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Editor-in-Chief
Tommy Boone, PhD, MPH, MA, FASEP, EPC
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The Struggle to Serve the Profession
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
“Expectation is a servant of the
will, the will is the result of a wish, and a wish is spun from the power
of spirit.” -- Marcus Bach
This work began many years ago, and has just
recently taken the form of an academic inquiry into the role of academic
exercise physiologists in the struggle to serve the profession. As
a college teacher for nearly four decades, I began revising my thinking
about exercise physiology about 10 years ago. At that time, my thoughts
changed from just teaching to chairing a department and teaching.
Although I'm responsible for numerous administrative decisions, my primary
motivation and what I think about most of time is teaching. To be
a teacher is uniquely special to me. It takes a lot of work and time
to organize the right content for the right reasons. Not everyone
is a teacher. In fact, many teachers aren't very good at teaching.
Teaching allows for an expression of feelings and thoughts that few other
jobs allow for or encourage. The unfolding of ideas in class could
not be more exciting to the teacher who is still learning. It is
therefore important that I teach despite my age or other considerations.
I am eternally thankful that I am a teacher. After all, it is a special
opportunity to share one's thinking with young people, to enjoy everything
about it, and get paid for doing so. Therein lies the understanding behind
my desire to do what is right on behalf of my students and exercise physiology.
However, "the power of spirit" to teach is always a mixed blessing.
Not all the students are equally motivated to learn. Some have no
idea what college is about. And, there are students who choose an
academic major without even knowing why! In short, when students
and faculty are not on the same page, there is little hope of a quick understanding
of the challenges within the profession. This lack of focus creates
circumstances that take from a unified purpose. As a result, teachers
who must teach within the transition period of change will struggle to
serve. This brief article is about the "struggle to serve".
The concept “to serve” is part of what
college teachers understand. They are expected to perform a “service”
to the students, the college, and the community. Service is an important
part of the academic model for promotion and tenure. It is a mutually
understood concept among the faculty and between the faculty and administrators.
Therefore, when there is a struggle to serve or to demonstrate one's service
to the institution, there is a problem that must be solved. Although
it may not have an immediate, direct influence on promotion or tenure,
faculty members are often predisposed to “serving” their students as part
of the service requirement. The typical backdrop to service is in
the classroom and laboratories. In other words, teaching is a service
and a duty, although traditionally "service" is something that is done
beyond teaching and research. When teaching is viewed as a form or
type of service, then the service in the form of teaching becomes problematic
when students fail to understand the purpose of the content. The
failure, then, sets the stage for the “struggle” per se. In terms
of content, most students understand what is expected (i.e., if its a kinesiology
course, then the content is about muscles). Yet, from discussions
with other teachers, when they bring up ideas relevant to students after
graduation than before graduation, they fail to grasp the importance.
For example, I’ve observed that some students aren't interested in legal
issues, negligence, and supervision of exercise programs before graduation.
These same students appear disinterested in the obvious benefits of having
a scope of practice.
A part of the problem stems from the overall
lack of professionalism and what it means to be a professional in the field.
Another part is the lingering effects of traditional thinking that exercise
physiology is little more than counting heart beats. Still further,
there is the lack of an agreement among academic exercise physiologists
as to what is exercise physiology and who is an exercise physiologists.
Hence, why should students know what is important, right, or wrong?
Until teachers take time to teach about the issues and concerns that impact
exercise physiology, serving students within the "professional frame of
thinking" will be a struggle. This point is concretely linked to
the fact that students have no knowledge of what constitutes professionalism
or why a professional organization is important. Few, if any, students
in exercise physiology or related programs talk about professionalism and,
if that isn’t bad enough, few faculty speak of professionalism. Further,
the conflict may be directly related to the students’ emphasis on athletics
and the faculty’s emphasis on research. Both kinds of thinking are
traditional and comfortable. Neither the students nor the faculty
across many campuses seem to understand the need for exercise physiology
to evolve. It can therefore be concluded that the history of exercise
physiology is in contrast with the contemporary thinking of the ASEP leadership
[1]. Yet, the latter must be understood and embraced if exercise
physiology is to survive beyond a "fitness professional" status.
Surely, the board certified exercise physiologist is more than a fitness
professional or a personal trainer? The question is, "Do students
understand the difference?" If they don't, which is very likely,
it is a problem, especially when teaching about professionalism, accountability,
and licensure rather than about running faster, jumping higher, and getting
stronger. Consider the factors that have contributed this dilemma:
In 1948, Morehouse and Miller
[2] published Physiology of Exercise text. The pioneering
work of researchers at that time was directed at the physiology of sport,
work, and war. The Intoduction of the text was written by David B.
