PEP
online

Professionalization of Exercise Physiologyonline

An international electronic
journal for exercise physiologists
ISSN 1099-5862

Vol 6 No 1 January 2003

 



BEEFING UP PROFESSIONAL DEVELOPMENT: A Top-Priority Initiative 
Tommy Boone, PhD, MPH, MA, FASEP, EPC
Professor and Chair
Director, Exercise Physiology Laboratories
The College of St. Scholastica
Duluth, MN 55811
 
“The purpose of curriculum building in exercise physiology is to provide cognitive and hands-on learning experiences that will enable students to develop professional behaviors that promote the greatest possible application of our body of knowledge for every individual in society.”  -- 
William T. Boone, Jr.
As I reflect on the needs of our emerging profession, the most obvious is that we must nurture our educational concerns.  We are the only healthcare practitioners without an agreed upon and/or recognized undergraduate education in exercise physiology.  This, I believe is a major concern.  Curriculum building is an important process in all professionals.   Exercise physiologists cannot turn their back to the importance of professional competency.  Health and fitness consumers are demanding better quality care.  Let me also point out that there is a growing concern that students are not aware of the need for professional development of exercise physiology.  For whatever reason, they do not see the whole picture.  The need for change has its basis in the timely opportunity to reexamine the curriculum, especially from the standpoint of what information or skills are necessary to conduct the business of exercise physiology. 

The purpose of an undergraduate education in exercise physiology is to educate students with cognitive and hands-on laboratory skills required of professionals in the field.  This is not true for students who graduate with a major in exercise science with an emphasis in exercise physiology.  The recognized characteristics of an academic degree are not congruent with an emphasis or a concentration.  The student still graduates with a degree in exercise science.  The problem, of course, is that there are few recognized exercise science jobs as such in the public sector.  Also, there is no professional organization that is working just on the behalf of exercise science majors to help them correct the public sector problems.  I believe that this is true even though exercise science is linked to sports medicine.  While sports medicine has an excellent reputation, mostly by athletic trainers and medical doctors, exercise science is without leadership. 

Exercise physiologists may take issue with my distinction or my analysis, but tradition (and even a well designed, scientific body of knowledge unique to exercise physiologists) does not substitute for competency.  The obvious differences in what we do as academic exercise physiologists for our students and what physical therapists or nurses do for their students should result in major changes in how we view a college education.  No longer should professors be allow to teach exercise physiology courses if they are leaving the impression that students will graduate as exercise physiologists.  It is time to stop the madness.  I have written about this point many times.  If the professors are not going to initiate change within the departments they work, then it is time that the graduates from the departments register their complaints with the department chairs if not the President of the college or university.  It is hard to argue against this point if we understand the purpose of a college education. 

Registration of disappointment is important.  Registration of misdirection if not a mis-representation of the academic degree are important, too.  The responsibility to change is great, and it is entirely appropriate and required of every department to change especially if the department suggests, either directly or indirectly, that upon graduation “you can call yourself an exercise physiologist with an exercise science degree”.   I say that the situation we are in is an educational crisis!  Students should protest their education or the lack of it.  The teamwork of collective silence must change.  Professors must step forward and offer a rationale to their department chairs and deans why exercise science, as an academic degree, should be changed to exercise physiology. 

Similarly, graduates from kinesiology programs, human performance programs, or whatever the combination of words might be to give rise to yet another academic degree without a job possibility must wake up and smell the roses.  An expression, yes, reality -- you bet.  Graduates expect to locate a job that they can survive financially and otherwise.  If the degree is no more than a pre-physical therapy “exercise science” degree, then the faculty of these programs must state clearly up front that it is not exercise physiology.  The registration of this view must become today’s 21st century reality.  At least then, the students will know what they are getting into and what they will get from it.

We must get beyond the 20th century notion that as long as physical education is accredited within the context of the educational offerings that somehow exercise science has credibility.  There are no accredited exercise science programs in the United States, unless of course you understand that they are in essence physical educations programs of study.  The criteria for accredited exercise physiology program exist.  It is time to study the accreditation document developed by the American Society of Exercise Physiologists.  The ASEP accreditation will have a powerful impact on exercise physiology and the future and credibility of our students.  Most importantly, it will increase awareness of the ASEP effort to define exercise physiology with its own identity separate and apart from exercise science.  It will also increase awareness of the shortcomings of the non-exercise physiology programs of study.

