PEPonline Professionalization of Exercise Physiologyonline An international electronic journal for exercise physiologists ISSN 1099-5862 Vol 5 No 8 August 2002   The Psychocultural Science of Taking Responsibility Tommy Boone, PhD, MPH, MA, FASEP, EPC Professor and Chair Director, Exercise Physiology Laboratories The College of St. Scholastica Duluth, MN 55811 "We become wise not by remembering the past but by taking responsibility for the future.”  -- George Bernard Shaw MANY PRESENT DAY exercise physiologists have followed in the footsteps of pioneers like David Bruce Dill, Per-Olof Astrand, Erling Asmussen, Bruno Balke, Thomas Cureton, Bengt Saltin, Dave Costill, Jack Wilmore, Jim Skinner and hundreds of others [1].  The fruits of their collective research are now regarded as our body of knowledge.  To be sure, exercise physiologists have produced volumes of information pertaining to the human body, fitness, health and wellness, sports, and rehabilitation.  This article is not about down playing the profound importance of research.  Obviously, the research process is important, valuable, and necessary.  Researchers know that it is arduous work requiring discipline and training.  However, research per se does not make a discipline into a profession.  Until we take responsibility of professional development with conviction, the exercise physiology body of knowledge will remain incomplete.  Herein lies the purpose of this article.  "While it is clear that exercise physiologists know a great deal about the physiology of exercise, it is less clear what they know about taking responsibility for professionalism as well as the psychocultural science of professional development, professional credentials, and academic accreditation."  This raises important questions regarding the science of what psychology and culture have to do with professional development.  To begin with, science is a process of inquiry, perception, and verification.  As it pertains to exercise physiology, it is the psychological and cultural phenomena that explain, predict, and control the practice (and thus the future) of exercise physiology.  The more study we give to it – the more complete our thinking as fitness, sports, and rehabilitation professionals and the more successful we will be in marketing ourselves with other healthcare practitioners.  If this were not so, why is the path to professionalism a constant source of study, evaluation, analysis, and implementation throughout all professions?  The issues here are:  1. How do we open our minds to the study of professionalism?  2. How do we achieve professional credibility? Perhaps, a beginning point is in acknowledging that we are responsible for the conditions faced by our students in the public sector.  I recall a professor saying, “My job is to teach two courses a semester, do research, secure grants, and serve on committees.  It is not about whether my undergraduate students locate jobs or even what kind of jobs they get.” As you might imagine, I was more than a bit taken back by the professor’s comments.  Unfortunately, it wasn’t the first time.  Such comments are common.  Students are generally viewed important only to the extent that they are necessary for the courses to be taught and, therefore, the teacher has a “teaching” position.  If what I’ve said is even remotely true, it demonstrates our shared sense of failure.  For certain, it can’t be acceptable to say to every college graduate: “You should get a master’s degree.  That will solve your job problems.”  Then, later, the student may hear the college professor saying, “There is always the doctorate degree.”  And, even later, there is always the argument for post-doctorate work, especially if there are still no job opportunities.  Unfortunately, this has been the voice of many for years.  It is not the answer, however.  The Importance of Accountability Students have the right to believe that college teachers should be forthcoming in whether the academic program of study yields a job at graduation.  Similarly, the undergraduate degree should not be a “generic educational experience” from which the chair of the department and the faculty are not held accountable for the misrepresentation of the academic degree.  For example, too many students graduate from far too many university programs, either with a kinesiology degree, sports science degree, or exercise science degree, thinking that they are “exercise physiologists”.  This is a huge problem for the student and the employer in the public sector who has come to de-value exercise physiology simply due to the diverse academic preparation of their employees.  It is time that academic exercise physiologists look to themselves for a credible and objective picture of what the future should hold for their students.  1.  If the academic program is entitled “kinesiology” or any other description other than the title, exercise physiology, the faculty should make sure the students understand the distinction.  Exercise science is not exercise physiology!  Kinesiology is not exercise physiology!  Exercise science and sports studies is not exercise physiology!  