Professionalization of Exercise Physiologyonline     


ISSN 1099-5862   Vol 6 No 12  December 2003 
 



 
 



    Editor-in-Chief
    Tommy Boone, PhD, MPH, MA, FASEP, EPC
 

The Struggle for Meaning in Academic Exercise Physiology
Tommy Boone, PhD, MPH, MA, FASEP, EPC
Professor and Chair
Director, Exercise Physiology Laboratories
Department of Exercise Physiology
The College of St. Scholastica
Duluth, MN 55811
 
“A professional organization or society gains an advantage over a non-specific professional organization by carrying out its activities faster and better.”  -- William T. Boone
Introduction
At the age of 28, I found myself ABD (i.e., all but the dissertation).  The experience was neither threatening nor something I thought about when I accepted a teaching position at Wake Forest University.  However, what I learned was an important lesson.  First, if possible, it is best not to accept a university teaching position without having completed the doctorate degree.  Completing the degree afterwards doesn’t carry the same rewards as having the degree from the first day of employment.  Second, when in graduate school, ask more questions.  For example, what are the job opportunities beyond college teaching?  Why should someone invest time and money in exercise physiology?  What is the future of exercise physiology?  Don’t let the content and research time consume you.  While I learned to understand exercise physiology, I knew little about professionalism.  This point is particularly important.  Had I experienced discussions about professional development of exercise physiology along with the calculated statements about acute and chronic adaptations to exercise, I would not be shaking my head.  The faith that I placed in the professors was unquestioned.  I was taught that we were part of a “science” community, and that our task was to do research.  We were not taught how our specialized “research” knowledge would be used in the public sector. 

My reason for writing this article is not to show up the professors, but only to point out the out-of-step “thinking” of many academic exercise physiologists that continues today.  The first is that, while inspired by the graduate courses taken at Florida State University, the academic degree was essentially meaningless without a college teaching position.  Even today, if the undergraduate degree doesn’t result in a job, it is an abstraction, a problem, and an unfortunate expense.  Academic course work that encourages the title, exercise physiologist, ought to have a direct link to career opportunities other than teaching.  Secondly, when I was an undergraduate student at Northwestern State University, as a physical education major, I knew that there were very specific jobs in the public sector.  In other words, the academic degree had a highly specific purpose.  Graduates were considered professionals.  There were held to a higher standard and, therefore, they had accountability and respect.  I did not know that this was not the case with exercise physiology.  Perhaps, even worse, after teaching college courses for close to 20 years, I didn’t know the questions to ask or the concerns that should have been considered.  Now, after 36 years of college teaching, I understand that answers to these questions are central to the struggle for meaning in academic exercise physiology.

Years Leading Up to a Sense of Purpose
This article is an attempt to understand the “struggle” and the academic landscape of exercise physiology across the past 50 years of exercise physiology with close ties to sports medicine.  In a sense, it is a step back in time to see exercise physiology for what it was in the late 1960s and early 1970s.  As I’ve said, the future belonged to the doctorate prepared exercise physiologist.  Historically speaking, as a college teacher, the intellectual challenge that associates with being an exercise physiologist is significant and engaging.  There is a sense in which exercise physiology is exactly on the same level as chemistry, biology, physics, nursing, and other science-oriented academic degrees.  Hence, it is easy to understand that when I was hired at Wake Forest University, I believed 100% that I was an exercise physiologist (although I still had to complete the dissertation).  I had a good mental map of what I believed was necessary to be an exercise physiologist.  The science-thinking person in me understood what was important.  My thinking was one with exercise physiology of the time.  And, frankly, I enjoyed doing research, writing scientific manuscripts, and books.

Without understanding fully what I was doing, as Graduate Coordinator of five academic departments at the University of Southern Mississippi (after leaving North Carolina in 1981), I tried unsuccessfully to restructure the doctorate program and to identify it as an Exercise Physiology degree.  The consultant to the School of Human Performance disagreed.  Instead, regardless of the high concentration of course work identified as exercise physiology, the title “Human Performance” was accepted.  This was a major mistake that is still being played out across the United States.  Fortunately, after taking the chair position at The College of St. Scholastica in 1993, I had the opportunity to make the kind of changes necessary to convert my previous work from exercise science and/or human performance to exercise physiology.  Within a year at St. Scholastica, the Department of Exercise Science was renamed the Department of Exercise Physiology.  The courses were updated in both content and laboratory experiences [1].  The department offers 12 exercise physiology courses with eight courses that require 2-hour labs each week.  The ASEP Board of Accreditation has recently (spring, 2003) accredited the St. Scholastica exercise physiology major [2].  Now, there are six accredited programs of study in the United States [3].