Dill, who wrote "It is not enought to make neat studies of frogs' nerve-muscle
preparations, of swimming rats and of pating dogs. Man himself must
be the subject; many of the advances in exercise physiology have come from
self-experimentation." [2, p. 9] Dill's use of the words "exercise
physiology" is impressive. Certainly, at that time, there was little
to serious thinking about exercise physiology as a healthcare profession.
It was then as it still is today primarily about research on the physiology
of sport. In 1965, Karpovich [3] published the sixth edition of Physiology
of Muscular Activity. Although easily interpreted as an exercise
physiology text, it was written for the physical educator. Similarly,
the 1970 Textbook of Work Physiology, by Astrand and Rodahl, was
written for the physiologist, the physical educator, and the clinican.
It was not written to meet the needs of the student of exercise physiology
[4]. It wasn't until 1986 [5] that a text was written that placed
considerable emphasis on the use of exercise physiology to "...understand
the role that exercise plays in the development of a healthy life-style
based on legitimate research (i.e., Physiology of Exercise and Sport
by
Noble). Still, Nobe did not define exercise physiology. In
1993, the problem continues with the text by Fox, Bowers, and Foss,
The
Physiological Basis for Exercise and Sport [6]. Instead of a
definition that would allow for a profession to be built from underneath
it, the authors wrote, "Exercise physiology is an aspect of kinesiology
and sports medicine that involves the study of how the body, from a functional
standpoint, responds, adjusts, and adapts to exercise." [6, p. 3]
Unfortunately, this definition is still believed by many exercise physiologists
today.
In 1994, Wilmore and Costill [7] published
Physiology
of Sport and Exercise. They wrote that "Exercise physiology is
the study of how our bodies' structures and functions are altered when
we are exposed to acute and chronic bouts of exercise. Here again,
the definition is somewhat in agreement with Fox, Bowers, and Foss.
This is yet another example of not having the right definition from which
to build a profession. These researchers were primarily physical
educators who were interested in "...how the body adapts physiologically
to the acute stress of exercise, or physical activity, and the chronic
stress of physical activity." [7, p. 5] Brooks and colleagues [8]
published Exercise Physiology, second edition, in 1996. The
defined exercise physiology as "...a branch of physiology that deals with
the functioning of the body during exercise." [8, p. 3] In
1997, Plowman and Smith [9] published Exercise Physiology for Health,
Fitness, and Performance. They wrote that "Exercise physiology
can be defined as both a basic and an applied science that describes, explains,
and uses the body's response to exercise and adaptation to exercise training
to maximize human physical potential." [9, p. 3] Note that the definition
is similar to the previous definitions plus it supports Dill's earlier
1948 comment. In other words, little progress was made across essentially
50 years in the definition of exercise physiology. In fact, the authors
of the fourth edition, 2001 Exercise Physiology text [10], did not
even try to define exercise physiology!
Prior to the founding of ASEP, it should be
clear that Exercise Physiology was defined as the acute and chronic adaptations
to exercise. No one had a problem with the definition or the lack
of a proper defintion for 50 years. Frankly, the academic exercise
physiologists apparently paid very little attention to the definition.
Had they done so, faculty in particular, the definition of "what is exercise
physiology" would have changed long ago. The historical and, yes,
sports medicine/physical education definition is not just inadequate but
totally incorrect. It is not possible to build a profession around
the definition(s). Perhaps that was always the point; the doctorate
prepared exercise physiologists are primarily researchers. They teach
when they have to and, where possible, assign their classes to doctorate
students. No one (until the past 10 years) actually expected exercise
physiologists to emerge from an undergraduate program. Maybe the
mix of physical education with kinesiology and exercise science courses
is sufficient to create a “health and fitness” certification, and maybe
the master prepared graduates could call themselves “fitness professionals”.
But, neither the kinesiologist, exercise scientist (if there is such a
thing), or the fitness professional is an exercise physiologist.
Now, it is clear that the struggle to serve is partly due to lack of leadership
by exercise physiologists at the college level for many decades (perhaps,
as long as 50 plus years).
While research is important to exercise
physiology, it must have a purpose beyond jumping higher, running faster,
and getting stronger. Athletics is all about athletics. Exercise
physiology cannot be just about athletics. It must also be about
health, fitness, wellness, and rehabilitation [11]. In other words,
exercise physiology has always been rooted in the tradition of healthcare.
