PEPonline Professionalization of Exercise Physiologyonline An international electronic journal for exercise physiologists ISSN 1099-5862 Vol 5 No 11 November 2002   Exercise Physiology of the Future: Thinking Out of the Box Tommy Boone, PhD, MPH, MA, FASEP, EPC Professor and Chair Director, Exercise Physiology Laboratories The College of St. Scholastica Duluth, MN 55811 “…college professor might consider talking with individuals who comprise the potential job market in a given community and clarify what they need in an employee.  They might brainstorm ideas for new jobs in- and outside of the typical exercise physiology market (e.g., businesses with fitness clubs, shoes stores with a physical evaluation component, cardiology suites, nutritionists and weight control businesses, stress management, and so forth).  More discussion with business owners might improve the image of the field as well as create new contacts and employment opportunities.” [1] FOR SEVERAL YEARS, I’ve written about “changing our paradigm" and what it will mean to exercise physiology.  Today, I’m writing about another means of thinking about the future.  It is simple and to the point.  It is about “thinking-out-of-the-box" or, as more commonly stated, “outside the box”.  Most of us have heard the phrase and have probably used it from time to time.  We are probably less familiar with the phrase, “breakthrough thinking”.  But, to the point, do we know what it means to “think” from a position other than the commonly accepted inside sports medicine model?  Perhaps, equally (if not more) important, do we know what it means to fail to grow in how we think about what we are and what we do as educated individuals?  These questions need answers, and we need to take charge of what we call “Exercise Physiology”.  Since groupthink is also a problem within our field, this is another reason or call for “out-of-the-box” thinking that often times requires putting one’s reputation on the block.  And yet, the commitment to one’s future often requires the confirmation of one’s world defined by actions, faith, and hope. “We are all prisoners of our hope.  It is our hope that sustains us.  It is our vision of what could be that inspires us and those we lead.”  -- C. William Pollard Exercise physiologists have in common a physical education heritage.  Most know that exercise physiology evolved from physical education, which goes by several different names today.  So, it is not something new to find an academic concentration in exercise physiology within a kinesiology department and major.  It is not a bad way to evolve, but it has created major difficulties.  The most common of which is the continued lack of academic independence and the sense of an unchanging way to think beyond yesterday. Most exercise physiologists seem happy to keep it this way, especially since only a significant few are trying to bring the field into the 21st century.  The problem is that when thinking becomes “grounded in the past” without reflection on its contemporary value to society, there is sufficient reason to believe there is a problem.  This is why thinking from a position other than the historical one is imperative.  This type of thinking (for lack of a better description) is often times referred to as “thinking-out-of-the-box”.  Perhaps, more specifically, in regards to exercise physiology, it is thinking from outside of the sports medicine paradigm.  The American Society of Exercise Physiologists model of outside-of-the-box thinking is concerned with what we do and what we are trying to become!  It is the first step to a more creative response to issues faced by our students and concerns about what is exercise physiology.  In actuality, it is a model that has been repeated many times by other professionals such as the: American Society of Biomechanics International Society of Exercise and Immunology Association for the Advancement of Applied Sports Psychology National Athletic Trainer’s Association North American Association of Sports Management  It takes only a few seconds to find these organizations on the Internet.  Each is recognized and appreciated for what it represents in the service to its members.  I hope therefore I can get us to think about the reality of ASEP as an organization not too different from other professional organizations and the reason ASEP was founded.  “The power of an exercise physiology organization is that it shapes options for the future. In fact, it provides the first organized opportunity to put the pieces together to impact regulatory change in academic stability. It is the place to start because it increases visibility and enhances the image of exercise physiology. It also allows for setting the agenda, determining the direction, and making the decisions about the future of the profession. It is the exercise physiologists' gateway for change.” [2] In one way, it is both logical and rational for exercise physiologists to reinvent themselves within the context of their own organization from which to think and explore the dimensions of their world.  Of course, in another way, it is a problem for those who are still thinking as a sports medicine professional.  Their thinking, shaped by years of building sports medicine, is outdated, yet it is hard for them to see the ASEP point of view since their thinking is 100% defined by earlier beliefs.  And, of course, this is the problem since sports medicine is not exercise physiology.  The old way of thinking is no longer useful to exercise physiologists interested in their own professional organization.  Stephanie P. Marshall, Administrator of the Illinois Mathematics and Science Academy, said it best:  "We cannot change what we do until we change how we think, and we cannot change how we think until we change who we are."  Changing how exercise physiologists think is critical to changing from the sports medicine/exercise science model to the ASEP model of exercise physiology.  Either we are exercise physiologists or we are sports medicine/exercise scientists, which is it?  