Cultivating
the Values of Professionalism
A
Professor's Point of View
Tommy Boone, PhD,
MPH, FASEP, EPC
Professor and Chair
Director, Exercise Physiology
Laboratories
College of St. Scholastica
Duluth, MN
"The greatest thing
in this world is not so much whre we are, but what direction we are going."
-- Oliver Wendell Holmes (1809-1894), American doctor and author
What is
Meant by the Word Professionalism?
Professionalism in
exercise physiology is a new concept. Few seem to understand what
is meant by professionalism or why its important. Professionalism
is a given, isn't it? If not, why bother with it? Of course
this is exactly the problem. Many non-professionals think they are
professional, and many occupations believe the members constitute a profession.
As Swick (1) points out, "Different groups have used
the word differently and for different reasons...it is easy to recognize
but difficult to define." Yet, there are specific criteria for what
is meant by the words profession, professional, professionalism, and professionalization.
According to some, "profession"
is defined as having a specific knowledge area with associated abilities
that are applied to the welfare of the public (2, 3).
A profession, then, much like the professions of medicine, law, and university
teaching, is ranked by the public at the top of prestigious occupations
(4). Exercise physiology can be defined as a profession
because the exercise physiologist (EP) requires a systematic knowledge
to perform similar activities which are passed on to students. This
definition is also consistent with an occupation of which, according to
Freidson (5), a profession is an occupation. So,
an occupation could be a profession, especially if it gives the members
control over its own body of knowledge and application to society's needs.
Since 1915, there have been
a number of different points of view regarding the characteristics of the
ideal profession (6-9). It is generally the same
that the core of the profession is the high intellectual responsibility
of learning, first, and conveying, second, the unique features, concepts,
and ideas based on a specific body of knowledge. There are other
important characteristics, especially the relationship with colleagues
and clients regulated by a code of ethics and a formal professional association.
With this understanding and, given that occupations may evolve into professions
(10), is exercise physiology an emerging profession?
It is interesting to note
that exercise physiologists do behave as professionals. Three criteria,
in particular, highlight this point of view: First, if the
exercise physiologist believes he/she knows what is the better fitness
program for "whatever" than the client, then the exercise physiologist
is performing as a professional. That is, the exercise physiologist
demonstrates a certain autonomy of judgement about health, fitness, rehabilitation,
and sports training issues. Second, if exercise physiologists form
a professional organization, such as ASEP, to protect the autonomy of the
profession through certification, licensure, and accreditation, then exercise
physiologists are performing as professionals. Third, if exercise
physiologists demonstrate specific competence in applying their shared
knowledge to benefit society, then they have achieved professional status.
Professionalism is often
defined as a "...commitment to one's work and the orientation toward service
rather than personal profit..." (10, p. 7).
The idea of being commited to one's work is similar to a sense of calling
(11). Professionalization refers to the
degree to which the characteristics of the ideal professions are demonstrated
in the everyday functions of the members. It is a process always
ongoing (12). As members of an occupation commit
themselves as professionals, the level of professionalism rises and, thus
the professionalization of the occupation moves closer to the professional
status that ultimately defines the profession.
Interestingly, it is the
word "professionalism" that is at the heart of an emerging profession.
Members must come to understand what it means to them. Swick states
that it is "...like pornography: easy to recognize but difficult to define."
(1, p. 2). Given the assumption that exercise physiology
is evolving as a profession, and given that professions require their members
to demonstrate professionalism, then it is necessary that exercise physiologists
understand clearly what exercise physiology professionalism entails.
If they choose to look the other way, then exercise physiology will remain
a discipline.
If, on the other hand, the
study and application of professionalism are considered as important as
research, then the exercise physiologists' effort to develop something
of a monopoly over their work should continue the professionalization of
exercise physiology. This point is exactly the missing piece in the
brief history of exercise physiology. For decades, no one has emphasized
the importance of exercise physiology as a calling. It was and continues
to be an occupation but not by deliberate teachings, however.
Academic exercise physiologists, those privileged with both position and
reasonable financial stability, teach their courses and connect with their
students on about the same level as was true when they were in college.