Founding of the Exercise Physiology Society
After writing the bylaws and constitution for the American Society of Exercise Physiologists in 1996 and after incorporating the ASEP organization as a non-profit professional organization of exercise physiologists in 1997 in the state of Minnesota, my thinking towards the American College of Sports Medicine (ACSM) changed.  In just a few years, my ACSM friends and colleagues no longer existed.  The truth is my work towards developing ASEP was then (and still is) a contradiction in how they think about ACSM.  Here again, the issue isn’t ACSM per se but the exercise physiologists who have dedicated their life’s work to ACSM.  It is hard for them to accept that change is inevitable, that even if the ACSM/exercise physiology research is great, neither the organization nor the research defines or enables the professional development of exercise physiologists.  Although ACSM produced important certifications, none is linked to the exercise physiologist per se.  This has been “the” problem that has preventive the development of an academic degree in exercise physiology throughout our colleges and universities.  In fact, it is probably this reality that creates the tension between ACSM and ASEP. 

It is my pleasure (if not responsibility) to point out that the ASEP leadership is not interested in making the ACSM leadership and/or members look bad.  If anything, we have great respect for the leadership of the ACSM organization and the work of dedicated exercise physiologists.  However, that doesn’t mean that exercise physiologists should not have our own professional organization.  Not only do we have the right to our own professional organization, we have the responsibility to do the right thing as well.  This point should be obvious to anyone who teaches students and who cares about whether they can find a job upon graduation.  Also, it should be obvious that having just any certification, even a sports medicine certification, isn’t enough if it doesn’t have the professional meaning or impact that it should.  Physical therapists, nurses, and others understand this point.  Why don’t we?  Part of the problem is that we were taught how to think as professors.  We were taught to do research and to help athletes jump higher and run faster.  We were not taught that exercise physiology has important healthcare implications.  This should not come as a surprise despite our relationship with ACSM and research networking.  Everyone, including me, for many years believed that ACSM was “the” organization of exercise physiologists.  Of course this was never true even though exercise physiologists, perhaps more so than any other group of professionals, helped shape the direction of the organization.  Since 1954, ACSM has served as an opportunity to present research and to connect with other researchers.  This same opportunity exists today, but “research” doesn’t make ACSM the organization of exercise physiologists.  There are probably 20+ different professionals with their own professional organization as members of ACSM [4].

Research and Exercise Physiologists
The exercise of “doing research” is a big deal.  The balance of power among academics is directly a function of credible research.  Those who do more research are generally more powerful, and are able to make departmental changes requiring significant financial resources quicker than those with less power.  Thus, both the administration and the faculty are interested in doing research and publishing scientific papers.  Promotion and tenure are linked to research, both in the number of publications and the quality of the manuscripts.  The voting on tenure is hardly a joke.  Inevitably, it identifies professors who stay and those who leave the university.  The battle over research is real, but notoriously understood among good researchers.  That is, the debate about who is the better researcher is essentially meaningless when manuscripts are published.  The priority of importance is given to those who publish and/or present at national meetings.  The critical point in the development of an emerging profession is that research is part of professional development, but it isn’t enough to convince the public of unswerving professionalism.  This may also come as a shock to those who have improved their conditions within the sports medicine community through presenting research posters.

