Psychometric Testing of NASA-TLX to Measure Learners’ Cognitive Load in Individual and Group Nursing Simulations

•Multiple factors contribute to cognitive load during nursing simulation.•NASA-TLX is a reliable measure of cognitive load in individual simulation settings.•Additional testing of NASA-TLX sensitivity in group simulation is needed.•Triangulation of data can support NASA-TLX results and improve scientific rigor. The National Aeronautics and Space Administration-Task Load Index (NASATLX) is a subjective instrument for measuring cognitive load. Originally designed for aviation, it has proven a valid and reliable instrument across disciplines. Despite extensive use, its ability to measure cognitive load in group and individual nursing simulation has yet to be explored. This secondary analysis investigates NASA-TLX psychometric properties among 488 surveys completed by learners from a Bachelor's nursing program during individual and group simulation. Psychometric tests included item analysis, Cronbach's alpha, inter-item correlations, and exploratory factor analysis. NASA-TLX demonstrated acceptable reliability and validity in individual simulation; however, there was less reliability in group simulations. Administration variances across individual and group simulation impact NASATLX validity and reliability.