Without realizing that change is good and inevitable, they go about teaching
as they were taught. Rapid advances were made in a multitude of scientific
areas under the title, exercise physiology. Yet, the academics have
done little to move exercise physiology into the public sector. Without
a sense of purpose and application, graduates without the PhD degree find
themselves lost and without a voice of support.
It seems only logical that
the academics are responsible for upgrading the undergraduate curriculum,
and for demonstrating a course of action to empower the graduates.
Teachers have a duty to individual students and to helping them understand
the application of the exercise physiology body of knowledge, and they
also have a duty to teach the values of professionalism, which include
but are not limited to altruism, accountability, integrity, and respect
for others. This point, in particular, brings us to the heart of
the matter. That is, if college teachers are responsible for teaching
professionalism but fail in demonstrating it before their students by not
doing so, then clearly professionalism is missing in the students' education.
Exercise physiology professionalism,
as a college teacher, reflects the teachers' willingness to put their personal
interests aside to meet the needs of students. The fact that there
is little evidence that exercise physiology teachers are willing to subordinate
self-interest is a serious threat to whether the academic discipline (or,
more correctly, an occupation of only PhD exercise physiologists) will
emerge successfully as a profession. Hence, it is imperative that
the academics respond to the needs of the students, and the concerns as
reflected in the public sector. The importance of leadership by the
academics cannot be overstated. They must demonstrate a compassionate
understanding of the issues and concerns of the non-PhDs in exercise physiology.
Where is the academics' integrity if the degree is eventually realized
to be meaningless? Where is the honor in failing to help so many
young people who aspire to altruism and a chance to help others?
The challenge for this generation
of academics is not to let the present generation of students loose interest
in exercise physiology. The faculty must ensure that their students
understand exercise physiology is about a profession not a trade.
It is about helping students learn the criteria for professionalism, and
how the current emphasis on sports medicine threatens exercise physiology
as an emerging profession. Faculty and students must remain steadfastly
committed to professional values.
A major goal of the exercise
physiology education should be to encourage students to join ASEP student
chapters at the college level and to join the ASEP national organization
to continue to engage in professional partnership with other exercise physiologists.
What is hoped is that what is learned and experienced at the national level
will reach back into the undergraduates' education to shape the curriculum
and commitment to professionalism. Both organizations will help in
the merging of education and practice. The faculty will become more
responsive to the students' needs within the community. Students' in turn
will demonstrate an increased desire for lifelong learning.
The shared relationship between
education and work in the community, and the same between faculty and students
allow for a seamless reflection and interaction of what is learned in college
and thus applied in the community. The process of faculty acting
as mentors, guides, and finally as colleagues with their students brings
the original purpose of the education full circle. Finally, with
emphasis on professionalism, faculty and students alike share a pattern
of reflection and need for each other that builds self-esteem and sense
of efficacy and empowerment.
The organizations, particularly,
ASEP and then the state organizations followed by the students chapters,
learn from each other and in turn contribute back to the exercise physiologists
in the community and, where important and required, share in the work to
establish credibility (as in state licensure). This form of interactive
learning and dependence allows the healthcare community, in particular,
and society, in general, to learn from the national organization of the
professionals. What is important is that exercise physiologists must
recognize that the professional development of exercise physiology as an
emerging profession does not occur in an isolated enviornment. Individuals
are important, but professionalism occurs as exercise physiology professionals
study and learn together, work in the community, attend organizational
settings, and hang together to overcome challenges. Properly structured
and conducted, all exercise physiologists will come to engage in a new
vision of the professsional development of exercise physiology.
The
Professional Development of Exercise Physiology
The question today
is, "What is a priority item for all exercise physiologists?" The
answer: Professionalism and the development of the exercise physiology
curriculum. The topics have appeared a number of times throughout
the published articles in PEPonline
(13).
They have also appeared with some consistency during the three ASEP annual
meetings (14). Otherwise, an outsider would think
that by the obvious lack of a discussion of professionalism during conferences
and in the scientific journals is not important to exercise physiologists.
But, it is important and it is increasingly becoming the 21st century topic
in support of the values that are associated with the emerging profession
of exercise physiology.
Far too long now, exercise
physiologists have placed too much emphasis on research. While publishing
is important, the emphasis has resulted in too little opportunity to reflect
on the current needs of the profession. In support of the need for
professionalism, the professional development of exercise physiology requires
the faculty to admit that teaching is as important as research in a university.
