#3 In Scientific Dialogue With...Dr Brennen Mills - Senior Lecturer and Researcher in the School of Medical & Health Sciences (SMHS) at Edith Cowan University (ECU)

Welcome to In Scientific Dialogue With. The Women and Infants Research Foundation’s (WIRF's) podcast series celebrating the pioneers shaping the future of women’s, maternal and newborn health.

This series spotlights incredible individuals driving innovation – medical researchers, clinicians, nurses, midwives, and professionals in allied health.

Each episode’s guest will discuss their innovative work and how it may transform maternal care and clinical practices from improving preterm birth outcomes to maternal mental health, gynaecology, and more.

So, sit back and join us for In Scientific Dialogue With.

--------------------------------------------------------------------------------------------------------------------

Welcome to Episode 3 of In Scientific Dialogue With...

I’m your host Vicki Main and in this episode we speak with Dr Brennen Mills who is a Senior Lecturer and active researcher in the School of Medical & Health Sciences (SMHS) and Leads the Simulation & Immersive Digital Technology Group (SIDTG) at Edith Cowan University (ECU) in Western Australia. 

Dr Mills’ background is in the development and evaluation of innovative technologies and high-fidelity simulation-based learning environments for education and training, with a focus on resilience building and enhancing preparedness in pressurised settings. This includes the development and evaluation of novel pathways for digital, augmented and virtual reality technology. 

Welcome, Dr. Brennen Mills

Transcript

Vicki Main (Speaker 1) – 0:09:
Welcome to In Scientific Dialog with the Women and Infants Research Foundation’s podcast series celebrating the pioneers shaping the future of women’s, maternal, and newborn health. This series spotlights incredible individuals driving innovation—medical researchers, clinicians, nurses, midwives, and other professionals in allied health. Each episode’s guest will discuss their innovative work and help me explore how they’re transforming maternal care and clinical practices—from improving preterm birth outcomes and maternal mental health to advances in gynaecology and beyond.  So sit back and join us In Scientific Dialogue.

Vicki Main – 0:54:
Welcome to Episode 2 of the In Scientific Dialog with WIRF podcast. I’m your host, Vicki Main. In this episode, we speak with Dr. Brennan Mills, a senior lecturer and active researcher in the School of Medical and Health Sciences at Edith Cowan University in Western Australia. He leads the Simulation and Immersive Digital Technology group.
Dr. Mills has a background in developing and evaluating innovative technologies and high-fidelity simulation-based learning environments, with a focus on building resilience and enhancing preparedness in high-pressure settings. This includes cutting-edge work with digital, augmented, and virtual reality.

Dr. Mills, welcome to the show and thank you.
 As someone leading the Simulation and Immersive Digital Technology Group at ECU, what are some of the most exciting projects or developments happening in your lab right now?

Dr. Brennan Mills (Speaker 2) – 1:56:
Yeah, great question. There is some really cool stuff going on. There are a lot of moving parts with the technology now, and AI integration has opened up a lot of doors—especially in gamification and virtual/digital media. Big tech companies like NVIDIA, Google, and Meta are even releasing open-source tools, which is amazing for the rest of us.

One of our biggest projects right now is a half-a-million-dollar grant from the WA Department of Health to develop a de-escalation training tool for healthcare clinicians. Violence in healthcare settings—particularly from aggressive patients—is a serious issue. So we're leveraging AI and VR to build a training tool with a virtual avatar named “Barry”—and Barry is... angry.

You wear a VR headset and talk to Barry. Thanks to AI, he responds to you in real time with novel, emotionally charged reactions. The idea is to train clinicians at scale on how to de-escalate aggressive encounters safely and effectively. It's one of our most innovative projects.

We're also doing some cool work with Defence, around parachute preparedness for special operations forces and terrain visualization. And of course, a lot of our focus is currently on the Neonate VR project thanks to the WIRF grant, which I know we’ll talk about shortly.

Our team is growing—we’ve got 8–10 software developers and researchers, and about 5–6 PhD students across these various projects. So yeah, it’s busy but incredibly rewarding. Seeing this technology actually making a difference is fantastic.

Vicki Main – 5:02:
And that brings us to your WIRF-funded project. In 2023, you received a Research Acceleration Award from the Women and Infants Research Foundation for a highly innovative virtual reality training program. I actually had a demo—it was incredibly realistic! I didn’t deliver a baby, but I did check vital signs and breathing.

Can you talk about the development and objectives of the Neonate in VR program, and how it aims to improve emergency responses in those critical first minutes of life?

Dr. Brennan Mills – 6:01:
Absolutely. The thing with VR is, some people are hesitant to adopt it—they're waiting for it to become a "silver bullet" that does everything. Others jump on it for everything, even when it’s not always appropriate. The truth is, VR has very specific, powerful use cases, and this project is a perfect example.

In the pre-hospital emergency setting, obstetric and neonatal cases are low-frequency but high-risk. Paramedics might only deal with one of these every few years, so it’s hard to justify devoting significant training time to them—especially when they need to stay sharp on cardiac arrests, trauma, etc.

