CHONG JIA EN, LYNELLE

Executive Summary/Abstract

We were posted to Changi General Hospital (CGH) for WOW!, an attachment program. The department that we were specifically under was the Civil Aviation Medical Centre (CAMC) that was recently established in CGH as of June 2019. It is the first aviation medical centre to be established in a government restructured hospital, and aims to provide medical services to support aviation personnel in anticipation of future traffic growth.

The provision of these medical services to aviation professionals used to be mainly located at Raffles Medical Group in Changi Airport, but it was recently relocated to the Integrated Building of Changi General Hospital.

Since the workload and pressure aviation professionals have to face are extremely high, the CAMC exists to ensure that all working aviation professionals are sufficiently healthy, both mentally and physically, to be responsible for hundreds of lives and carry out their job competently.

Background Information oN the Organisation

The CGH Campus’ vision is to focus on promoting holistic, patient-centred care for the people of eastern Singapore. It achieves this through integrated and innovative facilities that enable the delivery of seamless, high-quality healthcare services. Under this vision, CGH has added two new facilities – The Integrated Building and the Medical Centre. Opened in December 2014, the Integrated Building provides a conducive healing environment for patients across hospital and rehabilitation settings, including the eventual transition of patients back to their homes.

The Medical Centre houses a variety of outpatient centres, with more than 130 consultation rooms for specialist outpatient care and minor surgery rooms. It is designed to enable multi-disciplinary consultation and facilities integrated specialist outpatient care.

CGH believes in delivering the best patient care with passion and empathy. To improve care for patients, CGH has adopted a proactive integrated care approach. CGH aims to deliver better, seamless and Integrated Medical services by partnering healthcare providers in the east and innovating by adopting new medical technologies and systems.

Background Information oN the Project

The project is a research study on pilots and air traffic control officers’ patient experiences with the health screening in CAMC to better improve the medical services provided in CAMC, as well as find out their perceptions of health in relation to their job. Since the CAMC was only established recently, and there were some changes to the health screening aviation professionals have to go through, this study was aimed at finding out some of the possible concerns the aviation professionals might have towards the medical examination procedure and the CAMC, and discover potential areas of improvement for the clinic. This gathering of information was done via interviews with both pilots and air traffic officers, as well as the clinic staff (the doctors, clinic assistants and counter staff).

Elaboration of activities done

2) Online Research

We then did some research on pilots, air traffic controllers and the designated medical examiners. By finding out exactly what the jobs of pilots and air traffic controllers (ATCs) entail, we were able to better understand some of the struggles these aviation professionals faced, and learn about the importance of the medical examination. We also learnt more about them in hopes of being able to engage in small talk during the interview, since small talk would allow them to open up, and we would then be able to draw more information out of them. However, to better understand the relationship between the medical examiners and the aviation professionals, we also did research on the medical examiners. The whole research process gave us a deeper and much clearer understanding of the issue this project was on, and it also helped us come up with some interview questions.

3) Crafting of Interview Questions

Next, we came up with the interview questions. The drafting of interview questions was a much longer process compared to the two steps above. We would come up with questions, and get them vetted by our mentor, Dr Mok. Based on Dr Mok's feedback, we would then modify our questions, or include some questions that he himself came up with. After interview sessions, we would also come up with new interview questions we would like to include, and the previous process would then be repeated. The biggest challenge in the drafting of interview questions was being tactful. I had in mind what I wanted to find out from the aviation professionals, but it was difficult to phrase it in a way that was not too blunt or offensive. Instead of asking it in one question, we sometimes had to phrase questions in a way that would naturally lead up to the question we wanted to ask.

4) Interviewing of Aviation Personnel

The most important step was to interview the aviation professionals. Our group has 3 people, so we had planned to interview them in pairs, with one asking the questions, and the other writing down everything the interviewee had said. During the interview, we had to remember to maintain eye contact, smile to look friendly and frequently nod our heads to show the interviewee that we were paying attention. The whole process went quite smoothly during the first two sessions because Dr Mok would first brief the aviation professionals before sending them to us. But the session after that was extremely busy, and we had to approach them ourselves. It was the nervousness and fear of being rejected that made it extremely difficult to walk up to them. Since there were so many pilots present in the clinic during the third interview session, we also had to split up, and sometimes we ended up interviewing one person each. It was quite stressful to have to write while asking the questions while having to be friendly to the interviewee.

5) Observing of Medical Examination Procedure

We also observed the medical examination procedure and took down notes. This was to verify some of the claims the interviewees made and to see for ourselves the whole process of the medical check-up. We sat in for all the tests for the eye, ECG and the taking of blood.

Deliverables

We gave a presentation on the findings of our interviews, as well as our experiences in carrying out the interviews.