In fact, according to Shils: "A university in which teachers shirk
their pedagogical obligation in order to advance 'their own work' - as
if their sole obligation is to do research - infringes on the academic
ethic." (15)
It should go without saying
that negligence in the performance of the faculty on behalf of the students
ought to be identified as such. It is one thing to merely transmit
a body of factual or theoretical knowledge, and another with regard to
the value inherent in the teaching and preparation of young professionals.
To not consider this point as a cry for something different is to do a
lot less than originally expected of the faculty. Only with rare exceptions
(16) the reader runs across a professor who understands
that the job of teaching is to empower the students. It is this single
truth that separates the best teachers from the ordinary ones.
The discussion of professionalism
is admittedly very difficult for exercise physiologists. Their devotion
to research has decreased their understanding and skills in knowing the
valid and important from the invalid and unimportant. It is imperative,
however, that this differentiation be understood, and that concerns exist
that must be addressed by the university faculty even if it is a hardship.
Again, according to Shils: (17) "The critical scrutiny
of the tradition and particularly of the most recent increments to it is
an obligation of a university teacher to his colleagues in his own university
and at others, present and future, even where it requires that he render
negative judgements on their work."
One of the assumptions of
a college education is that the graduates will be in a much better position
to locate good paying jobs. Another assumption is that the graduates
will be treated with respect and as professionals. Although there
are exceptions, it is clear that many graduates of programs that teach
invalid and unimportant information have considerable difficulty in getting
a good paying job with respect. The unfortunate yet open belief that
clinical exercise physiology is exercise physiology has not helped, but
neither has the faculty in defining the differences. They, too, remain
bound by tradition and contradiction in thinking that have not served them
well. In fact, many college professors seem completely untouched
and unaffected by the existence of undergraduate and master-prepared professionals
without jobs.
It is time to set the record
straight. The faculty of exercise physiology programs can no longer
turn their face from this issue. They are obligated to doing something
about it. Students expect it from them and, frankly, they are entitled
to expect something good in return for the cost of their education. Although
certain institutions intermittently have changed their curricula, the changes
have been too small to promote professionalism. What is needed to encourage
professional development is an ongoing, critical reflection of such questions
as:
-
What is exercise physiology?
-
How does exercise physiology
differ from exercise science?
-
What is an exercise physiologist?
-
How does an exercise physiologist
differ from an exercise scientist?
-
What are the rules of conduct,
and how does the exercise physiologist go about developing professionalism?
-
What is the philosophy of exercise
physiology?
-
Where do exercise physiologists
practice in the public sector?
-
What does the traditional history
of exercise physiology differ from its contemporary history, and are they
in conflict?
-
What is the exercise physiology
faculty doing to help students learn to think critically about themselves
and their profession?
Answers to these questions should
help foster the development of professionalism. But, it is unlikely
that the students will be confronted with these types of questions if the
faculty do not place a higher value on a broader intellectual experience.
Simply stated, learning about the physiology of training by itself, however
important, does little to encourage the critical thinking that is necessary
to understand the emerging profession and its role in society. Stated
somewhat differently, students need the intellectual and emotional education
associated with answers to questions about professionalism in addition
to the science of rehabilitation of heart patients. If only the latter
is presented, then the students' education is lacking. The curriculum
must be more than just science if the students are to grow in their understanding
of professionalism.
Hence, in short, there is
one vital criterion to decide what kinds of courses and laboratory experiences
go into creating a curriculum: this criterion is the probability that the
courses will contribute to a deeper understanding of why the students are
majoring in exercise physiology and how it contributes to the well-being
of society. This one factor alone is important to the students' understanding
of the specific ways which exercise physiologists are called upon or urged
to serve their society. Everyone of these services, when finally
considered by the faculty and approved by society, will justify the students'
college expenses. This critical analysis is not confined to exercise
physiology. It has been understood for decades by other professions.
Academics who therefore teach
exercise physiology to students who believe they want to become exercise
physiologists themselves have a special obligation not to betray the trust
which is given them. It goes without saying that the changes in curriculum
to reflect the ethical steps toward professionalism should conform with
a tone of conviction on behalf of all students. It is not only a
matter that must be corrected, it is also a matter of the nature of changes
among professionals and their obligations to the customers (i.e., the students).