We saw very clearly that paramedics often lack confidence and preparedness when responding to obstetric emergencies. Sometimes, due to stress or inexperience, their default is to rush patients to hospital rather than providing optimal care on scene.

So we thought, if we can’t increase in-person training hours, can we provide scalable, immersive, and targeted training via VR?

We built an early prototype with initial funding from WA Health. It was a huge team effort—including a PhD student—and the result is a simulation where the user assesses a newborn in those vital first minutes: checking breathing, responsiveness, APGAR scores, and more.

Now, thanks to the WIRF grant, we’re moving into a larger-scale rollout with St John Ambulance WA and other partners. We're collecting more validation data to refine and expand it. And interestingly, it’s already being adopted in in-hospital training for midwifery students, so the use cases are growing.

Vicki Main – 11:19:
You’ve raised some really important points. VR clearly has a place in blended learning, especially in high-pressure medical scenarios. Have there been any specific breakthroughs or feedback that highlight the real-world impact of your research so far?

Dr. Brennan Mills – 12:23:
Yes, definitely. There’s a growing body of evidence supporting simulation-based learning, and now the same is happening for digital and VR-based training.

People used to ask, "But is there literature to support this?"—and now the answer is a resounding yes. We’re seeing systematic reviews, meta-analyses, and strong qualitative data showing that immersive tech has a real impact on learning outcomes.

Of course, we’re very rigorous in evaluation. The worst-case scenario for us is spending public money to build a tool that end users don’t like or find useful. So everything we do is co-designed with frontline clinicians. We listen. We test. We iterate.

And that’s where we've seen impact—especially in high-stakes environments where traditional simulation is expensive and logistically difficult. For example, our VR mass casualty training for paramedics allowed us to simulate things like plane crashes without needing dozens of actors and props.

We’re careful not to misuse VR—if a learning objective doesn’t benefit from being immersive, we don’t force it. But when it fits, like in neonatal or de-escalation training, the results are compelling.

Vicki Main – 17:14:
In your work, you also focus on building resilience in healthcare professionals. How does that impact both their competence and their confidence in real-world scenarios?

Dr. Brennan Mills – 17:28:
That’s such an important point. Confidence and preparedness are tightly linked. We’ve all faced situations—like public speaking—where stress comes from feeling unprepared.

In healthcare, especially in emergencies, being underprepared can cause real harm—not just to the patient, but to the clinician’s mental health. We’re seeing high rates of burnout and attrition, especially post-COVID. Training that builds confidence can genuinely help mitigate that.

In VR, you can rehearse rare scenarios until your response becomes second nature. You reduce the anxiety that comes with uncertainty. That’s incredibly powerful. We've published studies where paramedics—some very experienced—say they feel dread when dispatched to a maternity case. They don’t feel equipped.

If we can give them better tools—training that’s accessible, immersive, and meaningful—then we’re not just improving care, we're also protecting our healthcare workers.

Vicki Main – 21:16:
You’ve worked with a range of professionals—doctors, nurses, midwives, paramedics. What’s been their reaction to this training? And have you seen any measurable improvements in clinical outcomes?

Dr. Brennan Mills – 21:45:
The feedback has been overwhelmingly positive, which is actually kind of surprising—especially from seasoned clinicians. There’s always some initial hesitation, especially around new tech. Some worry they'll look silly in a headset. But once immersed, people often say, “Wow, I need more of that.”

In terms of clinical outcomes, that's the golden question—but it’s incredibly difficult to track. Measuring the direct impact of educational innovation on real-world outcomes requires longitudinal studies, funding, and patient data—often over five years.

There are evaluation models, like Kirkpatrick’s, that help guide this. We can and do measure things like learner satisfaction, knowledge acquisition, skill transfer, etc. But connecting that to patient outcomes is a big challenge—and rare. Some groups have done it, and those studies are crucial.

Vicki Main – 25:28:
Looking ahead, how do you see virtual and augmented reality shaping the future of maternal and newborn care over the next 5–10 years?

Dr. Brennan Mills – 25:50:
Good question. VR and AR have different strengths. Augmented Reality (AR) overlays digital data on the real world—great for live clinical support, like patient monitoring or surgical guidance. It’s already being explored in sectors like mining, defense

Vicki Main 

Lastly, what advice would you give to young researchers or professionals who are interested in pursuing a career in simulation and immersive technologies, especially within the context of maternal and newborn health?

Vicki Main 

What’s next for you Brennen? Could you share your career and life goals moving forward?

Thank you so much for joining us on the In Scientific Dialogue with WIRF podcast. If you'd like to learn more about WIRF or explore opportunities to get involved in future fundraising efforts, be sure to check out the link in the show notes.

Additionally, if you're a researcher, obstetrician, gynaecologist, clinician, or midwife working in women's health in Western Australia, don’t miss the In Scientific Dialogue event on Friday, 5th September. We’d love to see you there!