Over the course of the past two years, I have learned many different skills

that I have been able to use as a tool for success. In EXP 510, I learned about
risk management, which included types of legal claims, areas of risk
management, and the basis for legal claims against health/fitness facilities and
staff and strategies to reduce liability. I have used what I had learned in this
chapter and applied it in my internship to always remember the importance of
why I maintain order and cleanliness within the fitness center. It is also a
reminder of why instructing and supervising clients properly are so important. I
learned about physical activity to include the definitions, classification, benefits,
quantity, and the risks that are associated with exercise. I have applied many
topics I had learned in this chapter in my internships. For an example, during
client intake session we inform each individual that they need to fill out an entry
slip before initiating exercise for the day. Subjects on this slip include but is not
limited to full name, weight, monitor number, and if they had exercised since
there last session. Many clients commonly get this confused to where they state
cutting the grass or working on the house. I would have to remind these
individuals that exercise is physical activity that is planned, structured, and
repetitive, and is done to improve or maintain one or more components of
physical fitness. This is the type of activity that is asked to record on the slip in
order for staff to document and progress properly. In many different scenarios,
knowing specific benefits to exercise that pertained to each individual was useful
in explaining what this rehabilitation program can do for them. I would review
what diseases, conditions, and comorbidities each client presented with and
explain which benefits will improve their health and specifically overall quality of
life. This would be used as a self-motivator as a reminder for the client of the
results that occur with hard work.
I learned extensively about preparticipation health screening, which
included the purpose and components, risk classification, contraindications, and
effects of common medications on HR and BP at rest and during exercise. I had
used what I had learned from ACSMs CVD Risk Factors and Defining Criteria
daily in order to diagnose and educate each client on what classifies as a risk
factor in addition to reasons why they would be at low, moderate or high risk.
Contraindications were used on numerous occasions and was key on the
exercise professional knowing whether it was an absolute or relative. For an
example, one instance occurred where a client presented in severe hypertension
due to not taking BP medication as prescribed the day before or the morning of.
The staff members had forgotten what BP accounted as relative and which
absolute. I referred from ACSM guidelines and stated from the book what the
decision should be. It is crucial to always remember what differs between relative
and absolute, especially in high sensitive situations where a clinical decision
needs to be made quickly. I learned about exercise testing which included the
purpose, special considerations, common modes, pre-test instructions, test order,
normal vs. abnormal responses, and termination criteria. During my summer
internship for an example, I was able to inform certain clients who were about to
participate in a stress test, reasons why certain foods and drinks need to be
avoided. I believe there was a disconnect between what instructions are given to
the client and the point when they arrive for the test. To the best that I could, I

tried to fill this gap and inform as many as possible of the purpose and procedure
of the tests that were implemented.
I learned about exercise prescription for apparently healthy individuals,
which included the common components, factors to consider, exercise
progression and recovery, and injury management. Memorizing the FITT principle
for apparently healthy individuals was useful for visualizing the modifications that
were made for each disease and condition. I used what I had learned in this
chapter on a daily basis with clients during my internships. Informing each client
why, when, and how often each exercise session is progressed is vital for
complete client understanding. Once fully understood, the clients in turn were
able to progress themselves after discharge appropriately according to ACSM
and AACVPR guidelines. Information on factors to consider when prescribing
exercise was also frequently used every day. To ensure maximal exercise
adherence factors such as clients goals, current health status, current level of
fitness, and barriers were comprehensively addressed to make each exercise
prescription individualized and most beneficial.
I also learned about goal setting which included the definition, types,
principles and common problems, and how various behavioral theories and
strategies influence behavior change targeting physical activity and diet. For
many clients during my internships, I aided in modifying their goals so that they
were based off of the SMART principle to promote success. I would then state
why SMART goals work: focuses effort, fosters problem solving and motivation,
reduces uncertainty and anxiety, and increases satisfaction. Often I would help
each client by using the staircase approach and break their goals down into a
series of short-term goals, which demonstrated progression. Most clients made
outcome goals, which included losing weight, and getting back in shape.
However, some made performance goals, which included using the treadmill to
achieve a specific jogging pace in order to run in a 5k this fall. It was useful to
remember what factors positively influenced adherence such as: client
knowledge and commitment, good patient-physician relationship, written
instructions for exercise program, self-monitoring behavior, adequate follow-up
and re-assessment, and positive feedback and social support. I would encourage
all of my clients by using these tools to influence adherence. I would also make a
point to mention some of the factors that negatively influence adherence as well
such as: smoking, being overweight, injuries, readiness for change, rapid
progression, vigorous exercise, and lack of purposefulness.
During EXP 516 and EXP 520, I was able to expand my knowledge of
working with individuals with different diseases and conditions. I implemented
and used the information I learned in regards to prescribing exercise to patients
who presented post cardiac event and/or with COPD, diabetes, cancer, and
stroke. I was able to make a distinction for clients of why we would prescribe
exercise in a different manner for those with different conditions. In addition, I
was able to explain to clients who did not fully understand their condition of what