Unfortunately, it is only since 1997 that the ASEP leadership has re-defined
exercise physiology apart from the obvious link to athletics. Here
again, exercise physiology is not exercise (or sports) nutrition.
Although part of the subject matter of exercise physiology, no one should
be driven to push dietary or sports supplements onto athletes. Athletics
is not just about winning. It is much more than that, and exercise
physiologists are much more than technicians. But, here again, this
is part of the struggle. It seems that some students are down right
happy to stand by a treadmill and monitor heart rate day after day.
The struggle is in trying to help them think of what they could be doing.
With the right education and professional credentials, they could be leaders
in health, wellness, and rehabilitation. The problem is that they
don’t seem to get the big picture and, of course, it all comes back to
the faculty who are responsible for sharing the picture and time for it
to sink in.
“Exercise Physiology is
the identification of physiological mechanisms underlying physical activity,
thecomprehensive 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.”
Exercise Physiologist is a person
who has an academic degree in exercise physiology, or who is certified
by ASEP to practice exercise physiology [via the Exercise Physiologist
Certified exam (EPC)], or who has a doctorate degree with an academic degree
or emphasis in exercise physiology from an accredited college or university.”
[12]
It is noteworthy that physical therapists
in academic settings are entrusted to share professionalism with their
students. This aspect of their academic position largely represents
the value placed on professional development. They understand the
importance of having a professional code of ethics and scope of practice.
Nurses in the academic setting teach professionalism. It is not a
struggle because physical therapy students and nursing students appear
to understand from the beginning that professionalism, professional development,
accountability, and standards of professional practice are as important
as other subject matter. This is not true in exercise physiology.
Of course, there are only a few colleges and universities with an undergraduate
(or graduate) academic degree in exercise physiology [13]. Knowing
this, living with it, and sharing it with students, faculty, and friends
are also part of the struggle to serve. The problem can only be fixed
by upgrading programs through ASEP accreditation [14] to exercise physiology
programs of study. It cannot be fixed by calling the problem, which
presently exists with 30 plus different names, by a similar name (i.e.,
fitness professionals). Fixing the problem requires a completely
new way of thinking. Part of this problem is that exercise physiologists
have not embraced professionalism [15].
One can safely say that the role of an
exercise specialist or fitness profession in the public sector is a contradiction
to the ASEP definition of an exercise physiologist [12]. Therefore,
one wonders how the sports medicine declaration that has supposedly justified
its powers and influence over exercise physiology has been maintained even
into the 21st century. It is interesting to note that the declaration
is far from complete, however. In this sense, the exercise physiology
heritage with sports medicine is appreciated, and therefore, is valued
and will always be remembered. That is, in brief, exercise physiologists
helped create a forum whereby their research could be presented, talked
about, and published. That process is still important because it
is fundamental to continuing the scientific base that is largely the specialized
body of knowledge exercise physiologists have created. Yet, in an
age of change, in order to fully realize the potential invested in the
knowledge base of exercise physiology, regardless of feelings otherwise,
exercise physiologists must capture it within a scope of practice that
is tied to licensure. But, the struggle to serve is part of this
issue of exercise physiologists failing to move exercise physiology from
a research discipline to a profession and, therefore, failing to discover
the implications for service in the public sector. It is not enough
for exercise physiologists to understand the value of exercise and to encourage
the public to exercise. Several established professions do that all
the time.
To effectively undertake a study of the
role of exercise physiology in the public sector, exercise physiologists
must consider the integrated disciplinary body of knowledge that defines
exercise physiology. To do this, however, they must look beyond their
immediate interest in research. This should not come as a surprise,
although it will be a surprise to many exercise physiologists. They,
in particular, will need to rethink what they are teaching and why it is
important [16]. Every profession must have a reason for its existence
if the public is to acknowledge it. There must be something about
what the members of the profession do that is unique to their education
and “service” to the public as healthcare professionals. The irony
of course is that the ASEP organization was founded to help with the rethinking
process, to move students from an inferior education to a respectable field
of study, and to embrace professionalism just as other healthcare professionals
have done.
It seems obvious that the unfolding of
the ASEP effort has by no means been overlooked or underestimated except
in the service department. To serve students and the profession is
important. To always do so under stress and general unrest is not
healthy. Students of exercise physiology should expect discussions
of professionalism, the importance of ethical thinking, and the politics
of professional development. Yet it is more than curious to find
students not necessarily contrary in their thinking about professionalism,
but overall less engaged in the symbolic significance of the ASEP effort.
