personality traits, cognitive abilities, and risk-taking behaviors — influence young drivers’ crash risk.

“Ultimately, we want to identify the training that gives teenagers the best chance to have safe, equitable mobility,” Dr. Winston said.  

How Do Teens Learn to Drive?

The only large-scale, rigorous study of driver education to date — called the DeKalb study — was conducted in DeKalb County, Georgia, in 1983.

The DeKalb study showed that driver training led to some reduction in crash risk early in licensure for teenagers, but not over a longer follow-up of one to two years later. The findings suggested that the availability of driver education led students to become licensed sooner, and therefore, crashes and violations happened at an earlier age.

The study results, along with a lack of funding for driver’s education in schools, led many states to eliminate mandated driver education and training for young drivers. Instead, states like Pennsylvania have adopted Graduated Driver Licensing (GDL) laws, which typically apply to adolescents under 18 and restricts initial driving experience to lower risk conditions.

Dr. Walshe says the DeKalb study predated contemporary standards in GDL laws and driver education standards, which limit its applicability to today’s young drivers. Moreover, CIRP research has shown that without supplemental behind-the-wheel training, drivers may enter licensure underprepared and have the highest crash rates. 

“Crash risk is highest in the first few months of licensure, with more than 70 percent of young driver crashes due to three main driver errors: They scan poorly, they go too fast or too slow for road conditions, and they don’t keep their eyes on the road,” said Dr. Walshe, an incoming Professor of Pediatrics who leads of the Neuroscience of Driving research program at CIRP.   “We believe those are trainable skills.”

To test the hypothesis that proper training can reduce crash risk for younger teen drivers, Dr. Walshe and colleagues partnered with the state of Ohio. For drivers under 18, the state requires GDL, in addition to mandated behind-the-wheel training with a professional instructor before licensure. The researchers found that those licensed under 18 experienced lower crash rates, higher licensing exam pass rates, and safer performance on a validated virtual driving assessment than those licensed at 18 who did not receive professional training.

“In Ohio, 16-year-olds had the lowest crash rates, despite being the youngest new drivers,” Dr. Walshe said. “We think this is because they were required to complete such rigorous behind-the-wheel training. But since we were only looking at age-based trends, we couldn’t definitively say that it was the training that made the difference.”

The DRIVER Study

The DRIVER study in Pennsylvania will build on the team’s initial findings in Ohio by testing different driver training interventions for reducing crashes early in licensure, when accident risk is highest.

A diverse sample of 1,000 participants will be recruited from multiple CHOP Primary Care practices in urban, suburban, and rural locations throughout the Greater Philadelphia region. They will receive either free online driver training or free behind-the-wheel driver lessons by a certified driving instructor. 

Each study participant will take a virtual driving assessment (VDA) at the beginning of the study and after they receive their license. Developed and validated at CHOP, the VDA exposes drivers to common crash scenarios to measure their ability to drive safely and avoid crashes.  

Participants’ driving will be monitored with a smartphone app for up to six months after licensure. The app, provided by Penn, uses telematics to monitor crash-risk behavior during driving trips. Participants also will complete in-clinic and follow-up surveys of driving experience, behaviors, and personality traits, as well as computer-based assessments to measure cognitive abilities.

“Driving is a rich, complex behavior to learn as a teenager, at a time when you’re still developing these cognitive skills,” Dr. Walshe said. “So, we’re going to better understand the role of cognitive development in learning to drive. The next step would be getting to understand the individual characteristics of those teens for whom the training we are testing may be insufficient, and how to overcome those characteristics.” 

Having this information available could one day lead to a precision medicine approach to driver’s education, in which training and other interventions are tailored to each individual student, Dr. Romer said.

“The first time you do something, you’re more prone to make mistakes, and that’s how you learn,” Dr. Romer said “But we don’t want teenagers getting into crashes to learn. We want them to learn in a safe environment before going on the road by themselves. If they can do that, it’s a plus for all of us.”