“Our students are not on an even playing field with other healthcare practitioners.  They need something to gain the competitive edge.  That something is – a professional academic degree.”
The accreditation criteria were developed in the late 1990s and include the first-ever organizational effort to embrace the professional aspects of exercise physiology.  The fact that it has taken so long is unbelievably slow on our part as academic exercise physiologists.  We have been too entrenched in our immediate association with the traditional treatment of our unique body of knowledge.  As a result, the inertia of the physical education – kinesiology - exercise science philosophy versus exercise physiology has stopped us from creating our own identity in the healthcare field.  I know that members of the healthcare professionals are looking at us and shaking their heads.  They know that we have a powerful academic body of knowledge, but no one is leading them or inspiring them.  They understand that we have failed to see the significance of our work beyond publications. 

In short, we have failed to anticipate the value of what we are and what we do.  We have also failed to appreciate the needs of our customers.  That’s right.  We should be predicting how our information we be increasingly more valuable and how we can use our education to make a living besides teaching.  Others are doing it with far less an education than we have.  Where is our innovation and anticipation?  We need to rethink the fundamental way that exercise physiology has operated.  In other words, a serious paradigm shift is exactly what we need to become the healthcare practitioners of the 21st century. 

While we cannot change the past, we should be trying to leverage our future to ensure the very best for all exercise physiologists.  It isn’t too late, however.  The fact that there are essentially no articles about exercise physiology curriculum bears directly on the problem of silence.  Students from diverse academic majors will continue to have a tough time of it when sitting for the Exercise Physiologist Certified (EPC) exam.  If the faculty are not involved in curriculum reform, students will not have a chance of competing successfully in the public sector.  Accountability and authority are the hallmark of a professional.  A change in curriculum should have a positive influence on the students’ likelihood of passing the exam. 

“You can and should shape your own future.  Because, if you don’t, someone else surely will.”  -- Joel A. Barker
Changing the curriculum is in response to the needs of students and the emerging profession.  If we don’t shape up and do the right thing, others will do it for us.  Education should not be an obstacle to finding a job or passing a professional certification.  Rather, it should expedite the students’ achievements and transition to becoming a professional.  In my own work, I have found that this true.  One’s education is directly correlated to one’s work.  I have witnessed extraordinary examples of this for several years now.  It would appear that no matter who you are or what you do, you would have come to the same conclusion as I have.  At the very least, we should recognize that exercise physiology is not exercise science.  And, if we can agree on this point, then, it is reasonable to believe that this change in thinking will create a new way, if not, a dramatically new way to view exercise physiology. 

This new way of thinking has already resulted in major changes in other healthcare professionals.  The new thinking that has triggered, for the most part, an understanding of the importance of licensure.  Meaningful and strategically aligned steps are put into place to insure licensure for those who believe that is it absolutely important to their work.  There is, of course, good reason to believe that exercise physiologists can work successfully as board certified professionals, too.  Licensure may not as important for all exercise physiologists.  The alternative is a professional certification for candidates who meet the criteria to sit for the Exercise Physiologist Certified exam. Only time will tell whether (and when licensure becomes a reality) if it is the ticket to success that everyone believes it to be.

What is reality is that we know the new exam works.  Now, students have the opportunity to call themselves by a professional title.  Indeed, it is now possible to achieve the same desirable outcomes as other healthcare practitioners.  Unfortunately, though, new thinking requires a process time for understanding and application.  Other professions know this reality all too well.  Their literature is replete with not only research, but articles on professionalism and the professionalization of their field.  Students in these fields of study are expected to learn the path of professionalism just as they are required to learn the scientific basis of their work. 

“Students are the hub around which the educational wheel turns.” – Em O. Bevis [1]
The idea of studying professionalism is new to exercise physiology.  Students are seldom ever required to study the professional practice of exercise physiology and, yet it is absolutely imperative to synthesize and summarize the implications of the undergraduate education.  The ASEP effort to set standards is new, refreshing, and without precedent.  In due time, curricula across the United States will expand and match the needs of the undergraduate students in exercise physiology.  This expansion will take considerable effort in the management of educational institutions.  Students graduating from these institutions will be comfortable with their title, and they will be among us the first to pioneer further developments and application of many of the concepts and ideas specific to exercise physiology.

Until then, it is especially important to hold accountable every college teacher who refers to him- or herself as an exercise physiologist.  Their decision to embrace the ASEP perspective to mandate change will have far-reaching and important consequences.  The process of developing accredited exercise physiology programs of study, and the ASEP’s continuing professional developments in the standards of practice will inextricably bound our students to the healthcare field of work.  By inference, their education will be viewed in the same way as the education of students in other healthcare fields.  This is, of course, based on the ever-important changes that are inevitable if students and faculty are to comprehend the evidenced-based approach to continued public sector inclusion and practice.

