From Airplanes to Ophthalmology: Three aviation lessons every healthcare worker should know

Hi, Orbis Community!

I’m Dr. Dominique Salh. Before earning my MD, I obtained a private pilot’s license. Since completing medical school, I’ve embarked on my journey toward a career in ophthalmology and am now in my first year of residency at McGill University in Montreal, Canada.

As healthcare providers, we strive to maintain a delicate balance of discipline, compassion, skill, and advocacy, all while acknowledging the constraints of our system—and, of course, our own limitations. This balance allows us to prioritize our patients’ outcomes and safety.

Similarly, in aviation, the concept of balancing skill and safety is thoroughly explored throughout pilot training. In this post, I’ll share key lessons from aviation that I believe every healthcare provider should consider.

Pilot decision-making is a fundamental component of the Canadian pilot training curriculum, particularly in "Ground School," which involves didactic, classroom instruction that student pilots must attend. Decision-making is also emphasized both inside and outside the airplane — during pre-flight briefings, flight hours, and simulation training. Finally, decision-making competency is assessed in both theory and practice through the written Transport Canada exam (PPAER) and the final practical "check ride.”

Although the types of decisions made by healthcare workers and pilots may differ, both fields benefit from a structured approach that encourages learners to synthesize critical information before making decisions. I believe that any professional responsible for significant decisions in their career should receive formal training in decision-making.

Currently, no consistent curriculum exists for medical learners in Canada. Therefore, I will share some aviation models as a starting point. Two of my favourite decision-making approaches in aviation are the DECIDE model and the 3 P’s. With minor adjustments to their original formats, I believe these models could be effectively adapted to the healthcare setting.

My favourite aviation risk management mnemonic is the IM SAFE checklist, which is familiar to every Canadian-trained pilot. This checklist is often the first risk assessment a pilot performs before a flight and can be revisited multiple times leading up to the flight, if necessary. Healthcare providers—particularly those performing complex procedures and surgeries—should consider the “IM SAFE” checkpoints before beginning their work.

However, the importance of these risk-mitigating practices is not always explicitly discussed with medical learners. Take a moment to reflect on whether you have failed to recognize one of these points before going to work or school in a healthcare role.

Another valuable risk management tool I’d like to share is establishing a routine. Performing the steps of a task in the same order each time significantly reduces the likelihood of error. I can’t stress enough how important routine is to risk management.

Competency based learning is new to the medical field, being largely implemented at the post graduate medical education level. It describes the sequential progression through learning objectives, wherein the learner must first demonstrate competency in a primary skill, based on a predetermined standard, before progressing to more advanced skills.

Medical professionals may not realize that the aviation field relied on competency-based frameworks long before the Canadian medical education system. In Competency Based Training and Assessment (CBTA), a learner’s areas for improvement are discussed openly and non-judgmentally to support growth and tailor the educational experience.

Personalized curriculums may be challenging to implement in a hospital setting, but all patients would benefit from professionals who communicate well and regularly solicit constructive feedback. I believe aviation’s success with CBTA stems from the equal commitment and buy-in from both students and instructors. Without the ongoing input from instructors and examiners, CBTA for student pilots would not be possible. In the medical field, we must work towards ensuring that both learners and educators are consistently invested in learner development.

In conclusion, as healthcare providers we are so lucky to be involved in the work we do for our patients. Collectively, we should take all steps to continue to improve patient care where possible. These are three ideas I had, but I encourage you to reflect on the subject too. Until next time… Happy skies.