It seems contradictory to continue saying that we are one thing (exercise physiologists) from within the context of another thing (sports medicine/exercise science).  And, what is so obvious is that we cannot change how we think and what we do until we change what we have been.  I have found this point the most difficult challenge to deal with.  This brief article is yet another opportunity to examine how we can get from where we have been to where we need to be.  Sounds somewhat a simple task, but it is a major uphill battle.  To do something different, to build or to promote a new product, to engage in a new art form or to sell a different idea is always a struggle.  This is the challenge before the ASEP leadership.  It is also the opportunity to dream, plan, and support the spirit of the emerging profession of exercise physiologists.  In 1998, I stated it somewhat differently but with the same meaning:  “The spirit behind awareness is never destroyed.  It lasts long after professions are built.  It sustains the kind of world we would like to have.  It teaches us how to live, how to help others, and how to assimilate thoughts in stride with our dreams.  The spirit allows for and encourages…”  us to dream of a better future. [3] But like all things, dreams included, that have the potential to help others, every “opportunity” requires work and discipline not to mention vision and purpose.  And, either along with or just before the work begins, the vision for something better drives the heart of the effort.  And, yet before all this, there was the idea that was considered crazy, different, or unusual.  It is this thinking that is defined as “out-of-the-box” thoughts and possibilities.  The ASEP perspective or, if you will, the ASEP way to think is the definition of new insights into the new exercise physiology.  It represents the 21st century view of the multidisciplinary body of knowledge, hands-on laboratory experiences, and classroom instructional strategies.  “Students need adult support to draw them into a clear perspective about academics. Teachers can and should provide the emotional support in addition to the mental instructions.  In short, acting as a counselor, confidant, and advisor are highly important supportive experiences that all teachers need (and parents have come to expect). Mere exposure to research techniques and the art of publishing isn’t enough. Fostering sensibility and moral acuity are logical extensions of current thinking.” [4] The ASEP perspective is 100% about the reality of educational change, credibility, and accountability.  It is only by thinking as exercise physiologists that we have come to realize the importance in changing what we have been doing, especially for our students.  This new thinking about “what we are” and “why we deserve our own professional organization” has resulted in new insights and strategies.  Obviously, it is only a beginning and a new reality but it comes from the heart.  Therefore, the emergent paradigm of exercise physiology thinking is big since it represents the first-ever paradigm shift both in technical terms and in actualizing an improved education in the classroom.  The ASEP organization is our power and change agent, which reminds me of something I wrote in the October, 1997 issue of the ASEPNewsletter:  "Where does the power come from? Why is an idea so enabling, catching, and moving? The answer is rather simple, but in itself powerful. It is the hope of something better and different; something that an idea or a vision creates. Hope and faith are powerful motivators in creating change and providing for opportunities. With hope, there is always a chance of making progress. The power is in the belief that change will come with the idea. As a result, people are energized and compelled to commit voluntarily to achieving success." [7] The ASEP paradigm is the professional springboard to realize the promise of the new exercise physiology, where emphasis is placed on critical thinking, classroom activities, and hands-on experiences.  It is a new paradigm; one that is by no means completely accepted by the professoriate.  Like all new ideas, there is always resistance or, if you will, little cracks in how we think until we become overwhelmed by the truth, hard work, and extraordinary patience of the believers.  Eventually, the new ideas find their way into the actions of our college teachers and, then, it is just a matter of time as their work slowly wears down old patterns of behavior.  My views haven’t changed from my earlier thinking in 1998 when the PEPonline electronic journal was placed on the Internet:  “The development of alternative assessment strategies, including more emphasis on field experiences and internships -- hands-on practical types of work, clinical, and/or research -- are especially important adjuncts to traditional educational programs. There should be more innovative internship experiences for today's students. Internship placements should begin earlier not later during their academic program. Collaborative relationships should be built with local wellness, fitness, and rehabilitation centers and businesses to find ways to better prepare exercise physiologists. Students should have ongoing activities and opportunities to work on meaningful, useful, and enjoyable basic and applied projects to enhance, motivate, and authenticate the learning process.” [4] Keep in mind; we are still very much in the “beginning age” of educational reform for exercise physiology students. The ASEP list of accredited undergraduate programs in exercise physiology consists of four.  This is no anomaly just the conditions and time required to realize change.   As exercise physiology moves from a “sports medicine-exercise specialist” or technician-centered classroom to a learner-centered classroom, more and more professors will see the values that associate with change.  1. They will create more exacting lesson plans with an increase in the number of courses with labs.  2. Students will become more in charge of their own learning as it also becomes clear that teachers are still learning and will continue to do so along with their students.  