Driving after brain injury: Self-awareness and coping at the tactical level of control

Objective: To study whether metacognition is a prerequisite for coping at the tactical level of driving. Research design: A consecutive series of 30 drivers with acquired brain injury were assessed concerning cognitive functions and driving performance. In addition the drivers assessed their driving performance through self-rating. Results: On average the drivers had cognitive impairments compared to a healthy reference group. The group that passed the driving test and the group that failed the driving test did not differ in terms of cognitive functions. Neither did they differ in their self-ratings of driving performance. However, the group that failed the driving test significantly over- estimated their performances as compared to the assessments made by the professional driving inspector, while the group that passed the test made more accurate self- ratings. Conclusions: One interpretation of these results is that the group that made a more realistic evaluation of their driving performance were more aware of their cognitive capacity compared to those who failed the driving test. They seemed to have a better ability to adjust their driving behaviour at a tactical level. Thus, the subject's metacognition, awareness of his/ her own cognitive capacity, is important for coping with cognitive impairments at tactical driving.