It is very clear that in the early development of ASEP members who were intrinsically driven to present research learned to translate their work into other forms of oral and/or poster presentations.  Although presentations about professionalism are still far from a groundswell of huge numbers, there is now an understanding that the emergence of exercise physiology as a healthcare profession requires its members to study, discuss, and present the many facets of what constitute professionalism.  Understandably, those who were rebellious early on will consider it their duty along with the continuation of scientific studies.  It is also not surprising that so many were so confused early on.  Everyone now knows that professional organizations are especially predisposed to caring for their best thinking and appearance that tells the public who they are and what they do.  The ASEP’s answer to these kinds of issues is perfectly logical:  every new organization has to grow and learn.  No organization starts perfect with no misunderstandings or skeptics.  And, frankly, there is nothing mysterious about this point.  The state of any new organization invites humility, not certainty.  To think differently hints at a sense of wanting to see the organization fail.  It seems that is exactly what some academic exercise physiologists want and, yet there are acts of kindness by remarkable young and old exercise physiologists who believe we need our own professional society.  In fact, words of “great job” or “love the web site” have been pouring from individuals throughout the United States.  Much of it comes from non-doctorate prepared men and women.  It is becoming more and more clear to us what the future of ASEP holds for all exercise physiologists. 

The ASEP and ACSM Struggle
Despite the ASEP potential to make significant advancements in exercise physiology, a sense of resentment exists among exercise physiologists who have their roots in ACSM.  Their thinking is driven by their presence in sports medicine.  It is an inevitable stand against ASEP for the wrong reasons.  Signs of this struggle between the two organizations have existed since the founding of ASEP in 1997.  It may be that the two organizations are now locked in a battle in which neither side is likely to negotiate new thinking.  This has made it difficult for both organizations to create a new world of career opportunities for all exercise physiologists.  Unfortunately, it didn’t have to be this way.  In late 1995 and several times thereafter, the ASEP leadership tried to establish a physical relationship with the leaders of ACSM.  Even as recent as several months ago, there was a “first-time” opportunity with a sigh of relief at the passing of the crisis between ACSM and ASEP.  It could have been a beginning for great things.  Instead, the communication was designed for individual organizational survival and power, not mutual respect.  The ASEP President, Steve Jungbauer [5], and the ASEP Board of Directors [6] demonstrated strong leadership during the recent communications with ACSM.  Steve, in particular, helped us stay the course.  The road ahead of us is still uphill, but the turning point is our commitment to continue our work.  In other words, “Thou shalt have no other organization above ASEP.”  And, no ASEP member is obliged to obey or join against the ASEP thinking.  No one has to uphold the beliefs of another organization.  It is time to recover our greatness, our own professional consciences, and to obey our own consciences rather than the orders from others.  The impact of this feeling is felt more dramatically in ASEP in recent weeks than a year ago. 

There is intensity in the ASEP perspective to develop exercise physiology.  It is inspiring, creative, and a serious turning point that is striking.  Yet, the most uncomfortable lack of commitment of academic exercise physiologists to the ASEP beginning of a real reaction against not having professional credentials is a problem.  The political signals from the academics are unjustified.  The first target of their attack ought not be ASEP, the only professional organization to help their students.  It is simply an unjust action.  Their feelings are imbued with a sense of commitment to ACSM.  Indeed, it is an ironic twist that illustrates the deeply held beliefs that exercise physiology can flourish within sports medicine.  The debate about which organization can claim control over exercise physiology, ACSM or ASEP, is now over.  Obviously, ASEP is “the” professional organization of exercise physiologists.  But this point is not settled within the academic setting.  This isn’t a tragedy.  Rather, it is profound statement of individual career conditions within the university system versus the reality of career inconsistencies for recent graduates.

The Spirit of Professionalism
The academic elite know what the problem is, but have relegated responsibility to sports medicine and other non-exercise physiology groups.  It argues that they have not freed themselves from their past way of thinking.  Why it has been hard for them to discover their own values in their teaching and working with students is confusing.  One important possibility is groupthink.  Another is the evangelization of the sports medicine era, conquest, and exploitation.  Surely, it will be a nice day when all students are led gently but firmly beyond sports medicine to exercise physiology as a healthcare profession.  The image of universal unity within the exercise physiology ranks is reflected in the ASEP work and spirit of professionalism.  It is my dream that exercise physiologists can get out from under the sports medicine world (or similar worlds) to believe they can live, grow, think, and make it together with ASEP.  Therein lies the understanding behind my title:  The Struggle for Meaning in Academic Exercise Physiology.  It is close to the phrase “the struggle to believe”. 