3. We will see more teachers using individualized learning plans, particularly in reference to the design of research protocols to answer a specific question, the collection of cardiovascular data, statistical analysis, and the writing of manuscripts.  4. Students will be taught to collect cardiovascular data, profile the data in reference to a particular stressor (treatment), and discuss its relevance within a single comprehensive report.  5. They will be taught to recognize and solve real world problems, particularly those that relate to lifestyle management issues surrounding health and wellness.  6. Teachers will teach students for the purpose of helping them connect with an exercise physiology job and practice in the public sector.  Both will require a professional title, which was emphasized in 1999 in the PEPonline journal:  “Our power lies in our title as exercise physiologists” [6] and in our standards of professional practice.  These subtle but impressive changes along with new academic courses consistently taught from one institution to the next will be the mark of the New Exercise Physiology Academic Paradigm.  It would not have been possible within the old paradigm; it took a paradigm shift (i.e., out-of-the-box thinking by exercise physiologists).  The ASEP leadership has organized itself around the lack of accreditation, the lack of a comprehensive hands-on curriculum, the lack of critical reflection in the research curriculum, and the limitations of building a profession within the context of sports medicine/exercise science.  The organization is new and yet it has been extremely successful in building a network of professionals who are interested (if not, driven) to put exercise physiology on the academic map with a standard of professional practice.  “The strength of the competent practitioner (and thus the profession) lies in continuous adaptability. Unfortunately, this is precisely the missing piece. Adaptability. Building it into an organization is one thing; building it into a profession is another. It is an advanced way of thinking because it requires a new way of thinking. For example, why is there so little discussion about professional issues, what constitutes competence, or why have exercise physiologists not had a professional Code of Ethics? Is it not logical that a competent exercise physiologist must adhere to a standard of practice?” [5] The belief behind founding the “Society” was that a small but dedicated membership could make a difference in the future of exercise physiology.  It is fair to say that the membership has done just that.  ASEP has created significant in-roads into the public sector with new job opportunities and credibility for our students. Hands-on learning was recognized as a big part of the overall re-construction.  This is also why the ASEP Board of Certification created the “Exercise Physiologist Certified” or EPC credential with a comprehensive Part II to the exam.  Those who graduate from exercise physiology programs must demonstrate skills in the laboratory.  It is wrong to think that classroom work alone will teach students: (1) comprehensive stress test evaluations; (2) assessment and management of lifestyle diseases; (3) multiple measures of the musculoskeletal system and/or performance; (4) maximum oxygen consumption testing for athletes; and (5) health and fitness analysis of adults. What is important to consider here is this: In just a few years, exercise physiologists will see important changes in the academic preparation of the students: 1. The integration of classroom and laboratory experiences, and other paradigmatic shifts to embrace critical thinking.  In time, the new exercise physiology “out-of-the-box” thinking will be entrenched in the institutions.  2. Standardization of academic coursework with increased emphasis on cooperative learning and small group project-based research; both will become a common experience of undergraduate preparation, not the exception.  3.. Metabolic and other research technologies will be shared between the students and the faculty, not left just for faculty research.  4. Students will be more self-directed with integrated thinking from business and/or management departments, including but not limited to, psychology, biology, and nutrition.  5. The new model for classroom teaching will support individually- and cooperative-based learning as well as the importance of traveling to sites away from campus (physically) and virtually (by the internet).  6. Exercise physiologists will create and support the ASEP curriculum that allows for “real world” jobs and “real world” credibility.  “The New Exercise Physiology Paradigm: …[will be] an organization designed to support and build its members. Members create the organization!  The organization does not exist for members to belong to it, that is, to make the organization better without thinking about the welfare of the members.” [8]  Academic exercise physiologists will need to think like other educators who are able to emphasize both teaching and research.  They also will need to stop allowing (if not by default, encouraging) doctorate prepared non-college professionals, who are directors of cardiac rehabilitation programs, from dictating or leading academic policy and thinking.  Educators will be responsible for designing academic programs based on the best interest of the students and the profession.  Chairpersons and deans will think about the academic degree as a “product” that is critical to the well being of the student after graduation.  Similarly, the administrators and faculty will think about the following statement taken from the 2001 ASEP: A Call for Action presentation at the 4th ASEP National Meeting:  “Personal integrity, conviction, and the discipline to do what is right are essential to professional development.  So, why is it a problem that an exercise physiologist should disagree with the sports medicine model?  It shouldn’t be.  