Pulling Our Own Strings:  A Guide to Self-Regulation Within in Exercise Physiology
Janessa DeFreitas
Department of Exercise Physiology
The College of St. Scholastica
Duluth, MN 55811


IF EXERCISE PHYSIOLOGY is to develop as a profession, it depends on whether the students, someone like me, will take charge of what they have in front of them, namely, the opportunity to act.  If students are to “pull their own strings,” they must take certain steps that involve leadership as well as commitment.  As Boone [1] states in his book, Professional Development of Exercise Physiology, “Learning how to think versus what to think will be the unheralded revolution in exercise physiology.  Students will move from being regulated by others to self-regulated.”  It is therefore obvious that if students have certain goals and aspirations for a career in exercise physiology then they have to be able to devise a new way of thinking as well as acting, in order to make their goals a reality.  In other words, they have to become their own puppeteer. 

Assertiveness
Assertiveness lays a solid ground for "pulling your own strings."  It also demonstrates the level of confidence a person has within his/her field.  Be assertive is important when members of other professions do not think that you are capable of transitioning into the health care sector.  To be more aggressive is to have the self confidence to do so.  According to Jeffery Davidson, in his book [2], The Complete Idiots Guide to Assertiveness:  “that self confidence is the key to developing effective skills of being more assertive.  He also states that, “while it is possible to be assertive without being self confident, being assertive when you are self confident comes much more naturally” [4].  One disadvantage of not having much self-confidence and working within the health care system as exercise physiologists is that our intelligence is greatly underestimated and we are usually taken for granted.  We have earned the right to be confident in what we do.  Academically we are probably the only health care providers who understand human physiology in its totality.  Our title does not say exercise physiologist because it has a certain ring to it but because, intellectually, we are familiar with what goes on with the human body when it is placed under different stresses and when it is placed in different environments.  This gives us a niche over all other professionals who prescribe exercise to their patients, but have no clue what goes on with the cardiovascular physiology of a person.

Recently, I read an article entitled, "Up Where We Belong.”  It was written by a nurse, and I could not help but think that this is what exercise physiologists should be saying (i.e., that we belong up where all the other professions are on the health care ladder of success).  After I read the article several times, I realized that such thinking brings out the kind of confidence and assertiveness that we all need to possess in such a competitive arena.  I know that I have sometimes been in a stage where nothing looks certain, not my college career or my career in exercise physiology.  However, I know that if a situation arises where my knowledge and skills are being challenged, I am ready to place confidence in the education that I have invested in.  As exercise physiologists we must be ready to prove ourselves to other professions as well as to society if we want to secure a future doing what we do best.  In the article I just mentioned, the author makes a statement that could be redesigned to fit what we as exercise physiologists are and what we can be.  She said, “Don’t tell me nurses can’t manage, they do it every day.” [3]  In other words, I'm incline to say, “Don’t tell me that exercise physiologists aren't professionals, they demonstrate their professionalism every day."  So, to take the first bold step out into the world where getting a great job is always a challenge for exercise physiologists, and when jobs are avaliable under the supervision of someone who isn't credibility or competent, assertiveness is the answer to our question, “Can we do this?”

Networking
The role of networking leads us to public recognition and aids us in taking control of our career.  This comes from the practical experiences that we acquire during our academic years.  More so, although important, publishing research articles per se will not make exercise physiology a profession.  There must be a purpose in the public sector that is consistent with the ideals of a profession.  The purpose must set the stage for specific tasks, skills, and information provided by an occupational group that meets the need of the public” [1].  Thus, students must use the internship opportunities to their advantage.  The opportunities set the stage for networking that can be accomplished while doing hands on work with cardiac patients, diabetic children, and people who struggle with obesity within different areas of the healthcare system.  Networking comes from “making contact with people, developing those contacts into useful relationships, imparting work related information which is of use to others, giving and receiving mutual support and developing work opportunities for the future” [4].  Students must build bridges with the people they meet and establish credibility as well.  The latter plays an important role in networking since the public wants to work with professionals who are trustworthy and sincere with the services they provide.  By establishing credibility through networking, students are move towards “society’s identification with the group (exercise physiologists) as a profession and the term as having a social concept” [1].

