Form NHTSA Form 1264 NHTSA Form 1264 Postt Questionnaire

OMB Control No. 2127-New Expiration Date xx-xx-xxxx

Draft Post-experiment Questionnaire

Thank you very much for participating in our driving experiment. We would like to ask you a few questions. Your privacy is protected because your name will not appear on this questionnaire. (Note: This questionnaire will be administered orally with the subject still sitting in the driver’s seat and continuous audio recording. The experimenter may also use a small hand-held video camera to document problematic movements of the gear-selector as described by the subject in this de-briefing.)

A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-NEW. Public reporting for this collection of information is estimated to be approximately 90 minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Avenue SE, W51-316, Washington, DC, 20590.

Subject number: (entered by experimenter to link this questionnaire to eligibility responses for the same subject).
		DISCRETE RESPONSES TO BE CODED	INSTRUCTIONS TO EXPERIMENTER
9.	Which gear selector did you drive?	1=Conventional Console 2=Gated Console 3=Simple Joystick 4=Multifunction Joystick 5=Push Button 6=Rotary Knob	Confirm the answer to eligibility questionnaire question #6, make/model/year of the car respondent drives most frequently (baseline selector)
10.	How many driving simulations did you complete with this particular gear selector?
11.	Compared with the gear selector in the vehicle you drive most frequently, how would you rate the level of difficulty using this type of gear selector?	1=Much easier 2=Somewhat easier 3=About the same 4=Somewhat difficult 5=Much more difficult	Probe for explanation of difference, if any:
12.	Compared with the gear selector in the vehicle you drive most frequently, did this gear selector influence your way of driving?	1= About the same 2=Slight influence 3= Much influence	Probe for explanation of difference, if any:
13.	Do you now feel confident that you know how to use this gear selector?	1= Quite confident 2=Somewhat uncertain 3= Still confused	If other than Quite confident, demonstrate correct shifter movements, allow participant to try them, and probe to determine if subject understands.
14.	Please provide your opinion of the following statement: The simulation provided a realistic impression of routine driving conditions.	1=Strongly agree 2=Agree 3=Neutral 4=Disagree 5=Strongly disagree	Probe for explanation if response was Disagree or Strongly Disagree.
15.	Please provide your opinion of the following statement: The simulation provided a realistic impression of emergency driving conditions.	1=Strongly agree 2=Agree 3=Neutral 4=Disagree 5=Strongly disagree	Probe for explanation if response was Disagree or Strongly Disagree.
16.	Aside from the unintended acceleration, did the vehicle handle as you expected?	1=Very predictable 2=Somewhat predictable 3=Neutral 4=Somewhat unpredictable 5=Very unpredictable	Probe for explanation if response was Somewhat or Very Unpredictable.
17.	How would you describe your ability to accurately anticipate the vehicle response when shifting?	1=Very easy 2=Easy 3=Neutral 4=Difficult 5=Very difficult	Probe for explanation if response was other than Neutral.
18.	How would you describe your level of attention during the driving simulation?		Participant’s words verbatim.
19.	What features of this particular gear selector did you like?		Participant’s words verbatim.
20.	What features of this particular gear selector did you dislike?		Participant’s words verbatim.
21.	Would you consider purchasing a vehicle with this type of gear selector?	1=Strongly consider 2=Somewhat consider 3=Cannot decide 4=Unlikely to consider 5=Not at all
22.	If you have any comments or suggestions, please mention below.		Participant’s words verbatim.

NHTSA Form 1264 DRAFT page 2 of 2