It is not that academic exercise physiologists cannot or should not belong to sports medicine or other organizations.  That is not the intent of this article.  Exclusion is not the answer, especially when it is ASEP that is being excluded from mainstream academics.  One may persuasively argue that an equal share of responsibility for exercise physiology exists for both ASEP members and academics.  This raises the problem with the multitude of different academic degrees that reportedly allow for the title, Exercise Physiologist.  It is untenable to suggest that there is any value in continuing the way we have for the past 40 years.  The irony of the academic marginalization lies in the fact that academic exercise physiologists have failed to affirm the importance of change when they should be the change agents.  Taken literally, academic exercise physiologists have failed (and continue to fail) their students.  I argue that this sports medicine “institutionalized” thinking is lacking since it has substituted “fitness professionals” for “exercise physiologists”.  I argue also that the “thinking” is a faithful step to ensure the academic’s “official” position as researchers, if not physiologists.

Further, it is important to reaffirm that exercise physiologists are not physiologists!  This, too, is a distinction that is causing tension among the academic exercise physiologists.  Of significance here is my assertion that an exercise physiologists believe they are “physiologists”.  Such a questionable practice runs counter to the values of an academic degree.  On reason for such behavior is that before the founding of ASEP there was no standard of thinking for exercise physiologists.  Cultural norms didn’t exist within exercise physiology.  So, in effect, anyone could (and still does) use the “physiologist” title without being questioned.  This doesn’t make it right, however.  The practice is simply wrong and misleading, although deeply entrenched in exercise physiology.  The dilemma facing exercise physiologists is obvious:  to be a physiologist, you need an academic degree in physiology.  Amidst this confusion of who is an exercise physiologist and who is a physiologist, students are even more confused in their pursuit of jobs.  Here, the key stakeholders in undergraduate and graduate (master’s degree) programs want faculty members to act responsibly.  They want professors stop the teaching of “any degree program” as though it is exercise physiology.  Students want professors to act professionally and socially responsible by restructuring the degree programs with appropriate titles that allow for accreditation linked to board certification.  Yet, in discussing this very point with a professor from another university, it is business as usual.  Not only has he turned a blind eye to economic and political issues of lack of consistency in degree programs and titles, his laissez-faire attitude is directly in contrast to the issues and concerns students face at graduation.  In other words, it is the easy way out of serious ethical problems that surround the idea that the university department and/or laboratories are for the faculty and not for the students. 

Leadership is an Endless Journey
How long will the struggle against change last?  How many students will we fail, who will unjustly experience frustration?  How long must our students struggle for equality?  The dilemma facing chairs and directors of a department is either to update the academic major or to abstain from offering such programs and run the risk of law suits from students who are handicapped by misinformation.  Simply put, the students’ education has ethical, moral, and social implications and responsibilities.  This view is defined by the fact that students pay for an education that is linked to department statements that suggest important professional and economic benefits.  This view of increased responsibility of college departments on behalf of students is consistent with the cultural understanding that we “get what we pay for”.  When students finally realize that their education is not worth the money they invested, department chairs and exercise physiologists are not going to be able to say: “I was only doing my job as I knew it.”  Everyone should understand that if their beliefs are outdated, then, to be responsible to their clients (in this case, students), they must figure out how to do what is right. 

A starting point for a new way to think about exercise physiology is to consider the approach ASEP has taken to professionally shape and change how people think about exercise physiologists.  All the major ASEP documents have been written as a Bill of Rights that consensually defines an accepted standard of professional behavior for exercise physiologists.  This is particularly important if the public and other healthcare professionals are to understand our approach to an ethical relationship with clients.  The intent is to achieve the maximum benefit for our students and those already in the public sector.  While there are no hard-and-fast rules in how ASEP is changing exercise physiology, one especially important rule of thumb is to have a code of ethics and an ASEP philosophy regarding exercise physiology to ensure that our students will have increased career opportunities.  This thinking is consistent with numerous PEPonline articles written to communicate the ASEP Code of Ethics [7], the importance of academic accreditation [8], board certification for exercise physiologists [9], and just how serious ASEP is about ethics.

The ASEP Work is Altruistic
From a strategic point of view, ASEP is doing everything right.  The university teachers who aren’t thinking about their students aren’t thinking right.  They are not cognizant of their responsibilities to their stakeholders.  This is a history of failure and, frankly, it cannot be ignored any longer.  It is the university professor’s responsibility to ensure that the academic major has important and meaningful inroads into the public sector.  The major is supposed to produce goods and services of value to the stakeholder.  And, as I said, there is a legal responsibility expected of professors to obey.  This may be done by ASEP membership, by voluntarily enabling students to associate with ASEP, and by “doing the right thing” on behalf of students.  This rationale is altruistic.  It differs from publishing yet another research paper in expectation of receiving something in return.  It is more about students and less about professors!

