Training the Next Generation of 'Quantified Nurses'

Martijn de Groot at the Quantified Self Conference in San Francisco.  (Christina Farr/KQED)

At a bustling university town in the Netherlands, dozens of future nurses obsessively track their sleep, nutrition and exercise using the latest wearable health trackers.

These students are enrolled at Hanze University of Applied Sciences, which is based in Groningen, a city in the north of Netherlands. They are some of the first nurses in the world to receive a comprehensive education in the "Quantified Self" movement.

During the course of the program, the students perform a self-experiment, such as tracking how a physical activity affects stress levels. They can choose from dozens of tracking devices from a drawer stuffed full of options. The students will then learn how to analyze the data they collect and present their research to the group.

The program is taught by Martijn de Groot, a research director at the Groningen-based Quantified Self Institute. Yesterday, at the Quantified Self Conference in San Francisco, de Groot urged other medical educators to follow suit.

The cabinet full of mobile health devices
The drawer full of mobile health devices. (Martijn de Groot)

"There is a total lack of statistical literacy among health providers," he said. "That needs to change."

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De Groot is an advocate of the quantified self trend, which involves tracking metrics like mood, productivity, food intake and health, typically by using a range of activity monitors and other gadgets (although some opt to use very basic tools and chart their data on a spreadsheet). This movement is still in its infancy, but its core ideas are starting to trickle into the mainstream.

Millions of people worldwide are now monitoring their physical activity by using activity trackers. The wearable band market grew 684 percent globally in the first half of 2014 compared with the first half of 2013, according to research firm Canalys.

The Disconnect Between Patients and Providers

More patients than ever before are bringing data from their health-tracking devices, including Fitbits and Nike Fuelbands, into the doctor's office.

According to de Groot, few doctors and nurses are equipped to manage this data. They do not understand whether the data is reliable or clinically valid, and few have the skills to analyze and visualize it. Instead, many will choose to simply ignore the data.

De Groot teaching students
De Groot teaching students. (Martijn de Groot)

"If a patient comes in to a clinic and presents data from various devices, the health practitioner should at least be able to have a conversation with them about it," de Groot said.

But the vast majority of medical and nursing schools do not teach students today about statistics, or introduce them to mobile health apps and devices. De Groot said he spent months researching comparable programs, but found fewer than a handful.

De Groot told KQED that his goal isn't to turn hundreds of nurses into lifelong quantified selfers -- although some may become devotees to the movement. Instead, he hopes the students graduate from school with sufficient knowledge about mobile health to incorporate this potentially valuable pool of data into their clinical practice.

He also teaches them to differentiate between hundreds of tools on the market, which vary in quality and price.

Some activity monitors, like the Nike Fuelband, are frequently inaccurate, de Groot said. That wouldn't matter if the user is simply hoping to gain a general understanding of their activity levels over time. However, it would not be an appropriate device for a patient in recovery from surgery who must only walk a certain number of steps each day.

"Students understand that they can recommend devices based on the motive of the patient."

Why Nurses?

De Groot is currently training nurses, physical therapists and nutritionists, but not doctors.

Nurses in particular should receive this kind of training, he explained, as they spend the most time with patients. Nurses are on the front-lines of care, both in-person and after the patient has been discharged.

Students wear a variety of activity bands
Students wear a variety of activity bands. (Martijn de Groot)

The possibilities for wearable-technologies are endless: Nurses could sport hands-free devices, like Google Glass, to pull up a patient's medical record. The nurse could review data from smart-watches and fitness bands to ensure that patients are sleeping or eating adequately.

Nurses could also leverage medical wearables, like a CellScope, which lets patients perform ear exams with a smartphone, or AliveCor, a mobile attachment for the iPhone that can track a patient's heart health.

According to de Groot, many millennial nurses in Groningen are eager to learn new ways to access and interact with patients. The city has the youngest population in the Netherlands. One in five of its inhabitants is a student.

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"I tell them that the world is evolving and that they need to take notice and be prepared."

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