If someone said to you, “Look, I want to know your most attractive feature, “  it would be our applied physiology niche.  All anyone would have to do is read and study our research to understand this point.  In addition, we have learned to associate other academic areas of study, including but not limited to, psychology, biomechanics, pathology, nutrition, electrocardiography, cardiovascular physiology, and other related subjects.  The point is this: To continue our work as professionals, it is important that all students should get involved in the professional development of exercise physiology.  Students are a vital force within the ASEP organization.  Their integration is at the heart of core professional competencies.  This point is important, especially since it recognizes that the start of any great profession begins with the students.

It could be argued, therefore, in the spirit of change that the students themselves must structure their thinking in expectation of one of the biggest steps yet in the history of exercise physiology.  And, the step is fundamentally simple, that is, the ability to anticipate the strategic application of exercise physiology in the public sector.  Here, the needs of the public sector as well as the needs of our profession in the 21st century are great.  We must nurture society and, yes, we must nurture the profession as a whole.  We need answers to how we should build the profession to a higher level of comprehension and application.  We need answers to questions about efficacy, outcomes, and prevention, but also research that address the complexities of professionalism.  Our research on sports, rehabilitation, and many other aspects of exercise physiology is well established.  However, we need more collaborative research and personal communication about professionalism.  These are the associated conditions of the new model of perceiving exercise physiology.

Thus, it should come as no surprise that our house needs to be put in order.  Our educational programs need serious updating.  Faculty members throughout our institutions must contribute to the university’s mission to initiate responsible educational programs.  Our academic programs must be nurtured by professional accreditation.  Our faculty must support ASEP and hands-on resources to ensure new knowledge and career opportunities.  Second, it clearly important that those who teach primarily in our graduate schools must support the undergraduate changes as well as look for opportunities to incorporate similar changes at the graduate level.  In other words, we must start thinking with a new set of rules. 

It is my belief that our colleagues are probably asking, “How do we organize for going about playing the game according to new rules?”  The answer is not simple.  A beginning point obviously lies with curriculum change and development?”  May I point out that, “It has already been done.”  And, frankly, the document isn’t tricky or confusing.  It looks promising, and it works.  We have proof of the latter.  All we need to do now is to increase the implementation of the ASEP accreditation document.  The document is the most essential criterion for promoting exercise physiology.  It provides a common frame of reference in what must be done to provide academic consistency and unity of purpose to achieve our goals and objectives.   In other words, it a valuable beginning for selecting and arranging academic content that will promote the most efficient learning of exercise physiology. 

Curriculum building is a dynamic process.  In time, the conceptual framework that provided the guidelines for developing the accreditation document will change as our frame of reference is influenced and changed by our new beginnings in the public sector. The implications of this anticipated change are significant.  The truth is that change is uncomfortable for many teachers.  It comes with a price; one is the feeling that everything that has been comfortable is changing!  With change, we feel that we are somehow no longer in control.  We may need to take on new responsibilities or work longer hour.  The reality is that some of this is true, but not generally in the extreme.  In my own department, I understand that new ideas or proposals drive unsolved problems that appear more of a challenge than I want or need.  Yet, I know that however unsettling the prevailing paradigm, I must be open to change and understand the purpose behind it. 

Probably, one of the most significant feelings resulting from change is the anxiety and grief that associates with the expected loss of what we helped build.  The time and energy to get where we are may seem wasted with the onset of a new educational structure.  There may also be serious doubts about the new curriculum or thinking or the unknown that associates with it.  Faculty may disagree with each other about who is responsible for change or whether change is possible.  It may all seem absolutely absurd.  Colleagues may feel threaten by the reorganization, particularly if they stand to lose resources.  They may think that a hidden agenda is being played out whereby they will come up as the losers.  Almost every teacher has experienced these feelings in one form or another and, unfortunately, some of it is reality.

What is missing in exercise physiology is a philosophy.  We need a unifying point of view about the nature and significance of what is exercise physiology and who is an exercise physiologist.  Although ASEP has defined both as part of its Standards of Professional Practice, there is considerable room to make sense of our history in regards to our future.  This sense of valuing our history while also planning our future is in itself a philosophic source of professional power.  Together, we will continue to build the foundation for a sense of identity in the public sector, professional security with increased exposure as healthcare practitioners, and personal confidence as well as personal responsibility for our actions. 