In this sense, I’ve observed students who seem to look at their instructors
during class with little appreciation of the work that they do on the students’
behalf. It is obviously disconcerting and disappointing. This
isn’t true with physical therapy, nursing, or other recognized healthcare
professions. Part of the reason is that the students have worked
hard to get into those programs. For the most part, this is not true
when it comes to majoring in programs that are traditionally linked to
physical education, kinesiology, or exercise science. Whether
anyone wants to admit it or not, these programs accept just about any student
who attends college. So, I suppose these students are not thinking
about their major in the same context as students who apply to get in nursing
or physical therapy. I argue that this kind of system (i.e., one
or two courses that separate a physical education degree from an exercise
science degree) is not just less than desirable, but contrary to the 21st
century thinking that defines exercise physiology as a healthcare profession.
Taken literally, why don’t the academic exercise physiologists do something
about the problem?
Perhaps, the criteria for triggering change
are set out in the authentic, passionate support of ASEP. In short,
to influence others is to live the vision. To serve students and
the profession is to live the vision [17]. To not live the vision
is to say, in effect, “I don’t really care about it.” This kind of
thinking can run a person in circles, which brings to mind the statement
everyone has heard at some point: “You can lead a horse to water,
but you can’t make him drink.” The imagery that readily comes to
mind here is that of students who don’t understand the need for professional
development, and they don’t see any reason for talking about it.
Trying to force them to do so is futile. They have no idea about
the importance of regulation, professionalism, and accountability.
They don’t understand why the teacher has undertaken an official declaration
to discuss professional issues and concerns that face exercise physiologists.
They have no idea as to the nature of exercise physiology as an evolving
profession [18]. This dilemma presents itself as a serious obstacle
to serving the students. And, yet simply by a twist of mind students
can embrace change. An inner vision gives them the justification
to joins hands in the same effort. This isn’t a struggle, and it
is fun to be part of. But, when it doesn’t happen, it is a struggle
and the question is, “How can the struggle be eliminated?” What can
teachers do to help students reconsider deceptive practices by other organizations?
These are just a couple of the questions that relate to service.
Just recently, I was asked to speak to
a class of exercise physiology students. Several times during my
carefully chosen words with the potential to influence or launch a new
idea or hope for increased career opportunities, I realized that the secret
of my presentation regarding “licensure” was not having the impact that
I thought it would. This really surprised me. Instantly, I
wanted to take an inventory of what was going on but it was not possible
or appropriate at the time. Since then, I’ve thought a lot about
the students’ failure to assimilate the thoughts that associate with professionalism.
I suppose the art of awareness reminds us that we grow by many different
ways, and we do so at our own pace. Meaning simply this: I
had hoped that every student would be on the same page with me. I
had hoped that my presentation would be a “motivational piece”. Instead,
it was met with altogether something different. The students were
not ready to think differently. Also, they were not prepared by the
teacher to think outside of the box. It isn’t easy to serve.
Let me tell you that the 40-minute presentation was a challenge.
The spirit of the past pressed heavily upon the students. Every feeling
of hope was put aside with the willingness to stay in the 20th century
with the outdated sports medicine commitment. My attention to this
point was less than it should have been. I should have been better
prepared to address the concept of groupthink [19]. No matter what
I said or how I said it, the impact of what I said was of little consequence.
Whatever I thought I was going to say with ease met permission only with
considerable difficulty.
To serve is a struggle, but so is life.
At least this seems to be the right expression that awaits those who have
a similar passion. As I look at the world of healthcare professionals
today, I’m convinced that the struggle is a time dependent factor that
few exercise physiologists understand. By “time dependent” I mean
that the longer the idea is discussed (i.e., month after month, year after
year) the less difficult it is to talk about it. Gradually, time
itself gives permission to everyone to discuss the idea. This, it
seems to me, is important to understand. After all, to transcend
the grip of one’s past thinking, the breakthrough thinking must be a kind
of transformation that registers a significant effort. For one thing,
nobody said that it would be easy to turn exercise physiology from sports
medicine to something no one had even considered (such as their own professional
organization). What I’ve learned is that it is a matter of keeping
the topic of professionalism before the camera’s eye so to speak.