Exercise physiology means the identification of physiological mechanisms underlying physical activity, the comprehensive delivery of treatment services concerned with the analysis, improvement, and maintenance of health and fitness, rehabilitation of heart disease and other chronic diseases and/or disabilities, and the professional guidance and counsel of athletes and others interested in athletics, sports training, and human adaptability to acute and chronic exercise. [2]  2.  If there has been too much emphasis placed on research and not enough on the exercise physiology curriculum, professional development, and marketing of what we do in the public sector, then we should correct it.  The search for a better future requires that we come to a shared understanding of our emerging profession and this, in turn, implies a collective thinking to get beyond our past mistakes.  We need to think differently; each one who waits is guilty of wasting the opportunity to move exercise physiology into the 21st century.  In regards to #2, Robert Schuller [3] concluded the following:  “Patience is not a virtue if you sit back and wait for your problem to solve itself…merely waiting for it to happen could be the worst thing to do…many problems have the built-in capability to grow more serious with the passing of time.” The Path of Professionalism It is crucial, therefore, when an occupation moves to become a profession, to realize that all professions, regardless of their uniqueness are held accountable to simple yet powerful steps in the professionalization process.  Pragmatically speaking, it is not possible to achieve “profession status” without honoring the hierarchy of events that associate with professionalism.  Physical therapists, nurses, occupational therapists, and a host of others understand this point.  It is so important that “professional development” is one of several academic courses required of the students.  The path of professionalism requires careful study, planning, and implementation [4].  It is an acknowledged transfer of information and property of sorts as well as a shared understanding between the members of the profession or emerging profession and those who may wish to limit its power in the public sector.  The significance of this point for present purposes is that the members of the emerging profession of exercise physiology are fraught with major tensions and obstacles when they fail to understand the rules of professional development.  What is needed, in other words, is a better understanding of the “psychology and cultural conditions” for professional acceptance and social integration into the public sector.  Part of that understanding is coming to terms with the gradual redefinition of an occupation to a profession.  It is equally important to recognize the role of positive, collective thinking by members of the emerging profession in the analysis and preparation for handling the multitude of interrelated factors.  The psychology and cultural background of the members and their willingness to share the same vision are extremely important in laying a solid foundation for change and acceptance.  Too often, as has been obvious during recent years, members of the emerging profession are poorly prepared for the shift in new thinking.  Often times, there is the sense of losing what they have, including a general anxiety and/or fear of whether they have what it takes to be successful or even whether it is necessary (especially if their program is going rather well).  It is therefore not surprising that it takes time to turn the corner on new possibilities.  To emerge as a profession is a serious intellectual marathon.  Colleagues who find themselves as members of traditional thinking may find it difficult to believe that change is possible, especially when they have come to respect the thinking of the old establishment.  This is unfortunate for obvious reasons. “Few people are capable of expressing with equanimity opinions which differ from the prejudices of their social environment.  Most people are even incapable of forming such opinions.”  -- Albert Einstein  The Nature of Professionalism Members of different thinking bring to the table a perceived sense of the conflict, while failing to appreciate the common right of everyone to think and do as they please.  Feelings of persecution and even the anticipated likelihood of destruction of accomplishments (both personal and professional) are perceived as possible, if not expected realities among colleagues.  And, of course, there is the basic sense of lack of security and mistrust of anyone who suggests that there are benefits associated with the new alternative, even to the point of perhaps dismantling or stripping the person of accomplishments and/or respect.  Although not exhaustive by any means, this brief analysis is a basic demonstration of the discrimination and asymmetry in thinking without rational thought.  It is also part of the psychocultural science of coming to a closer and more detailed understanding of the practice of exercise physiology.  Here we see critical analysis and personal bias delicately balanced with creativity, but this is only true with emerging professions.  At the present time, there is no development of a psychocultural theory or the testing of new ideas as possible guides to ways of doing things within exercise physiology.  No where except within the context of the electronic PEPonline journal is there at least some consistent presentation of the nature of professionalism, the conflicts that associate with it, and role of society in the emerging profession of exercise physiology.  