3 Content Knowledge/ Skills Learnt

1) Knowledge about the field of aviation medicine

I learnt a lot of content specific to the field of aviation medicine. From the research we conducted, I found out about the medical tests pilots and ATCs have to undergo respectively, the frequency in which they have to come for these check-ups for the renewal of their license. Through our interviews, I heard a lot from the experiences the aviation personnel shared with me, and gained a deeper insight into their jobs as well as their perception of various issues (medical check-up, mental health etc.) I also found out the requirements needed to become a Designated Medical Examiner, tried out some of the tests for myself, as well as observe the whole process. Based on what the doctors shared with me, I was also able to understand the medical examinations from the doctor's point of view. Since we were able to see the medical examination from both sides (the medical examiners and the clients/applicants), I felt like we gained a more objective viewpoint of the whole process, and were able to validate/ question the validity of some of the opinions we heard from both parties.

2) Interview Skills

The crux of this project was to interview the aviation personnel, and I feel that all the interview sessions we went through really brushed up my skills as an interviewer. I first learnt how to craft interview questions based on what the CAMC wanted to find out, and the whole process really trained me to remain tactful in my questions while being able to achieve my objective of drawing out the needed information. During the interview process, rather than an interview, I learnt how to change it so that the interview was more like a conversation. Engaging in small talk to make them open up, nodding frequently to show that I was paying attention, and also giving adequate reactions to show interest, helped to prevent the interview from becoming a one-sided conversation, as the interviewee would continue speaking. I discovered that there was a lot more to interviewing other than reading off the questions we crafted and writing down notes. A lot of the interviewing process was about flexibility, and it also trained my listening skills. I had to listen to their answers, and ask questions aside from the ones that we crafted beforehand to lead the interviewee to reveal more information. Interviewing was also about being brave, overcoming the fear of rejection and being "shameless" in a way. Some interviewees would be really unwilling to talk, so I really had to be "shameless" in asking them to elaborate, taking the initiative to ask more questions, and prompting them to talk more. Keeping a smile on my face and acting friendly could also be quite difficult when the interviewee was really not keen to talk, but I learnt to carry forward despite their attitude towards me.

3) Being Proactive

Our external mentors were all quite busy, so rather than laying back and waiting for instructions like we were used to, it was more of us taking charge of our own activities during the day, and checking with them if the plans we had in mind were alright. Throughout the one month of job attachment at CGH, we had to frequently take the initiative to reach out to the external mentors. Aside from our scheduled days off, we were allowed to take charge of setting our own schedule, deciding when the interview sessions would be, and when we wanted the work to be done by. We also took the initiative to conduct research on whatever we were curious or lacking in knowledge on relating to our project, relying on ourselves to fill in the blanks in our minds. Other than being proactive, we also learnt to be independent, where aside from the daily regrouping and reporting back of information, a lot of our work done throughout the day was finished with little guidance from the external mentors.

2 Interesting Aspects of my learning

1) What was really interesting to me was the relationship between the aviation personnel and the designated medical examiners. Their relationship was not the regular patient-doctor relationship, as the aviation personnel were not there because they were sick and needed help, and rather than gaining benefits, some would even see it as a potential obstacle in their career because the results of the medical examination would determine whether or not they could continue working. From what I observed, the doctors genuinely wanted to best for their clients, but felt as if the aviation personnel saw them as trying to nitpick on their health, and pose difficulties for their career. In this situation where the doctors feel that they might not be appreciated for the services they provide and the job that they do, they still continue on with a heart that wishes for the best for their client. On the other hand, some of the aviation personnel were cautious towards their medical examiners, I assume especially during the consultation, where both parties would engage in small talk. In my eyes, I see their whole relationship as somewhat awkward because the interests of both parties might collide. However, from what I have heard from some pilots, some are able to recognise and appreciate that these medical check-ups are a form of personal insight to their health. Since the project allowed us to interview both sides, I felt that we were able to understand both perspectives and were given a more objective point of view, and we would be able to see some things that either sides might not be able to see or understand about each other. For the medical examiners, I hope they realize that some pilots do appreciate the medical services they are providing, that some pilots are grateful for the job the doctors do. For the aviation personnel, I hope that they can see that the doctors also want the best for them, rather than viewing the doctors as trying to pose difficulties for their career.

2) Another interesting point in my learning was the various insights I got from listening to different people throughout the whole job attachment process. During this one month, I have listened to the experiences of people that come from different walks of life. From the different opinions and experiences that they had, to the different ways they carried themselves, seeing and getting to talk to so many various people was quite eye-opening. Listening to the advice they gave based on their life experience was also quite interesting, and I felt as if I got quite some exposure, away from what I was used to. Some of the most memorable things would be a pilot sharing how he learnt to cope with his job causing rifts in his relationships, and a doctor sharing some advice with someone that was looking into pursuing a career in the medical field. The broad range of different opinions people had on issues, or the different attitudes people had towards life was just very refreshing and enlightening.

1 takeaway for life