Diagnostic Assessment and Countermeasure Selection: A Toolbox for Traffic Safety Practitioners (2024)
Chapter: 12 Blank Templates and Worksheets
CHAPTER 12
Blank Templates and Worksheets
This chapter contains blank template versions (Table 35 to Table 40) of tables and figures shown in other chapters. Practitioners can use these tables to perform the diagnostic procedures described in this toolset.
Table 35. A blank template for the Haddon Matrix as shown in Chapter 3, Table 5.
| Factors | ||||||
|---|---|---|---|---|---|---|
| Phases | Human | Vehicle | Physical Environment/Context | Social Environment | User-Mix Considerations | Interactions Between Users |
| Pre-event (Before the crash occurs) Factors that may increase the likelihood of the crash before the crash event |
• | • | • | • | • | • |
| Event (During the crash) Factors that may influence the injury or severity of the crash during the crash event |
• | • | • | • | • | • |
| Post-event (After the crash) Factors that may influence the survivability of the crash after the event |
• | • | • | • | • | • |
Note: This blank template is suitable for identifying factors related to personal attributes, vehicle attributes, and environmental attributes before, during, and after an injury or death to help generate ideas on crash prevention and countermeasure implementation.
Table 36. A blank template from Table 24 in Chapter 11.
| Roadway Schematic | ||||
| Segments | ||||
| Key Driving Tasks | ||||
| Visual Demands and Information Sources | ||||
| Effective Information Modes | ||||
| Vehicle-Control Demands | ||||
| Primary Speed Influences | ||||
Note: This template is suitable for documenting route information during the Collect Roadway Section Data process (section 11.3.1 in Chapter 11) and the Task Decomposition—Identify Segments process (section 11.3.5 in Chapter 11).
Table 37. A blank template version of Table 27 in Chapter 11.
| Task: | Workload Estimate (e.g., Table 20) | Process (Perceptual, Cognitive, Psychomotor) | Supplementary Notes |
| Subtask: | |||
| Subtask: | |||
| Subtask: | |||
| Subtask: |
Note: During the Task Decomposition—Identify Tasks and Subtasks process (section 11.3.6 in Chapter 11), this template is suitable for identifying tasks and subtasks.
Table 38. A blank template version of Figure 106 in Chapter 11.
| Segment | Task | Summed Workload Ratings for Perceptual Subtasks | Summed Workload Ratings for Cognitive Subtasks | Summed Workload Ratings for Psychomotor Subtasks | Time Interval 1 | Time Interval 2 | Time Interval 3 | Time Interval 4 |
| 1. | 1.1 | |||||||
| 1.2 | ||||||||
| 1.3 | ||||||||
| 1.4 | ||||||||
| 1.5 |
Note: This template is suitable for calculating summed workload ratings across workload type during the Assign Workload Values process (section 11.3.7 in Chapter 11) and for documenting forced- and self-paced tasks within segment time intervals during the Augment the Task Analysis with Additional Information process (section 11.3.8 in Chapter 11).
Table 39. A blank template version of Figure 107 in Chapter 11.
| 1. Segment Name | Interval 1 | Interval 2 | Interval 3 | Interval 4 |
| Total relative perceptual workload for Segment 1 |
Note: During the Assign Workload Values process (section 11.3.7 in Chapter 11), this template is suitable for calculating summed workload ratings within segment time intervals.
Table 40. A blank template version of Figure 108 in Chapter 11.
| Segment | Time interval | Summed Workload Ratings for Concurrent Perceptual Tasks | Summed Workload Ratings for Concurrent Cognitive Tasks | Summed Workload Ratings for Concurrent Psychomotor Tasks | Summed Workload Ratings for All Concurrent Tasks |
| 1. | 1 | ||||
| 2 | |||||
| 3 | |||||
| 4 |
Note: During the Assign Workload Values process (section 11.3.7 in Chapter 11), this template is suitable for documenting the summed workload ratings for each workload type within each segment time interval.