This needs to change.  More exercise physiologists, academic or otherwise, need to step up to the plate and be counted among others in the revolution before us. We need to do it for our students first and, then, for what we do or say we are as exercise physiologists.  Otherwise, for the majority of students who are thinking about exercise physiology (yet majoring in human performance or exercise science) as an academic area of study, the present conditions will most certainly make them victims of their own thinking and/or career expectations.  It would seem the best thing we could do, as honest exercise physiologists and mentors, is to get beyond our intractable conflict that continues to poorly define our collective and personal identity.  Also, it seems very appropriate that we should come to appreciate the role of societal beliefs and expectations in the acceptance of an occupation as a profession.  As long as the public views what we are (by past standards and/or conditions) and what we do through the lenses of their beliefs, it is always going to be a challenge in differentiating ourselves from other healthcare practitioners.  This is a problem.  Our students need a solid understanding of the relevant issues before them.  We can no longer, morally or ethically, leave our students behind in the process of change; we have to make the necessary effort to engage in new thinking to allow for new beliefs and a new image.  “Problems that are created by our current level of thinking can’t be solved by that same level of thinking.” – Albert Einstein The Professionalization Process The failure in understanding that everything changes is to believe that everything stays the same and, in so doing, everyone loses.  The PEPonline journal is designed to bring about a new level of thinking about exercise physiology.  It is one way to market and encourage new thoughts, ideas, and opportunities about our emerging profession.  Ironic as it may be, academic exercise physiologists refer to themselves as professionals but only in the context of a discipline.  If we should continue as a discipline, everyone loses.  When professors think as professionals, but act as though they are members of an occupation, we lose.  Without a dream, we have nothing.  With the dream of being a profession, we have everything.  Is it too strange to dream of exercise physiology with members who lay claim to understanding basic and applied aspects of physiology to all kinds of human issues?  Is it too difficult to dream that exercise physiology has its own body of knowledge whose members have created and have used in solving health and fitness problems?  If this dream (i.e., these thoughts and ideas) cannot be accepted by exercise physiologists, then they should stop teaching as though the students in their programs should have “the right to control their own work”.  Meaning, if it is not special to teach exercise physiology courses in exercise physiology programs when they could just as easily be taught in physical therapy or some other healthcare program, then maybe we should get out of the business.  The dream is to change this academic image to include the concept of professional autonomy and equality of status with other healthcare practitioners. Characteristics of a Profession For several years now, the PEPonline electronic articles have been about trying to understand the dynamic process of professionalism.  The term itself has been defined, along with articles about “What is exercise physiology?” and “Where do exercise physiologists work?”  It is different from the term professionalization, which is defined as an ongoing process whereby disciplines or occupations are observed to change certain characteristics in the direction of a profession [5].  Considerable work has been put forth in the articles to demonstrate that exercise physiology fits the characteristics of a profession [6]: 1. It is intellectual, carrying with it high responsibility. 2. It is based on a body of knowledge. 3. It is practical more so than theoretical. 4. It is taught within a credible educational format. 5. It is organized with its own professional organization. 6. It is motivated by altruism. Most exercise physiologists reflect the same professional attitudes as those of other professionals.  They are committed to their work and see it as having implications for better healthcare in society.  They understand the importance of a professional organization that is responsible for credible academic programs.  Other members of exercise physiology are committed as well, but they still believe that we are a discipline not an emerging profession.  For them, being a member of any organization, especially one that promotes research, is good enough.  This is a another serious problem.  They don’t seem to get the big picture.  Professionals need their own organization, but of course the plain truth is that no organization can be what it must be without committed members with the desire to evaluate the psychocultural science of taking responsibility.  Hence, for one to understand any organization, it is necessary to review in a fair and objective manner the relevant aspects of its agenda, bylaws and constitution, vision, and goals.  