These same professionals are required to plan for and put into place the
necessities for change. Necessities such as developing compassion,
communication skillls, and social responsibility (18),
and other necessities like certification, licensure, and accreditation
are essential criteria for stepping into the 21st century as exercise physiology
professionals.
This brings us to an interesting
point in this essay. How does the exercise physiology curriculum
continue to reinforce the importance of research and scientific thinking
and also address issues of professionalism? The first step
is to stop ignoring those who have been writing about the development of
exercise physiology professionalism. The second step is to
read the articles, study the content, evaluate its knowledge base, and
determine if there is evidence for such development. No one is saying
that the scientific approach to fitness, rehabilitation, and/or sports
training should be discontinued. Rather, what is said by these authors
is that the traditional approach to exercise physiology course work has
failed in bringing attention to the professional dimensions of exercise
physiologists. The implications are obvious. Without a new perspective,
a new way of viewing the future, and without important curriculum changes,
students (as well as the faculty) may continue to embrace the science path
with little serious understanding of the social, economic, and political
climates of the emerging profession. This allows for a continuation
of a certain predictable cynicism and resignation among the students and
the future of exercise physiology.
The study of professionalism
should be embedded in exercise physiology curriculum, along with the standard
lectures and laboratory experiences. More emphasis, however, should
be placed on critical thinking and what it means to think straight (19,
20). Students need the intellectual understanding to know the
difference between good science and pseudo-science (21).
In time, they (particulary, the recent graduates) will be more involved
in the issues and concerns of curriculum development. They will help
the faculty ask questions such as:
-
Why aren't more courses on critical
thinking required of exercise physiology students?
-
How is professionalism woven
into the traditional lecture format?
-
What are the implications of
analyzing the traditional curriculum tempered with skepticism for certain
courses?
-
Who decides the title of the
department, major, and profession?
-
What are the benefits, if any,
for continuing the assumption of differences "by title" between the so-called
clinical exercise physiologists and the exercise physiologists?
-
What is the proper relationship
between exercise physiologists and sports medicine?
-
How do we know that exercise
physiology is an emerging profession?
-
What happens to exercise physiology,
as an emerging profession vs. a discipline, should the members of the American
Society of Exercise Physiologists fail in realizing the ASEP Vision?
-
What are the professional implications
of these questions?
The questions are endless
if both the students and the faculty get together in the development of
the curriculum and the profession. It is up to both to reach out to the
other and make a difference where possible.
Students
as Customers
More and more college
professors are realizing that a college education is about the students
more so than the faculty. This realization has been slow in coming,
and it is still not the reality in the majority of institutions. Seldom
is the topic discussed at professional meetings or published in exercise
physiology journals. Not until the electronic development of the
Professionalization
of Exercise Physiologyonline
journal has an exercise physiologist written on the subject (22).
However, it is very likely that the students (and especially the recent
graduates) should be involved in guiding the development of the exercise
physiology curriculum.
The curriculum must be developed.
It cannot just stay as it has been for decades. Change is inevitable
if exercise physiology is to continue its movement towards professionalism.
The ASEP exercise physiology core is a beginning only (23).
While it is a much needed step to start the movement towards consistency
from one academic program to the next, and even consistency eventually
in the names of departments that offer exercise physiology degrees, it
is just the beginning. The exercise physiology faculty must get more
involved in guiding the students' education. They must also ask students
about their academic learning and hands-on experiences to determine if
what they are teaching is applicable to the types of jobs available in
the public sector.
If students are customers,
then it makes good sense to us that the faculty can no longer produce a
product that is flawed at graduation. Both the customers and that
which they become by their education, the product, are the same.
Given this connection as "the" important lesson in this essay, the exercise
physiology faculty cannot teach courses or provide experiences that have
little value in shaping the product (i.e., the customers) to gain meaningful
employment. The specialized education (or service) provided by the
faculty requires a certain specificity and correctness to help the students
become the exercise physiology product they expect to be.
The curriculum must have
a purpose that is shared not only between the faculty and the students
but also with the community at large. Just as teaching is a purposeful
activity, the students' education is organized (or should be) with a purpose
in mind which, generally speaking, is to access a good paying job.
