7th Pacific Rim Conference Abstracts 2–5 July 2025, Brisbane, Australia

Background and Objectives: Online awareness of performance is an important component of self-awareness that can impact rehabilitation outcomes.Online awareness, or the ability to detect errors and monitor performance during activities, is essential for cognitive strategy application and to promote safety and independence in the community.Robust methods to assess online awareness are required for adults with neurological conditions.The aim of this study was to make recommendations for a clinically useful method to assess online awareness in adult neurological rehabilitation. Method:This co-design study comprised three phases: (1) a conceptual analysis to define online awareness and identify existing assessment approaches for individuals with neurological conditions; (2) three rounds of Delphi surveys involving an international interdisciplinary expert panel to develop an online awareness assessment; and (3) pilot testing of the assessment in a neurological rehabilitation setting.Data were analysed using thematic analysis, descriptive statistics and content analysis. Results:The conceptual analysis generated an online awareness definition framework that included four key elements: appraisal, anticipation/prediction, monitoring, and self-evaluation.The analysis identified a lack of online awareness assessments.The Delphi process involved n = 24 expert clinicians, researchers and academics whose diverse perspectives supported development of the 'Online Awareness Behaviours Scale'.Across the three Delphi rounds there was considerable deliberation about the assessment content and scoring system.The assessment allows for individualised and patient-centred selection of activities that are relevant to the individual, and provides a structure and scoring system to quantify online awareness behaviours.In the pilot testing, feedback from 12 consumers indicated high levels of usability and acceptability and resulted in minor revisions to the assessment. Conclusions:The Online Awareness Behaviours Scale is a new clinically useful tool for rehabilitation clinicians that provides a comprehensive assessment of online awareness for individuals with neurological conditions.This new assessment advances current practices in cognitive rehabilitation and promotes development of targeted treatment plans.