BME alum blends her personal, professional passions to advocate for equity and accessibility in healthcare and medical devices

Nicole Bettè (BME BSE, 2016) is a Senior Human Factors Engineer whose personal experiences have informed and inspired her professional goals. In addition to her position with Kaleidoscope Innovation and Product Design, where she works as part of a team based at Eli Lilly in Indianapolis, Indiana, Bettè is Ms. Wheelchair New Hampshire USA 2023 and former Gilman Alumni Ambassador 2022-2023.

“I decided to join the Ms. Wheelchair USA program and apply for the Ms. Wheelchair New Hampshire USA title in order to have greater visibility for my platform, which is accessibility of healthcare and medical devices,” Bettè said. “As a Senior Human Factors Engineer, I’m in a great position to advocate for the accessibility of medical devices, both within the organizations where I work and also as a speaker at technical Human Factors Engineering conferences. I also reach out to disability advocacy organizations and ask for relevant stories directly from the voices of disabled people so that I can better advocate. Although my focus is on disability, I consider other aspects of accessibility as well, such as access barriers or inequity due to race/ethnicity, gender/sex, anthropometrics, etc.”

Bettè knew she wanted to dedicate her life to healthcare and medical devices. “I loved how much BMEs get to learn about different disciplines since it’s such a multidisciplinary field,” Bettè said. “Due to my educational background, I’ve been able to have in-depth technical conversations with mechanical engineers, electrical engineers, chemical engineers, material science engineers, industrial engineers, a variety of scientists, and a variety of medical professionals. Not many people can say that! I’ve always been naturally curious about a wide variety of subjects even while my heart was rooted in healthcare, so BME felt like a very natural degree to pursue as it kept my brain engaged in all sorts of ways.” Bettè also loves engineering, and discovered that BME was the perfect way to fuse her interests. “When deciding between a biology-focused science and biomedical engineering, biomedical engineering felt more natural to me as it’s more application-based,” she added. “I’ve always been a very creative thinker and fixer. I needed the engineering skills in order to channel all of that creativity and drive and turn it into practical solutions and real-world applications.”

Bettè’s journey to her degree and career encountered serious challenges along the way–challenges that would focus her career path to help others. “I struggled with illness and disability throughout college and spent what sometimes felt like half the time at medical appointments and emergency rooms,” she said. “I only had time and energy for academics, one or two extracurricular activities, and that’s it. I had practically no social life because any time outside of academics was spent looking for answers, or I was too ill to do anything. I didn’t know what was wrong. I was getting worse and was so afraid that I was dying that I signed up for a life insurance policy just before I began the arduous journey of seeking a diagnosis so that if I died young, my low-income parents wouldn’t have to shoulder the burden of the six-figure debt I had gotten myself into. Furthermore, toward the end of my academic career, I was working two jobs at almost minimum wage and had to rely on food stamps and food pantries to survive.”

Through grit and determination, Bettè graduated with honors. “That picture of me in my graduation gown that a U-M photographer took captured the pure joy and pride I felt at that moment,” she said. “When I entered that stadium for my graduation ceremony, I had earned it. I had defied all the odds that told me that I wouldn’t graduate because I was poor, Latina, neurodivergent, disabled, chronically ill, a child of a divorced mother who had dropped out of college, and raised by a Cuban grandmother who only had a middle school education and who unfortunately knows what it’s like to have to share bubble gum with her four siblings and to have to survive on the broth from the same bone multiple meals in a row. All in all, it took me three years longer than my peers to graduate, partially due to health reasons and partially due to internships, a few extra classes, and a semester studying abroad.”

Bettè’s health issues have stabilized and are now manageable. “I’m happy to report that I finally have a diagnosis (hypermobile Ehlers-Danlos Syndrome, a genetic connective tissue disorder), and no, I’m likely not going to die young,” she said. “I love my life and I love my job, and I have the help that I need. I’m disabled and proud of it, as my disability is a part of me and it has shaped the way I view life, has opened my heart and my mind to different perspectives, and has given me the experience, knowledge, and empathy to do what I do at work and do it well.”

Bettè encourages students who are facing challenges to reach out to the U-M community and to access available resources. “If you’re struggling with disability, don’t be afraid or ashamed to self-advocate, ask for help, and take advantage of every resource and accommodation U-M has to offer, just as I did,” she said. “U-M did an amazing job at retaining me. They have an impressive amount of structure and resources in place to help disabled and chronically ill students succeed. The staff and I were all very resourceful so that I could make it to that stadium and graduate. So, if you can, graduate. Disability in this country impoverishes most of us. It’s only because of my level of preparation and education that I’m not in poverty right now. I recognize that education in the U.S. is in great part a privilege, but if you happen to have made it this far as a student here and you’re vacillating between finishing and dropping out, finish, even if it means taking longer. I recommend working very closely with your professors and university staff, managing your schedule to give yourself time to rest and go to medical appointments, reducing your course load, mixing and matching hard courses with easier ones when possible, surrounding yourself with a strong positive support system of classmates, mentors, friends, and family who can help you, and, if necessary, taking a break (medical leave/sabbatical). There are also grants and scholarships available to help retain students who are in tough financial situations.”

Bettè believes that the need for diverse representation is great, and that bringing people who will advocate for equity and inclusion will improve accessibility for others in the future. “On that note, there are few disabled healthcare professionals and few disabled medical device engineers like me,” she said. “I wish to see more of us, so that our voices are represented and heard in this industry. I sincerely believe the lack of representation contributes to the access barriers we face in our healthcare system today (which includes inaccessible medical devices/equipment).”

Bettè explained that as a human factors engineer, she considers user safety, effectiveness, and ease of use as well as interface design accessibility, facility accessibility, and the inclusion of a wide variety of participants in usability studies, including disabled participants. In terms of design, she thinks about multiple aspects of accessibility including, but not limited to, these five things:

Enabling the design to provide information in multiple ways (not just visual or just auditory information) and receive information in multiple ways (not just typing or just speaking).
Simplifying the design and the instructions as much as possible to reduce the cognitive burden and complexity required to use it. This helps users’ ability to remain independent when using the device, reduces or sometimes eliminates the need for training, and reduces the likelihood that a use error will happen.
Optimizing the ergonomics of both physical and digital interfaces so that users are able to comfortably use the device (with one hand, for example).
Ensuring that the system or design works just as effectively and accurately for everyone who will use it. For example, sometimes optical devices don’t work as well for people with dark skin as they do for light skin, and with optical medical devices such as pulse oximeters and forehead thermometers, this can have adverse clinical impacts on people, hence its importance in health equity. Similarly, some devices don’t work as well on larger people compared to thinner people.
Leveraging universal and inclusive design principles across the entire development process.

Bettè is committed to reaching out to others so that their voices can also be heard. “If you want to share your story pertaining to access barriers in healthcare, please feel free to reach out to me at bettenicole@gmail.com,” she said. “Stories are the single most powerful tool we have for advocacy! Please share yours with me!”

To help advocate for healthcare equity and inclusion, especially medical device accessibility, use the #AccessibleMedTech hashtag that Bettè created on social media.

If anyone is interested in learning more about or applying to the Ms. Wheelchair USA disability pageant, visit https://www.mswheelchairusa.org/. Ms. Wheelchair USA is run by The Dane Foundation, a 501(c)(3) nonprofit organization with a mission of improving the quality of life of people with physical and developmental disabilities. To learn more about The Dane Foundation, visit http://www.thedanefoundation.org/.