With networking students are also able to market themselves as exercise physiologists.  As a student, it is scary knowing that I am going into a career that has been around for many years but still has not developed into a true profession.  It is evident that exercise physiologists who have earned the right of the title through four or five years of rigorous education within accredited programs along with hands on training are being marionettes to other professions.  They are not given the right of a solid foundation as a health care provider, and by the public we are generalized under titles such as ECG technicians, personal trainers, and physical educators.  So how do we change this way of thinking?  By taking the steps necessary to ensure that the public knows who we really are and the roles we play within healthcare and other health related fields.  In other words, “the public must come to realize that the professionals (exercise physiologists) possess the expertise not given to other professions” [1].

Commitment
Exercise physiologists must be committed to the professional development of exercise physiology.  It is a matter of taking responsibility for our future as healthcare professionals.  It is now up to us to hold on to what we have undertaken, regardless of the obstacles we may come upon.  In many cases, students who have graduated with exercise physiology degrees have networked with people and companies through their internships.  However, upon graduation they are faced with the dilemma of getting both the right job and the job that pays well versus having the career they want and have invested so much in.  Unfortunately, the outcome of this dilemma is usually the choice of having a job that pays well.  More so, their goals and aspirations for exercise physiology are now either placed on the back burner or they are thrown out the window.  Wanting to be ourselves as exercise physiologists is making the latter choice and knowing that, with commitment and hard work, we will succeed in achieving our goals and have a career that is financially stable.

Thus, pulling your own strings does not only mean commitment to one's career but also believing that it can happen.  Frank Lloyd Wright put it this way, “The thing always happens that you really believe in and the belief in a thing makes it happen” [5].  Belief in ourself and what we can accomplish goes back to having self confidence.  Belief that the things we want don’t always come easy and that with adequate motivation and hard work those things will be a possibility.  To reinforce Frank Lloyds importance of belief, Boone [1] has written that, “any vision of the future, any set of long range goals, to be helpful and believable must have passion.  Students must believe that there is a future in exercise physiology.”  Commitment and belief are two important parts of having independence within exercise physiology.  An overall commitment to the profession while establishing a good network and good credibility with co-workers, along with having the confidence to do the job is a significant start to recognition.  “Until the public recognizes that exercise physiologists are willing to commit to a lifetime career in exercise physiology, certain social and economic rewards, support, and prestige will not be granted” [1].  Therefore, it is important to understand that commitment becomes part the foundation that is laid for our career as exercise physiologists.

Creativity
Creativity is usually exemplified as “thinking outside the box” and, as exercise physiologists, we are always forced to do so.  Exercise physiology is a field where motivation is an important factor for our clients, whether it may be to start an exercise program or to change different lifestyle habits.  Thus, creativity is something that should be part of who we are as far as the changes we might want to make in people’s lives.  However creativity has to be developed in more ways than one if we are to establish ourselves as professionals.  This cannot happen until we get past the barriers that stunt creativity.  These barriers include, accepting the usual solutions to a problem and, in particular, accepting ritual and routine thinking.  When we are able to bring new and creative ideas to the table, even in the midst of ridicule, we are using our creativity.  Unfortunately, most of us get caught up in “promoting a culture that encourages conformity through the dismissal of alternative solution” [6].  For most professions to be where they are today, their founders or leaders had to be creative even though at the time it seemed ridiculous.  Creativity brings with it change, and with that change we are able to visualize what we are working towards and making it happen.  Thus, the idea of having a professional organization that represents us as exercise physiologists, having licensure, and taking a more active role in acquiring these things are all creative steps that need to be taken for us to become true professionals.  We cannot just look at ourselves individually.  We must also look at the big picture.  To do so, we have to come up with new ways of showing the public who we are in order to establish ourselves as professionals.