The birth of any organization of significance results from a belief in possibilities based on logical and straight thinking.  The price for the belief is large, but acceptable for most exercise physiologists who have examined the process of professionalization.  Otherwise, for others, the sacrifice and commitment becomes too much when the dream begins to weaken with differences and disagreements.  Obstacles to Professionalism Rubenfeld and Scheffer [7] point out that one of the biggest obstacles to the consideration of different beliefs is the security in what we are accustomed to doing.  This may be the reason why the membership in one organization is comfortable and the membership (or even the idea of membership) in another organization is believed to be risky.  It takes individuals who are willing to walk the walk to get beyond a safe habit.  Some of the insensitivity of our colleagues may also explain the discontent when considering another organization.  A third obstacle is sometimes the feeling of anxiety.  Anything new increases our level of anxiety.  As a result, we are confused because anxiety often decreases our thinking ability.  These obstacles can be associated with new organizations, although they don’t have to contribute to poor-quality thinking.  We can use the power of our minds to produce that which we think [8].  Formless as the mind may seem, it is self-evident that the power of new thinking cancels and erases everything unlike itself.  In fact, we can see the power and its results within our beliefs as they have played out in the evolution of the American Society of Exercise Physiologists (ASEP).  As a parallel in thought, it is widely believed that: “As a man thinketh in his heart, so is he.”  Can it be any clearer that if we are to have a future, it must arise from within and, therefore, “…what we are to become depends upon what we are thinking…” [8]  Exercise physiologists who are interested in thinking differently can learn to associate new ideas with new possibilities.  They can learn to develop ways to modify the limitations, perceived or real, that result from the overuse of secure and comfortable ways of thinking.  As an example, they can go with their “gut feeling” to see that change is supported, even when it is uncomfortable to do so.   And, they can learn to get beyond the notion that every idea has both a good and a bad element to it.  Seeing things as only “right” or “wrong” is not helpful in learning to appreciate new ideas.  Hence, we should work not with anxiety, but with a presence of mind consistent with a sense of purpose.  There is no way we can get to know ourselves better except by studying who we are.  It is this tactic of keeping our minds open to a fundamentally different way to think that is smart.  Imagine, in just a few years outside of mainstream thinking, new thinking by members of the ASEP organization has resulted in exercise physiologists having their own code of ethics, standards of professional practice, board certification, accreditation, and much more!   None of this could have been possible without first conceiving the impossible. “Those who have great faith, have great power.”  -- Ernest Holmes The Power of Dreams As history has demonstrated with other developing professions, the effort to accredit academic programs is extremely important.  It has opened the door to credibility in exercise physiology.   Students who may have felt hopelessly lost in the lack of professionalism at their institution now have hope.  Those who work on behalf of these students know their work is literally the backdrop to a more positive and promising horizon.  This is unprecedented work on behalf of all exercise physiologists.  This then should be recognized as an honorable thing, not a problem.  It should also be regarded as necessary, since no change can occur without an action causing a reaction.  Thus, without a better understanding of why the psychocultural science of exercise physiology, including the need to think beyond what we are now, no one is motivated to do the impossible.  With a better understanding why we need a professional organization, everything is possible.  New thinking leads to new possibilities and new leadership; both can and do shape the future.  Remember, “when you have a dream, you have everything” [9].  Dreams are the secret to success, especially:  1. When they are practical and fill a vital need for our students. 2. When they are unique; and  3. When they provide the opportunity for professional credibility.  Defining our Niche All we have to do is get over who we think we are and get on with who we really are!  In due time, we will be who we want to be and we will do what we want to do.  In other words, the challenge for all of us is to get outside of the black box.  We need to believe that exercise physiology “can be” and “will be” a profession like nursing, physical therapy, and other healthcare professions.  And, it is extremely important that we define “what business exercise physiologists are in”.  It is no longer acceptable to graduate students into a vacuum of little to nothing in real jobs.  As stated earlier, getting the college degree “only” without a promising connection to respectable and financially rewarding jobs is not acceptable.  