Training the Trainers: A Conversation with Cécile Monteil

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Cécile Monteil, a leading figure in French healthcare simulation, takes center stage in the second episode of SIM Moove, SIMZINE’s French-language podcast. In an insightful conversation with host Fouad Marhar, Monteil delves into the critical importance of training simulation educators and the far-reaching effects of simulation beyond clinical skills. She shares her unconventional journey into the field and her passion for “training the trainers,” emphasizing the need to create emotionally safe learning environments. Monteil also highlights how simulation can enhance team dynamics in healthcare and ultimately improve patient care.

A SIMZINE exclusive based on SIM Moove podcast interview with Dr. Cécile Monteil

In the second episode of SIM Moove, SIMZINE’s French-language healthcare simulation podcast, host Fouad Marhar sits down with Cécile Monteil, a passionate figure of the French simulation community. Their conversation unveils the crucial importance of properly training simulation instructors and the far-reaching impact of simulation beyond clinical skills.

From Innovation to Simulation: An Unexpected Journey

Cécile Monteil’s path to simulation wasn’t a straight line. After completing her medical internship in general medicine, she split her career between clinical practice and healthcare innovation. While working in the pediatric emergency department at Robert Debré Hospital in Paris, she explored various aspects of healthcare innovation through start-ups, media, and consultancy work.

Her entry into simulation was, by her own admission, somewhat serendipitous. Having never experienced simulation during her medical training, she was offered the position of medical director at iLumens, the simulation center at Université Paris Cité. True to her innovative spirit, she embraced the challenge head-on, serving as medical director for five years. Today, while no longer in that role, she continues to train at the facility regularly while also running an in-situ simulation program in her department.

The Importance of Psychological Safety in Simulation

When asked about her particular area of interest in simulation, Monteil’s passion for “training the trainers” becomes immediately apparent. She emphasizes that while simulation is expanding rapidly across France, not all trainers have access to proper training programs. “Being a teacher is not the same as being a caregiver,” she points out, highlighting that without proper training, simulation sessions might not only fail to achieve their educational goals but could potentially “harm learners’ confidence and careers”.

One of the central themes of the discussion is the concept of psychological safety in simulation. Cécile is a strong proponent of creating an emotionally secure environment for learners. She notes that while terms like “psychological safety” and “emotional security” have become buzzwords in recent years, their importance cannot be overstated. “These are not just nice concepts to throw around—they’re essential to effective learning,” she explains. “If learners don’t feel safe to fail, they won’t be able to fully engage in the simulation, and they won’t learn as effectively.”

Cécile recounts a memorable interaction with a surgical trainee during a faculty development session. The trainee initially resisted the idea of avoiding negative feedback during debriefings, equating it to hypocrisy. However, after going through the training, he came to see how focusing on constructive, supportive feedback could yield much better results, both for the learners and the overall learning environment. “At the end of the session, he told me it completely changed the way he approaches teaching, and that was incredibly rewarding to hear.”

In-Situ Simulation: Where Theory Meets Reality

Monteil’s work with in-situ simulation provides a fascinating glimpse into the practical applications of simulation training. In her pediatric emergency department, simulation sessions take place in the actual resuscitation room, providing invaluable insights into real-world challenges. These sessions have led to significant improvements in department organization, from restructuring equipment trolleys to redesigning wall-mounted information panels for better visibility during emergencies.

The beauty of in-situ simulation, according to Dr Monteil, lies in its ability to bridge the gap between controlled center-based training and clinical reality. While time constraints and environmental factors make these sessions more challenging to conduct, they offer unique opportunities to identify and address systemic issues that might otherwise go unnoticed.

Impact Beyond the Simulation Center

One of the most striking aspects of Dr Monteil’s approach is her emphasis on the ripple effects of simulation training. She shares how trained simulation instructors often return to their departments with enhanced communication and listening skills that benefit not only their professional relationships but also their personal lives. “It goes much further than just the simulation session,” Dr Monteil explains. “When you learn to communicate effectively in a high-stress simulation scenario, those skills carry over into other areas of your life,” she says. “I’ve seen it time and again—simulation trainees go back to their teams with a new perspective, and it can change the entire dynamic of the workplace for the better.”

She recounts several powerful examples of this impact, including a surgeon known as “the terror of the operating theatre” who transformed his communication style after learning new techniques through simulation training. Another success story involves the implementation of intraosseous access training, which significantly improved team confidence and performance during real emergencies.

Literary and Professional Influences

Dr Monteil’s approach to simulation education has been shaped by diverse influences. She specifically mentions “Avoiding Medical Errors through Simulation” by Sylvie and Pierre Engel as a transformative text, despite its uninviting cover. The book’s accessible writing style and comprehensive approach helped crystallize many concepts she was already working to implement.

Interestingly, she also credits Marshall Rosenberg’s work on non-violent communication as a crucial influence on her teaching methodology. This combination of medical and communication expertise reflects her holistic approach to simulation education.

Her early mentors, including Laurent Dupic and other colleagues at the simulation center, played crucial roles in shaping her understanding of the field. However, she emphasizes that her current evolution as an educator is increasingly influenced by her learners’ experiences and the practical challenges faced by trainers working with limited resources.

Building A Team

When it comes to developing simulation programs, Dr Monteil emphasizes the critical importance of selecting the right team members. Rather than making choices based on political considerations or seniority, she advocates for selecting individuals based on their personality profiles and genuine interest in teaching. “Not everyone can be a trainer,” she notes, “you need to have an appetite for teaching, and that’s okay.”

She shares her experience of building a simulation team within her department, highlighting the challenges of choosing appropriate candidates. While some suggested opening positions to volunteers, Cécile argues that this approach might not attract the right profiles, as people unfamiliar with simulation might not understand what the role truly entails. Instead, she advocates for carefully selecting individuals who demonstrate the necessary qualities: a natural inclination toward teaching, genuine benevolence, and the ability to create a safe learning environment.

Facing Challenges Head-On

Dr Monteil’s commitment to simulation education is perhaps best exemplified by her “never cancel” policy for simulation sessions. Despite the numerous obstacles that inevitably arise, particularly with in-situ simulation, she maintains a determined attitude: “I’m not leaving this hospital today without having done this simulation session.” This persistence, she argues, is essential for maintaining program momentum and demonstrating the value of simulation training.

A Message to Future Simulation Educators

Dr Monteil concludes with powerful advice for aspiring simulation educators, comparing their role to that of a parent teaching a child to walk. She emphasizes the enormous responsibility that comes with the position – the power to either build or break a caregiver’s confidence – while highlighting the incredible rewards of helping others grow and improve.

Her final message to newcomers in the field is both encouraging and sobering: while the responsibility is significant, the potential impact on healthcare education and patient care makes it all worthwhile. She advises persistence in the face of obstacles and emphasizes the importance of proper training and team selection.

As healthcare simulation continues to evolve, Dr Monteil’s insights offer valuable guidance for both new and experienced simulation educators. Her emphasis on structured training, emotional safety, and the broader impact of simulation education provides a compelling vision for the future of healthcare education. Through her work and advocacy, she demonstrates that simulation is not just a teaching tool but a catalyst for transformative change in healthcare delivery and education.ve. Resources are abundant, and team-based practice is essential for improving patient care quality and safety.”

Full conversation available in French on SIM Moove

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