Exercise physiology aims to assist society in achieving its maximum potential, in regards to health, fitness, rehabilitation, and sports.  Exercise physiology’s purpose is not unique.  We are in competition with professionals from medicine, nursing, physical therapy, occupational therapy, and other related professions.  In fact, we are in competition with various non-professional groups as well.  Today, it seems that almost anyone can be an allied health professional.  This is a major problem for all credible healthcare professions.  Like nursing, exercise physiology relies not just on its own scientific knowledge but from a variety of health related fields of study.  This is partly the reason why the accreditation curriculum is diverse with subject matter taken from biomechanics, nutrition, health, psychology, and other health, fitness, rehabilitation, and sports issues and concerns.

“Without caring there can be no quality.”  -- Joel A. Barker
Exercise physiologists are important to society.  In addition to being experts in sports training, wellness and health promotion, and rehabilitation of heart patients, they help with a variety of chronic illnesses and psychosocial problems.   As healthcare practitioners, our professional journey is just beginning.  And, yet the theoretical underpinnings of our work are well established in decades of scientific publications.  Our beliefs about the therapeutic benefits of exercise result from applied exercise physiology.  They are fundamental to what clinicians do worldwide.  In almost all professions, the process of reflection is foundational to the language of professionalism.  While we have certainly reflected through our published works, we have failed to develop a vision of a new curriculum and the philosophic support to operationalize it.  This is a problem that can be fixed. 

It begins with sharing the same understanding and care for our students and for what we do in the public sector.  This sharing is fundamental to changes at the personal level whereby we grow in confidence and leadership skills.  Together, we must come to terms with turning a mission into reality.  Unfortunately, what we do not have is a mission statement for exercise physiology.  In other words, what is the purpose of exercise physiology?  What is our mission?  I suggest that our mission from within the ASEP organization should be consistent with the mission of all “future” Departments of Exercise Physiology.  For example, the mission might be the following:

The Department of Exercise Physiology, an instructional department of the College of St. Scholastica, provides quality instructional services to St. Scholastica students who seek learning and career opportunities: 

  • To obtain an academic degree in exercise physiology; 
  • To obtain a board certification as exercise physiologist; 
  • To improve the application of exercise physiology hands-on skills and enhance the professional image of exercise physiology; and 
  • To increase the number and quality of exercise physiology career opportunities.
One thing is certain.  “The exercise science curriculum won’t cut it anymore.”  It won’t cut it in the public sector.  It won’t cut it any longer in our educational programs.  It is truly a problem, and this is why our students are in trouble.  Think about it.  Why do other healthcare professionals have a mission statement?  In short, a mission statement represents a reason for an organization’s conviction and pattern of thinking.  It is clear to me that we have abdicated our responsibility for too long now.  This failure to think in accordance with a mission has resulted in our lack of a shared vision and values.  This has led to the problems that we now face and, in particular, our biggest challenge – curriculum reform.
“Problems that are created by our current level of thinking can’t be solved by that same level of thinking.”  -- Einstein
The question, then, is how do we objectively step outside our past thinking and regain our focus?  The plain truth is that we must organize our thinking to ensure that exercise physiology survives our curriculum mistakes.  This is the summary statement of this article.  That is, with conviction and with prompt action, we can expect change to occur.  What this says to me is that we control our future.  We have the power to restructure, reorganize, redesign, and rethink exercise physiology.  This point cannot be stressed enough.  Resist it if you must, but reality is just a blink away.  And, when you think about it, reality is now.  After all, ASEP has already performed well beyond expectations.  Its leadership has helped us think ahead and create a mental picture of what is exercise physiology.  We now know where we are going.  We also know that a specific academic curriculum is required for success.

This view notwithstanding, many of our academic colleagues are appear unaware of the significance of an exercise physiology curriculum.  The past curriculum, which is essentially the present-day curriculum, has captured their attention and many, if they think about it at all, may think of it as something altogether out of their influence.  Of course, this perception is invalid.  Exercise physiologists have a lot more influence over the curriculum than they think.  If they would just focus their energy on changing it and making the change as important a goal as is research, their collective efforts would raise the visibility and credibility of exercise physiology. 

The tailoring of the details in an updated curriculum begins with our standards of professional practice.  We need to understand our “practice” both as a written document linked to our board certification with certain legal implications, and as a strategic process to becoming a customer-focused, healthcare organization.  In other words, as exercise physiologists, we need to get beyond the superficial and meaningless types of jobs and the thinking that associates with them.  This is the only way in which we will truly make a difference in how we grow as an organization and serve the public sector.  In other words, once we understand the collective meaning of our “practice”, we will know our place as professionals in the healthcare field of work. 

“Whatever you can do, or dream you can, begin it.  Boldness has genius, power, and magic in it.”  -- Goethe
References
1. Bevis, E.O. (1978). Curriculum Building in Nursing: A Process. Saint Louis, Missouri: The C. V. Company.
 
 




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