A National Role Delineation Study of FMCSA Medical Examiners

National Registry of Certified Medical Examiners Federal Motor Carrier Safety Administration

A National Role Delineation Study of

FMCSA Medical Examiners

August 2007

Conducted for the U.S. Department of Transportation Federal Motor Carrier Safety Administration

Prepared by

Axiom Resource Management, Inc.

The National Registry: A Roadmap to Improved Highway Safety

TABLE OF CONTENTS

Page Executive Summary ......................................................................................................................7

Introduction Background .....................................................................................................................15 The Role Delineation Study ............................................................................................16

Methodology The Task List...................................................................................................................17 Literature Review ............................................................................................................17 Working Integrated Product Team ..................................................................................18 Direct Observations Overview ...................................................................................................................19 Interview Questions and Responses .........................................................................20 Observed Tasks ........................................................................................................24 Regional Brainstorming Sessions ...................................................................................37 Task List Development and Revisions.............................................................................39 Working Integrated Product Team Survey Development ................................................39 Sample Selection .............................................................................................................40

Results Returned Surveys ............................................................................................................43 Task Rating Reliabilities ..................................................................................................45 Task List Adequacy .........................................................................................................46 Demographic Analyses....................................................................................................47 Evaluation of Sampling Bias Comparisons of Opt-In and Opt-Out Samples ..........................................................57 Analyses of Professional Networks ...........................................................................58 Task Criticality Analyses ..................................................................................................59 Development of Testing and Training Content Detailed Test Content Outline ...................................................................................63 Knowledge, Skills, and Abilities Statements..............................................................66 Study Limitations .............................................................................................................67

Conclusions................................................................................................................................. 69 References .................................................................................................................................. 71

LIST OF TABLES Page

Table 1. Working Integrated Product Team Members.............................................................18 Table 2. Examiner Responses to Interview Questions............................................................22 Table 3. Draft Task List after the Literature Review and Observations ...................................25 Table 4. List of Participants in Regional Brainstorming Meetings ...........................................38 Table 5. Resent Survey Log ....................................................................................................42 Table 6. Reliability Estimates for Task and Respondent Importance Ratings.........................45 Table 7. Breakdown of Responses Regarding Race/Ethnicity ................................................56 Table 8. Summary of Mean Task Importance Ratings ............................................................60 Table 9. Summary of Subgroup Exclusion Rules ...............................................................61-62 Table 10. Summary of Respondent Content-Weighting Preferences........................................65 Table 11. Test Specifications ...............................................................................................65-66

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LIST OF FIGURES

Page Figure 1. Relationship Between Sample Size and Error...........................................................43 Figure 2. Task List Adequacy ...................................................................................................46 Figure 3. Breakdown of Respondent Professions ....................................................................48 Figure 4. Breakdown of Respondent Experience in Current Profession ..................................48 Figure 5. Breakdown of Respondent Primary Job Functions ...................................................49 Figure 6. Breakdown of Respondent Healthcare Environments...............................................49 Figure 7. Percentage of Respondents Who Primarily Work in Occupational Health ................50 Figure 8. Percentage of Respondents Trained in Occupational Health....................................50 Figure 9. Percentage of Respondents Trained to Conduct CMV Driver Physical

Examinations .............................................................................................................51 Figure 10. Organizations Reported to have Provided CMV Driver Physical

Examination Training.................................................................................................51 Figure 11. General References Used by Respondents ..............................................................52 Figure 12. FMCSA References Used by Respondents ..............................................................52 Figure 13. Average Monthly Physical Examinations...................................................................53 Figure 14. Experience Performing CMV Driver Physical Examinations .....................................53 Figure 15. Communities in Which Respondents Practiced.........................................................54 Figure 16. Breakdown of Respondent Geographic Regions ......................................................54 Figure 17. Breakdown of Respondent Ages ...............................................................................55 Figure 18. Breakdown of Respondent Genders .........................................................................55

Appendix A B C D E F G H I J

K L M

N

O

TABLE OF APPENDICES

Title

Page

Task List Recommendations and Revisions from Regional Brainstorming Meetings....................................................................... A1

Role Delineation Survey ..................................................................................... B1

Opt-In Postcard, Survey Warning Postcard, and Follow-Up Survey................... C1

Background Information Frequency Tables for the Full Survey Sample............. D1

Background Information Frequency Tables for the Follow-Up Survey Sample................................................................................................................ E1

Comparisons Between Respondents to the Full and Follow-Up Surveys ...........F1

Extent Analysis ? Percentages in Ascending Order for the Whole Sample of Respondents Performing Each Task (Data for Exclusion Rule 1) .................. G1

Importance Analysis ? Task Mean Importance Ratings in Ascending Order for the Whole Sample (Data for Exclusion Rule 2) ................. H1

Importance Analysis for Population Subgroups ? Task Mean Importance Ratings for Geographic Region Subgroups (Data for Exclusion Rule 3) ..............I1

Importance Analysis for Population Subgroups ? Task Mean Importance Ratings for Profession Subgroups (Data for Exclusion Rule 4) ................................................................................................................. J1

Importance Analysis for Population Subgroups ? Task Mean Importance Ratings for Experience Subgroups (Data for Exclusion Rule 5) ...... K1

Importance Analysis for Population Subgroups ? Task Mean Importance Ratings for Primary Responsibility Subgroups (Data for Exclusion Rule 6).........L1

Importance Analysis for Population Subgroups ? Task Mean Importance Ratings for Occupational Health Training Subgroups (Data for Exclusion Rule 7) ................................................................................................................ M1

Importance Analysis for Population Subgroups ? Task Mean Importance Ratings for Physical Examination Training Subgroups (Data for Exclusion Rule 8) ................................................................................................................ N1

Importance Analysis for Population Subgroups ? Task Mean Importance Ratings for Average Number of Physical Examinations Performed Per Month Subgroups (Data for Exclusion Rule 9) ................................................... O1

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