This central purpose of teaching must therefore be rational (24).
It must help the students learn to be exercise physiologists within the
larger society.
This idea is not completely
new. Just recently, the faculty of medical schools (25-27)
have considered it important to ask students what might be more helpful
for their learning. Students are encouraged to make constructive
suggestions to their professors. Faculty in turn identify the interests
of society that increase the students' opportunities for employment.
This type of thinking should also work in exercise physiology where congruence
between course methods and public sector jobs actually increases a more
positive partnership between both faculty and students.
This is a significant problem
that needs some critical reflection. Logically, the exercise physiology
faculty should take the lead in getting more students (and especially those
who are already working in the public sector) involved in shaping the curriculum.
With a better and deeper understanding of what is actually necessary to
work in the public sector, both the acquisition of jobs and the education
of the students will be more manageable. For this reason, faculty
who are especially interested in teaching should partner with students
to design, implement, and/or evaluate the courses that are presently being
taught in addition to the consideration of entirely new courses.
The distinction is the emphasis
on faculty teaching and the application of concepts and ideas to benefit
the public as faculty scholarship equal to publishing. The challenge
before the faculty is to build an infrastructure to foster and reward scholarship
in teaching that will advance the students' objectives both professionally
and financially. The process is new but possible, and it is likely
to be ongoing for many decades to come. Students and faculty will
need to negotiate and interact at all levels of the education process.
Departments should have forums for enabling the infrastructure, and the
opportunity for increased faculty and student sharing, collaboration, and
exchange of what works to empower the customers.
Those engaged in the importance
of recognizing that students go to college to strengthened their chances
of landing a great job understand the intent of this thinking. New
intellectual understandings can surface from the very act of trying and,
then believing in the necessity to share in the students' challenges after
college. Eventually, it will be clear and made explicit that the
faculty serve the students and that the partnership is valued and encouraged.
To facilitate this thinking, exercise physiology departments should make
several changes. First, at the time of hiring all faculty
members, they must have the understanding of "students as customers".
Second, the faculty members must demonstrate an understanding of the
obstacles that the non-PhD exercise physiologists face in the public sector.
Third,
a formal demonstration of the faculty member's support and devotion to
the students. Without this, it would be next to impossible to encourage
new thinking to change the traditional ideas.
Since it is unlikely that
the changes will take place across all departments, the existing exercise
physiology departments (by name) should lead the way. Obviously,
the formalized process has been outlined by the ASEP accreditation document
(24). It is the beginning, and it is the challenge
before all faculty of exercise physiology. In time, and after sufficient
analysis, it is fair to say that support for one name (i.e., exercise physiology),
and one department (i.e., the department of exercise physiology), should
be acknowledged as the new exercise physiology model to support
the movement of exercise physiology professionalism.
Like the subject of this
essay, which cannot occur in a vacuum but rather built on a partnership,
professionalism cannot flourish without effort, planning, and a vision
of a new exercise physiology curriculum. Professionalism is a priority
in exercise physiology. Without it, there is no corrective agent
against the physical education tradition that has resulted in the narrow
thinking of exercise physiology as clinical exercise physiology.
Unfortunately, students continue to embrace the "clinical" title without
an understanding of its shortcomings. As customers, they need a better
idea of the larger perspective of the emerging profession. One way
to do so is to encourage the faculty to initiate professional development
committees, programs, and conferences.
Exercise physiology professors
must cultivate the values of professionalism in their academic programs
and students. A serious review of how students are educated and by
what titles they refer to themselves is lacking. Hence, the customers
(i.e., the students) are seldom aware of or encouraged to study the fundamental
elements of professionalism: altruism, accountability, excellence, duty,
integrity, and respect for others (28). Both faculty
and students need self-reflective thinking; a habit of thinking that is
open-ended that sets the stage for the eventual philosophy and history
of exercise physiology. Learning to think critically about content
and application is important. Similarly, the scientific strengths
and limits of the exercise physiology body of knowledge must be ascertained
as well as the necessary integration of the same with the public sector.
In the end, it is up to the exercise physiology faculty to create the academic
environment to empower the students (i.e., their customers) and to develop
professionalism throughout their education and professional careers.
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Copyright
©1997-2000 American Society of Exercise Physiologists. All Rights
Reserved.
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