Wheelchair Skills Test in Simulated Versus Community Settings: a Mixed-Methods Crossover Study of Experienced Motorized Mobility Scooter Users.

Purpose: The Wheelchair Skills Test (WST) is commonly conducted in a simulated setting. Although the WST can be done in the community setting, its usefulness in this setting has not been systematically evaluated. The purpose of this study was to compare the WST in the simulated versus community settings, and to explore participants' perceptions of performing in each environment. Methods: For this mixed-methods study, we studied 20 motorized mobility scooter users who had used their devices for. 3months. Each participant completed the WST Version 4.3 twice in random order once in a simulated setting and once in their community within a two-week period. Semi-structured interviews were conducted after completion of the WST in both environments. A self-report version of the WST (WST-Q) was also completed that measured perceived capacity, frequency of skill performance, and confidence. Results: The mean (SD) total WST score in the simulated setting was 88.9% (8.6) and 92.7% (7.8) in the community setting. The two WST scores were moderately correlated (r = 0.306, p = 0.190). Community-setting WST scores were moderately correlated with WST-Q confidence scores. Simulated-setting scores were moderately correlated with WST-Q frequency scores. Although most participants preferred performing the WST in their communities due to convenience and familiarity, they perceived the simulated setting to be reflective of their community settings. Conclusion: Despite challenges, community-based testing may provide a better reflection of everyday performance for scooter users than testing in a simulated environment.