A department should be responsible to its stakeholders.  I believe what is presently obvious to anyone who has his or her eyes open is that the continued failure of academic exercise physiologists to fulfill their ethical responsibilities to their students will eventually result in legal suits to the detriment of the department and its economic survival.  This thinking is supported by Keith Davis who states: “…those who do not use power in a manner that society considers responsible will tend to lose it.” [10]  Chairs of departments and/or exercise physiologists must willingly police their departments and act responsibly on behalf of their students or their power, position, and opportunity will be reduced by increased outside regulation via the university administration or public.  If chairs do not wish to face the uncertainty of failing to change, they must be willing to actively embrace the increasing certainty that associates with the ASEP perspective.  It is the first step in strategic planning to realize the exchange of ideas and to generate new ones to help regulate a professional environment and increased market share for students.

Megatrends for Exercise Physiologists
One way to identify department developments toward the professionalism of exercise physiology is to ask if the ASEP Board of Accreditation has accredited the department’s academic major.  This is also very likely to determine the future of the department insofar as exercise physiology is concerned.  As noted earlier, only a few departments, unfortunately, have successfully met the striengent requirements for accreditation.  Obviously, the trend for increased departmental success, both ethically and strategically, lies with the essential “baby boom” effect of the ASEP 21st century perspective.  That is, to the extent that accreditation is new, it is a baby boom perspective yet to be realized as a strong tradition of exercise physiology professionals.  Just as John Naisbitt, who wrote Megatrends, proposed 10 broad influences [11], I propose the following “megatrends” for exercise physiologists. 

1. We are moving from an exercise science major to an exercise physiology major. 
2. We are moving from a technology thinking to an integrated healthcare thinking.
3. We are moving from sports medicine to a future as exercise physiologists.
4. We are moving from filling available jobs in the public sector to strategically identified niche careers.
5. We are moving from an exclusive emphasis on research to a boarder analysis of our specialized knowledge, to an integrated application, to prevention and rehabilitation of dysfunction and/or disease.
6. We are moving away from reliance on sports medicine accomplishments to ASEP opportunities.
7. We are moving from exercise physiologists identified by the doctorate degree to exercise physiologists defined by the ASEP board certification.
8. We are moving from our dependence on historical thinking in favor of 21st century networking among all exercise physiologists.
9. We are moving from clinical exercise physiology to exercise physiology.
10. We are moving from an organization groupthink existence to a society of personal and professional possibilities with increased career options.
The Niche is Healthcare
The trend for something different for all exercise physiologists reflects the awareness that sports medicine failed undergraduate students for more than 50 years.  To the extent that the exercise physiologists of the past decades did their best is not an issue.  But, each stakeholder (i.e., each student) is worth more than the 10 or 20 hard working exercise physiologists and all of their research presentations and publications.  The professor’s role is to empower his or her students, not to empower him- or herself.  Teaching is about imparting information to students to enable them, not to add another publication to one’s resume.  This is undoubtedly a lesson that will take some time to learn.   The collective strength of ASEP members will establish a new exercise physiology, a new way to promote exercise physiology, and a new link to potential customers beyond our present dreams.

The “link” is critical to the exercise physiology “niche”.   It is the ASEP transition from a specialist thinking to a healthcare perspective.  The niche is healthcare!  Everything ASEP has done (and will do) is a direct strategic process to define the exercise physiologist’s professional distinction.  The organization represents a new way of thinking about exercise physiology.  Members compete for a professional niche, not cash cow certifications or other immediate rewards.  They are leaders in the integration of fitness, wellness, rehabilitation, and athletics.   Board certified exercise physiologists with undergraduate and master’s degrees along with the doctorate prepared exercise physiologists work together to strengthen their collective niche as healthcare professionals. 