The truth is that most students and their parents believe that the purpose of a college education is to find solid work.  Parents and students have come to place their trust in the educational system.  When it works, it is proof of why it exists.  When it works, it is proof of the value of in having dedicated teachers and administrators.  When it fails to work, it destroys faith in the educational system and, yes, in those who administer it.  This is why it is so important that an education produces an effect exactly like it is believed it should.  This is also why it is so important to define our “niche” in the public sector.  Once this has been done with credible success, we can avoid continuing to shoot ourselves in the foot.  This is the reason for the Standards of Professional Practice [2] for exercise physiologists.  It is our credible connection between the academic degree and the career opportunity in society.  Until modified by the ASEP Board of Directors, the declarations within the Standards document are immutable agreements that not only govern members of the emerging profession but define exercise physiology in the public sector.  “Corporations are successful not because of the hundred and one good little actions they take to save money on paper clips and telephone calls, but because of one of two major strategies that are brilliant.”  -- Dr. Michael J. Kami Understanding Resistance  Understanding the science of the psychocultural factors that impinges on the characteristics of a profession is inevitable.  There is hardly any organization that is not planning for 10 to 15 years from now.  Members of these organizations are reinventing themselves, their image or they have board members who are talking about their dream of doing something different because of the perceived need to do so.  Being different, understanding the difference, and having a purpose are important indicators of success. Understanding the traits or characteristics of professions can help us with our attitude about “who we are” and why we think our knowledge is specific to exercise physiology.  And, in particular, we need to work at understanding our vision and in acquiring a shared attitude towards the community of exercise physiologists to reduce the resistance to taking responsibility for professionalism and the professionalization of exercise physiology.  No one should be surprised at the unwillingness of some to further exercise physiology professionalism.  There will always be general resistance in just about everything we do.  No one should intimidate others because they are still evolving from yesterday’s thinking.  Survival itself requires change, readjustment, and a renewed way of thinking that results from the need to be accountable.  Shared information must be accountable, whether it is in the college classroom, at professional meetings, or implemented in the public sector. The Reality Check Without shared information, we are likely to continue as we have without questioning the process.  This is the case when our students are not supported in the public sector.  Instead of continuing with the same traditional way of doing things year after year, we need something new.  A better education is a start; one that is credible through accreditation.  This is the wake-up call, if not our “reality check” we have needed for decades.  It should be obvious that “credibility” is the reason for the existence of a professional organization of exercise physiologists.  Ignorance or the failure to adjust is no longer acceptable.  The past cascade of events that has resulted in no emphasis on professional development can no longer be tolerated.  Similarly, it is no longer appropriate to prioritize students out of the public sector equation of financially good jobs and the opportunity to work with respect.  Instead, it is time to imagine the power in the articulation of a new exercise physiology. “Man is what he believes.”  -- Anton Chekbov Exercise physiologists are at a turning point [4].  The American Society of Exercise Physiologists is the window of opportunity, if not the reality check for exercise physiologists throughout the United States.  Everything is in place.  Just one more thing is needed.  The Society needs members to focus their energy on the unified vision the individual members share.  This is our reality check; the willingness to take responsibility.  Henry Ford had the right idea, “Don’t find fault, find a remedy.”  An important part of finding a remedy is to know your competitors.  It is not surprising that exercise physiologists have paid so little attention to identifying and understanding competitors.  Yet it is obvious that marketing allied health educational programs [10] without a marketing plan to identify competitors is no plan at all.  What should be apparent is that without a clear sense of the struggle against the beliefs of others, preserving one’s own beliefs is laboriously earned.  However unsettling this thinking may appear, the pursuit of self-development would only drift along without guidance by a shared vision.  This idea of “knowing your competitors” is new.  This is because beneath all great products (organizations included) there is a set of common underlying principles of development and survival.  This brings us to the shared aspect of membership and purpose.  