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Brittany Brennan, assistant professor in ºù«Ӱҵ's College of Nursing, will use her research grant to investigate how prebriefing for computer-based simulation impacts mental workload and student outcomes in nursing education.

ºù«Ӱҵ is a nationally recognized leader in the field of health care simulation.

That statement was reaffirmed at the 2025 International Meeting on Simulation Healthcare this past January. Brittany Brennan, assistant professor in the College of Nursing, received the Society for Simulation in Healthcare's Early Career Mentored Research Award, which recognizes "outstanding early-career researchers who are making meaningful contributions to the field of health care simulation."

Health care simulation allows future nurses to become competent in their skills, practice, teamwork and communication in a safe and realistic environment. Simulation scenarios allow students the opportunity to train for their future careers before stepping into a clinical environment. For the past 25 years, SDSU has been training future nurses through its Healthcare Simulation Center and has been leading research to improve simulation education.

Brennan will use her $10,000 grant award from the Society for Simulation in Healthcare to optimize and improve computer-based simulations, a new frontier in health care simulations, with state-of-the-art eye-tracking technology. 

"This unique biosensor technology captures visual data such as eye movements, fixation points and pupil dilation," Brennan said. "These physiological responses serve as objective indicators of cognitive load, helping us understand how much mental effort a student is using during a simulation."

Brennan is collaborating with Phuong Nguyen, assistant professor in SDSU's Jerome J. Lohr College of Engineering, to conduct the project.

Tobii, a technology company headquartered in Sweden, has been developing eye-tracking technology for more than 20 years. After having delivered the first remote eye tracker, it has now developed an affordable and technologically feasible eye tracker that can be easily attached to computer monitors. This tool is now making its way into many different research fields, and the collaborative SDSU project will be one of the first times eye tracking will be used in health care simulation education and research — a field in which SDSU's College of Nursing is a nationally recognized leader.

The key to Tobii's eye-tracking technology are sensors and cameras that measure where someone is looking, also known as the "point of gaze." The cameras in the monitor detect eye movements which reveal a range of signals including scan patterns, blinks and pupil dilation. The eye tracker uses a processor and algorithms to convert these signals into data that researchers, like Nguyen, analyze to reveal insights into decision-making, fatigue, attention and memory.

In this project, Tobii's eye tracker will be attached to computer monitors used for screen-based simulation education. Nursing students will experience the screen-based program, and the eye tracker will capture data from the students. After data has been collected from the program’s trial period, the data will be analyzed by Nguyen, a faculty member in the Department of Construction and Concrete Industry Management, to see where the challenges, or the difficult parts of the program, lie.

"With these factors, we can determine how hard the task was for the student," Nguyen explained. "We can determine the cognitive load for the screen-based simulation as well."

The data will allow Brennan to identify prebriefing strategies that help students who may be overwhelmed or disengaged, and support them in achieving optimal focus during simulation-based learning. Prebriefing, a structured orientation and preparation that takes place before a simulation, prepares students for the scenario they are about to participate in.

"Prebriefing helps participants feel psychologically safe to learn and better prepared to participate," Brennan said. "We are specifically exploring whether high-quality prebriefing reduces cognitive load, which is the amount of mental effort required to process and apply information during complex tasks like clinical decision-making."

The project has the potential to significantly improve how simulation is used in health care education, Brennan says.

"By identifying whether prebriefing effectively reduces cognitive load, we can inform best practices for preparing students before simulation-based training," Brennan said. "This will help educators design more supportive learning environments that boost student performance and confidence — critical factors in developing safe, competent health care professionals."