In a world of conflict, confusion, and effort towards making sense of life, disagreeing with colleagues ought to be considered imperative if growth and new vision are important.  The privilege of disagreeing is just that, a privilege.  Daring to question anything is appropriate and necessary for an understanding of what is right.  The cloud of unknowing or simply not knowing what is straight thinking is a problem.  True knowledge and understanding come from asking questions, constructing hypotheses, and going about the steps of critical reflection.  True knowledge comes from insight; a moment in time when what has been standard thinking is questioned.  Greatness is awakened in each of us when truth within us calls out and tells us what to do.” [9] Just as Thomas Edison looked into the future at the possibilities that could be.  Exercise physiologists must not be concerned with the past, except to learn from it.  They need to plan for the future by thinking “out-of-the-box”.  Here are several tips on how to look forward:  1. The first lesson:  “Live in the present moment with your face to the future”.  Successful people control their lives, both personally and professionally.  They live in the moment, but they have an understanding of what is ahead (i.e., they know where they are going).  Part of their success is that they are always reading and thinking through the conditions of life (i.e., what has happened, what is happening, and what is likely to happen).  This is exactly the road taken by the ASEP leadership.  They understand their destination and they have made important plans along the way to get there.  2. The second lesson:  “Successful people understand that the future is what they make it.”  Hence, if the old paradigm isn’t working, then the future can be changed.  It takes work and passion fueled by a strong vision of something better.  3. The third lesson:  “Work and the passion for something better are visualized and internalized until the mind and heart can smell, taste, and touch the dream (vision).”  Robert Schuller [10] said it best:  "...you can do anything you want to do.  You can be anything you want to be. You can go anywhere from where you are -- if you are willing to dream big and work hard."  “The idea that nothing can stop a person from becoming the best, and that anyone has the power within him- or herself to achieve his/her dream isn’t just a dream.  I believe we all have passion.  It is just that at times different circumstances, people, even friends and colleagues keep us from realizing our potential.  We are discouraged when others laugh at us.  We may even feel that what we are doing is not just wrong but dumb. For many of us, we need support and understanding to release our passion.  We are compelled to keep quiet and to follow along.  Gradually, we forget about our dreams, and our motivation to help others.  We become too self-centered with our own issues and, thus lose sight of the good feelings that once inspired us.  Life isn’t what we expected it would be, and where’s the energy?  Without a vision or a purpose for your work, the day drags on like yesterday.  Nothing seems right.  Where’s your passion? Passion is the force that drives us forward even when our motive, intellect, and character are questioned.  It is the vision of something better for all exercise physiologists.  The idea that we have the right to our own future is a good feeling.  It is inspirational.  It is motivational, especially the desire and drive to rule over our destiny.  We are gradually coming to understand the shift away from sports medicine leadership.  While useful some years ago, it is now important to define ourselves as exercise physiologists.” [11] The opportunity is now to make sure that tomorrow (our future) will not be like yesterday (our past).  Never has there been a greater opportunity for exercise physiologists throughout the United States, if not worldwide.  To help nurture and encourage members of our profession, to contribute to their excellence, and to see them grow profitably, be willing to talk, listen, and share in the ASEP decisions and actions to focus on the future. “A leader must never sacrifice tomorrow on the altar of yesterday.”  -- Peter Drucker  References 1. Boone, T. (1998). Contemporary Exercise Physiologists: Thinking Beyond the Classroom! Professionalization of Exercise Physiology. Vol 1 No 1 [Online]. Available http://www.asep.org/asep/asep/pro3.htm 2.  Boone, T. (1998). Perspectives on Change. Professionalization of Exercise Physiology. Vol 1 No 1 [Online]. Available http://www.asep.org/asep/asep/pro2.htm 3.  Boone, T. (1998). The Power in Critical Reflection. Professionalization of Exercise Physiology. Vol 1 No 2 [Online]. Available http://www.asep.org/asep/asep/pro5.htm 4.  Boone, T. (1998). Preparing Exercise Physiology Teachers. Professionalization of Exercise Physiology. Vol 1 No 3 [Online]. Available http://www.asep.org/asep/asep/pro12.htm 5.  Boone, T. (1998). Competence. Professionalization of Exercise Physiology. Vol 1 No 5 [Online]. Available http://www.asep.org/asep/asep/pro15.htm 6.  Boone, T. (1999). What’s In a Title? Professionalization of Exercise Physiology. Vol 2 No 1 [Online]. Available http://www.asep.org/asep/asep/fldr/terms6.htm 7.  Boone, T. (1997). The Power Behind a Vision. ASEPNewsletter. Vol 1 No 2 [Online]. Available http://www.asep.org/asep/asep/fldr/links1.htm 8.  Boone, T. (1999). Strategic Intent: The ASEP Vision. Professionalization of Exercise Physiology. Vol 2 No 7 [Online]. Available http://www.asep.org/asep/asep/julypep.html 9.  Boone, T. (2001). ASEP: A Call for Action. Professionalization of Exercise Physiology. Vol 4 No 10 [Online]. Available http://www.asep.org/asep/asep/ASEPCALLforACTION.html 10.  Schuller, R. H. (1983). Tough Times Never Last, But Tough People Do!  New York, NY:  Thomas Nelson Publishers.  11. Boone, T. (2000). Passion: The Inner Drive. Professionalization of Exercise Physiology. Vol 3 No 2 [Online]. Available http://www.asep.org/asep/asep/feb1.html Copyright ©1997-2007 American Society of Exercise Physiologists   All Rights Reserved.