According to Rees, “a major danger is searching for a speedy answer to problems and seizing the first option that emerges, particularly a tried and tested solution” [6].  For exercise physiologists, there are a lot of  “tried and tested” solutions but none that has proven to be “speedy” within the field of exercise physiology.  Problems such as obesity, diabetes, and heart disease are all problems that are seemingly impossible to solve. Rather, we have to look past the difficulty of solving these problems and try to improve or prevent them.  Part of the process of being creative while solving problems is to engage in critical thinking.  This kind of thinking does not only promote creativity but also forward thinking.  This gets us out of conformity, thus we are able to analyze the situation and decipher if there is more to the problem than is stated.  We are also able to move past bias and see the problem for what it really is and not what someone else wants us to see.  Part of  “pulling our own strings” involves a tremendous amount of critical thinking and creativity; both are necessary if we are to move forward without the strain of someone else’s ideas hovering over our heads. 

Taking Charge
Taking charge is being able to grasp all the steps discussed as well as having the motivation to continually do so in the face of failure.  It is taking on the responsibility of others within this field that have the vision but lack the courage.  I have come across exercise physiologists throughout my undergraduate program who have had great ideas and ways to incorporate them, but they are too afraid to take that one step into the unknown.  It is said that, “ambiguity and not having clear answers are a part of professional life as one move into more responsible positions” [7].  At some point in our lives we all have experienced this, but it is by experience through making mistakes that we learn it is possible to do whatever we put our minds to even if it means trying a thousand times.  Thus, taking charge is taking a leadership role in a our personal and professional development. 

However, it is important to remember that taking charge does not start at the end of our academic years or at the beginning of becoming a professional.  Rather, it begins with the small tasks or projects that we are appointed to do throughout our academic lifetime.  We have to take charge of who we want to become and our involvement with college recreational facilities, funded walks, and weight loss programs.  These are just some of the few places that we can start making an impression as students within the exercise physiology programs.  Recognition begins with taking charge and being accountable for the services we are willing to provide within a smaller community.  If we can start with defining ourselves as exercise physiologists on a small scale, then it would be a much easier transition for us on a much larger scale.

Making Change Possible
We cannot expect to pull our own strings if we do not embrace change.  Change is what every exercise physiologist thrives for every time he/she steps into the healthcare arena.  There is a longing for change within the field of exercise physiology because of its place among the other professions.  This change comes with establishing a common ground for exercise physiologists within the profession of exercise physiology.  Because there is a lack of a common ground, the title “exercise physiologist” for example, acts a barrier that may block the path towards change.  More so, the title might be carried by any one who may have expertise in one area or another and is associated with the field.  However, most of these people may lack the academics that may deem them as exercise physiologists.  To emphasize this point; “it is one thing for a medical doctor to coach a team and be referred to as a coach.  It is altogether a different thing to refer to oneself as an exercise physiologist just because he/she introduces a stimulus and then measures the subject’s physiologic responses when the person is a psychologist” [1].  There are other examples of where change is needed within exercise physiology, but all of them depend on whether or not we are ready to commit to making these changes a reality.  Overall, we want to be independent within the career of exercise physiology and more so we want to be able to pull our own strings.  But, it can only be done if we stop underestimating our own power and intelligence.  We must also stop overestimating the power and intelligence of others within the health care arena.  We have to believe that we are health care professionals. 


References

1. Boone, T. (2001). Professional Development of Exercise Physiology. Lewiston, New York: The Edwin Mellen Press.
2. Davidson, J.P. (1999). The Complete Idiots Guide to Assertiveness. New York: Alpha Books
3. Bates, J. (2004). Up Where We Belong. Nursing Standard. Vol. 18(4).
4. Alexander, L. (1997). Career Networking:  How to Develop the Right Contacts to Help You Throughout Your Working Life. Oxford Press.
5. Wright, F. (2002).  Wining Words: Quotations to Up Lift, Inspire, Motivate and Delight. New York: Portland House.
6. Rees C. (2004). Celebrate Creativity. Nursing Standard. Vol. 19(14).
7. Kerfoot, K. (1998). Management is Taught, Leadership is Learned. Dermatology Nursing. Vol. 10(3).