is occurring physiologically. Frequently, I would have an individual that would

change their perspective due to physiologically understanding their condition and
now realizing what benefits of exercise would be most helpful.
During my Practicum III and IV, I had the opportunity to learn the
differences not only between ProHealth Care and Aurora medical systems but
between different populations. The first half of Practicum IV, I supervised the year
1 graduate students as they worked with clients with exercise testing,
prescription, and tailored patient education. During the second half of Practicum
IV, I worked directly with two clients post-stroke and was able to incorporate
exercise testing, prescription, and tailored patient education with this population
as well. I believe through all of my internship experiences, I have been able to
work with most populations in all departments of the hospital including Phase I-IV
Cardiopulmonary Rehabilitation and CVD Stress Testing. Due to these
experiences, I believe I have made myself more marketable to employers having
a diverse background with a various skill set.
During EXP 620, I was able to learn what it takes to start an evidencebased business within our field and scope of practice. I was able to expand what
I already knew about how to start a business with the simplicities of proper
marketing, assessment and outcomes, risk management, and appropriate
budgeting. I believe this class has set me up for success in the future now
understanding the details that are needed to be and stay profitable.
For my final thesis project, I was able to fully understand the components
of reviewing current literature, conducting a pilot study, and the IRB processes
within a local hospital and university. I was able to conduct a research study at
Oconomowoc Memorial Hospital during my first summer internship dealing with
the prevalence of fall risk. I then was able to gather the results, after the study
was complete, and present a proposed study with new assessments to the
research institute at Waukesha and Oconomowoc Memorial Hospitals. This was
approved by the hospital to start within their Cardiac Rehabilitation departments
but unfortunately was not approved by the university in time prior to graduation. I
was able to write a comprehensive review of literature on the prevalence of fall
risk and what interventions and assessments for falls have been most reliable. I
have been in contact with the research institution at ProHealth, and they have
agreed for me to continue this research and conduct my new proposed study as
soon as I graduate as I am an employee within their hospital and want to
continue to develop my professional career..
I have been working in a position within the CardioPulmonary
Rehabilitation department at both Waukesha and Oconomowoc Memorial
Hospitals for the last 7 months. In order to apply for this I had to take an
extensive TalentMine strengths questionnaire to see if I would be a fit for this
position. I believe this described my strengths very well in stating that my top four
were motivation, interaction, cognition, and execution. With being motivated it is

important for me that I am always improving. A professional goal for this is to

work for a department who shows a clear path with specific opportunities for
learning and growth. It is also important for me to track my progress. A goal for
this is to work for a department who has clear expectations of deliverables and/or
specific metrics of success. Having a strength in interaction is crucial for our field
as a CEP. Due to this I find myself wanting to work for a strong team. A goal of
mine is to work for a department with a clear united mission that I agree and hold
true to. With having this strength, I want to contribute value to the team through
my work. A goal for this will include a workplace that shows how role
expectations contribute to team purpose. As having a strength in cognition, I am
inspired by challenging problems that may intimidate others. A goal will include
working for a department that incorporates problem solving into the job demands.
In addition, I enjoy brainstorming with fellow associates to uncover a source of a
problem. A professional goal for this would include working in an environment
that is made up of groups and committees who cooperatively problem solve.
Another strength I believe I possess is execution. I believe rules are made for a
reason and that they should be followed. A goal is to work for a department that
identifies strict safety standards that are enforced by the company. I believe I am
also most confident when a company follows clear, reliable practices for service
delivery. It is important for me to have a goal to find a work environment that
identifies processes applied to improve service quality.
A weakness I believe I need to work on in order to become a stronger
professional and CEP is patient education delivery. I believe I have observed
many different styles of teaching but I need to learn how to adapt to a style that
works best for me. I want to be able to give patient education to every client
differently, by his or her learning style and patient characteristics for better client
understanding. Some clients come into Cardiac Rehabilitation and want to just be
told how to exercise without any further information. They self-report having
already been educated on major topics prior to entering the program. These are
the clients I want to have the ability to educate them on materials that are
necessary to their specific conditions. I believe interviewing and patient education
delivery skills are an art that will be mastered with time. I will continue to work on
my style of delivery and education in order to be a better professional and CEP.
As a CEP, I believe I have grown as a student and as a professional
significantly since I have entered this Masters of Science in Exercise Physiology
program. I believe I have had to learn the hard way of what it takes in order to
make the jump from an undergraduate to graduate level. I believe through it all, it
has made me that much stronger of an individual and professional and I have
been determined to succeed in this field. I believe I have shown through the past
internships that with the present curriculum, if the tools are used properly,
employers will want you to be apart of their comprehensive healthcare team. I
have no question that these past two years has fully prepared me with the skills
(ACSM-KSAs) needed to be a skilled RCEP and great asset to the
CardioPulmonary Rehabilitation and CVD departments.