Even the phenomenal changes that associate with a “first-ever” code of
ethics and standards of practice must be discussed, written about, and
woven into exercise physiology classes. In writing this piece, I
am disposed by nature to believe in possibilities.
I believe in them, invite them,
and expect them. I believe in service to ASEP, students, and the
public. I anticipate that more exercise physiologists will enthusiastically
embrace the ASEP vision. Even since the founding of ASEP, I just
never expected anything else. I expected students to become members
of ASEP. I expected members of ASEP to become board certified.
I expected non-ASEP exercise physiologists to join ASEP. I expected
a new way to think about exercise physiology would happen. What I’ve
learned is that expectation does make things happen. I just didn’t
expect the struggle to serve!
References
1. Boone, T. and Robergs, R. (2003).
Original Thinking by the ASEP Founders. Professionalization of Exercise
Physiologyonline. Vol 6, No. 11 [Online].
http://www.asep.org/asep/asep/originalTHINKINGbyASEPfounders.html
2. Morehouse, L.E. and Miller, A.T.
(1948). Physiology of Exercise. St. Louis, MO: The C.V. Mosby Company.
3. Karpovich, P.V. (1965). Physiology
of Muscular Activity. Philadelphia, PA: W.B. Saunders Company.
4. Astrand, P-O. and Rodahl, K.
(1970). Textbook of Work Physiology. New York, NY: McGraw-Hill Book Company.
5. Noble, B.J. (1986). Physiology
of Exercise and Sport. St. Louis, MO: Times Mirror/Mosby College Publishing.
6. Fox, E.L., Bowers, R.W., and
Foss, M.L. (1993). The Physiological Basis for Exercise and Sport. Madison,
WI: Brown & Benchmark.
7. Wilmore, J.H. and Costill, D.L.
(1994). Physiology of Sport and Exercise. Champaign, IL: Human Kinetics.
8. Brooks, G.A., Fahey, T.D., and
White, T.P. (1996). Exercise Physiology. Mountain View, CA: Mayfield Publishing
Company.
8. Plowman, S. A. and Smith, D.L.
(1997). Exercise Physiology for Health, Fitness, and Performance. Boston,
MA: Ally and Bacon.
10.Powers, S.K. and Howley, E.T. (2001),
Exercise Physiology: Theory and Application to Fitness and Performance.
Madison, WI: McGraw-Hill.
11.Boone, T. (2003). You Are Not a Healthcare
Professional. Professionalization of Exercise Physiologyonline.
Vol 6, No. 12 [Online]. http://www.asep.org/asep/asep/ExercisePHYSIOLOGISTasHEALTHCAREprofessional.html
12.American Society of Exercise Physiologists.
(2003). ASEP. [Online]. http://www.asep.org/
13.The College of St. Scholastica. (2004).
Undergraduate Degree in Exercise Physiology. [Online]. http://admissions.css.edu/factsheets/exercphys.shtml
and http://www.asep.org/asep/ASEP/ExercisePhysiologyGraduateProgram.html
14.American Society of Exercise Physiologists.
(2004). Guidelines for the Accreditation of Undergraduate Programs in Exercise
Physiology. [Online]. http://www.asep.org/accreditation/
15.Boone, T. (2001). Cultivating the Values
of Professionalism: A Professor's Point of View. Professionalization
of Exercise Physiologyonline. Vol 4, No. 1
[Online]. http://www.asep.org/asep/asep/DefiningProfessionalism.html
16.Boone, T. (2002). A New Academic Paradigm
for Exercise Physiology Teachers. Professionalization of Exercise
Physiologyonline. Vol 5, No. 9 [Online].
http://www.asep.org/asep/asep/TeachingWithINTEGRITY.html
17.Boone, T. (2003). A Shared Vision Precedes
Reality: A Personal Perspective. Professionalization of Exercise
Physiologyonline. Vol 6, No. 6 [Online].
http://www.asep.org/asep/asep/SharedVisionPrecedesReality.html
18.Boone, T. (2003). Overcoming Institutional
Inertia with Leadership. Professionalization of Exercise Physiologyonline.
Vol 6, No. 2 [Online]. http://www.asep.org/asep/asep/OvercomingInstitutionalInertiaWithLeadership.html
19.Boone, T. (2002). Exercise Physiology
of the Future: Thinking Out of the Box. Professionalization of Exercise
Physiologyonline. Vol 5, No. 11 [Online].
http://www.asep.org/asep/asep/ThinkingOutsideTheBoxExercisePhysiology.html
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