A Shared Vision Shaped by Passion One can argue with considerable support that imagination is the front runner to action.  And, without a doubt, exercise physiologists at all academic levels need to be more active in supporting their professional organization.  The basic psychology and cultural issues have been examined in “taking responsibility” [11].  It is not surprising why the older establishment has been slow in assuming leadership roles in professional development.  It is surprising, however, why the younger members are out in the streets fighting for their right to influence and shape the emerging profession.  Understandably, the shift from “yesterday’s thinking” to “tomorrow’s thinking” is something that does not happen without effort.  Everyone would agree that it is both a struggle and a lot of work.  It is risky, too.  But, it can be (and generally is) an emotional and intellectual creation that does not allow for silencing.  Within the mind and hearts of individuals who singly and/or collectively have the same vision, there is a single voice that is armed to co-exist with the thinking that gives rise to new possibilities.  Armed with this knowledge, our future as exercise physiologists lies in this voice, shaped by passion to: 1. Create the future to improve what we do, how we do it, and why it is important.  2. Feel valued and appreciated for professional education and expertise.  3. Convert our body of knowledge to a standard application and practice.  4. Look to the future and plan for our professionalism.  These statements of belief are consistent with the purpose to contribute time, energy, and money to improve the lives and common good of the members of the emerging profession of exercise physiology and the healthcare concerns of society.  For this reason, we must have faith in knowing that we are right.  We must therefore not allow anything or anyone to enter our thoughts that will weaken us.  And, we must keep our faith strong.  We must learn to do “whatever it takes” to bring hope to our students and to our colleagues as well.  We must learn to anticipate trends and developments that bring opportunity to a new tomorrow.  The attitude of “whatever it takes” must not be lukewarm.  We must have conviction!  Waiting for time or someone else to solve our problems is not the answer.  “It is not a question of failing or succeeding.  It is simply a question of sticking to an idea until it becomes a tangible reality.” – Ernest Holmes Faith is Power Exercise physiologists must come to understand the power they have in shaping their future.  It is not a complicated fact, and there really isn’t anything about it that is mysterious.  It is as most fathers tell their sons, “If you want to play football, then take a chance.  Believe in yourself.”   So, what does this have to do with exercise physiologists? 1. We don’t have to surrender opportunities to others.  2. We can learn to have a shared voice on who we wish to be and work at being that professional.  3. We can forget about those who would disagree with us or belittle our efforts, and  4. We can acknowledge that when failure is not possible, nothing can stop us.  Again, when we don’t surrender leadership to others, our opportunities are unlimited.  We can still (and we must) do research but not just physiology research.  We must also do research on professional development.  Doing so will help liberate us from past thinking.  This is not really anything new; it is tomorrow’s realities.  It is faith in a new and transformed future for our students.  And, yes, it is a matter of taking responsibility.  “If you refuse to accept anything less than a credible professional organization of exercise physiologists, you can expect to get it.”  -- William Boone References 1. McArdle, W.D., Katch, F.I., and Katch, V.L. (2001). Exercise Physiology: Energy, Nutrition, and Human Performance. 5th Edition. Philadelphia, PA: Lippincott Williams & Wilkins. 2. ASEP Board of Certification (2002). Standards of Professional Practice. [Online]. http://www.css.edu/ASEP/StandardsofProfessionalPractice.html 3. Schuller, R.H. (1983). Tough Times Never Last, But Tough People Do!  New York, NY: Thomas Nelson Publishers. 4. Boone, T. (2001). Professional Development of Exercise Physiology. Lewiston, NY: The Edwin Mellen Press.  5. Maloney, M.M. (1986). Professionalization of Nursing: Current Issues and Trends. Philadelphia, PA: J.B. Lippincott Company. 6. Flexner, A. (1915). “Is Social Work a Profession?”  In Proceedings of the National Conference of Charities and Corrections. Chicago, IL: Hildermann Printing Company, pp. 578-581. 7. Rubenfeld, M.G. and Scheffer, B.K. (1995). Critical Thinking in Nursing: An Interactive Approach. Philadelphia, PA: J.B. Lippincott Company.  8. Holmes, E. (1998). The Science of Mind: A Philosophy, A Faith, A Way of Life. New York, NY: Jeremy P. Tarcher/Putnam. 9. Robbins, A. (1986). Unlimited Power. New York, NY: Fawcett Columbine. 10. Hassel, P.L. and Palmer, D.R. (1992). Marketing Allied Health Educational Programs. Santa Clara, CA: Eagle Publishing & Communications. 11. Boone, T. (2001). Taking Responsibility for Professionalism. PEPonline, Vol 4, No 2, February [Online]. http://www.asep.org/asep/asep/TakingRESPONSIBILITY.html Copyright ©1997-2007 American Society of Exercise Physiologists   All Rights Reserved.