“If we believe in exercise physiologists as healthcare professionals, then clearly we cannot wait for all exercise physiologists to change or for the chairs of the academic institutions to update their thinking. 
We, who understand the shared vision, must assume personal and professional responsibility for our own future.”  -- William T. Boone
The Invitation to Share the ASEP Vision
Many of the things I’ve written about in this article represent the force behind changing my mind about “what is exercise physiology” and “who is an exercise physiologist”.  It is my personal transformation, freedom, and self-realization to ensure new and credible career opportunities for all exercise physiologists.  Our shared vision is the building block to guide our work, to reshape our thinking, and live according to the 21st century view of exercise physiology.  It is a shift in prevailing values and beliefs away from sports medicine to exercise physiology.  The shift is the "Breakpoint" to mastering our own future [12].   Neither sports medicine nor others, doctorate prepared exercise physiologists nor directors of clinical programs can solve our problems.  The flaws created by the lack of leadership on behalf of academic exercise physiologists are just too fatal without a complete reshaping of their thinking.  As that happens, the power of our shared vision will replace the inadequacies of the past.  Until then, the intention of the ASEP leadership is to unveil, before anyone who is willing to connect with reality, of the sports medicine myth [13].  The lack of a passionate commitment to ASEP is unsettling.  Academic exercise physiologists must get off the fence.  This isn’t meant to be personal.  Rather, I’m writing about the importance of a passionate commitment to a shared communication and respect for students.  If we are willing to change the way we have been thinking, we will be able to help our students create a different future.  It really isn’t much more than rethinking who we have been to what we want to be. 
  • I invite university teachers to come together with a willingness to solve our problems. 
  • I invite you to join ASEP and to share in its development.
  • I invite you to express to others a strong sense of professional spirit.
  • I invite you to commit to changing the way things are and help guide all exercise physiologists to a better future. 
  • I invite you to say “enough is enough”. 
  • I invite you to join the endless journey of professional development by sharing your actions, feelings, and ideas. 
  • I invite you to take time to think about exercise physiologists who are in synch with the ASEP vision.
  • I invite you to teach others what we think and what we value about ASEP.
  • I invite you to look into the future under the control and direction of the ASEP leadership.
  • I invite you to develop a can-do attitude, to stretch yourself, and to believe that you can make a difference.
  • I invite you to help all exercise physiologists come together with a unified voice.


References
1. The College of St. Scholastica. (2003). Exercise Physiology Health Science Division. [Online]. http://www2.css.edu/publications/advisor/ExercisePhysiology.html
2. American Society of Exercise Physiologists. (2003).  Guidelines for the Accreditation of Undergraduate Programs in Exercise Physiology. [Online]. http://www.asep.org/asep/asep/accredit.htm
3. American Society of Exercise Physiologists. (2003). Exercise Physiology Accredited Academic Programs in the United States. [Online]. http://www.asep.org/asep/asep/accreditedINSTITUTIONS.html
4. American College of Sports Medicine. (2003). Membership. [Online]. http://www.acsm.org/membership/index.htm
5. Jungbauer, S. (2003). ASEP President. [Online]. http://www.jungbauer.org/Steve.htm
6. American Society of Exercise Physiologists. (2003). ASEP Board of Directors. [Online]. http://www.asep.org/asep/asep/execbod.htm
7. American Society of Exercise Physiologists. (2003). ASEP Code of Ethics.  [Online]. http://www.asep.org/asep/asep/ethics.htm
8. American Society of Exercise Physiologists. (2003). Board of Accreditation for Exercise Physiologists. [Online]. http://www.exercisephysiologists.com/boardofaccreditation/index.html
9. American Society of Exercise Physiologists. (2003). Board of Certification for Exercise Physiologists. [Online]. http://www.exercisephysiologists.com/boardofcertification/index.html
10. Davis, K. (1974). The Meaning and Scope of Social Responsibility.  In Contemporary Management: Issues and Viewpoints.  Edited by J.W. McGuire.  Englewood Cliffs, NJ: Prentice-Hall, p. 631. 
11. Naisbitt, J. (1982). Megatrends. New York, NY: Warner Books.
12. Land, G. and Jarman, B. (1992). Breakpoint and Beyond: Mastering the Future – Today. New York, NY: Harper-Collins Publishers.
13. Boone, T. (2001). The Sports Medicine Myth. Professionalization of Exercise Physiologyonline. Vol 4, No. 7 [Online]. http://www.asep.org/asep/asep/SportsMedicineMyth.html

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