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Chapter 23

Ethics &Professional

BehaviorIN THIS CHAPTER

What Makes a Professional

Professional Principles

Professional Standards

Risk Management

Scope of Practice

Standard Protocols

Emergency/Safety Procedures

Documentation

Program Implementation

Liability Coverage

CHAPTER 23 REV_Layout 1 9/20/12 12:16 PM

What Makes a Professional The personal trainer profession is evolving into a recognized and respected part of the allied health care system of support. An important part of the ongoing development of the industry is the advancement of professional competencies and the elevation of standards of practice (21). Establishing the highest level of professionalism within the industry will ensure growth and future opportunity within the field. Professionalism starts with the desire to achieve greatness within one’s chosen field of practice (7). Striving to reach the highest level of the profession is a personal attribute that leads to success (4). This suggests that to perform optimally within a profession, one must identify the qualities that are possessed and exemplified by the most successful and respected practitioners. Professionalism is defined as the conduct, aims, or qualities that characterize or mark a profession or a professional person. It is not just attained from the desire to achieve in one’s chosen field but also originates from performance of routine actions, compliance with industry standards, and management of external perceptions (20). Importantly, external perception is often the measure that consumers use for judgment of professionalism. Perception is commonly defined by outward appearance, ability to communicate, pursuit of inquiry to remain updated within the field, and conveying confidence. For many people, appearance is the first measure of professionalism (12). It suggests that the attention to detail and the level of seriousness one takes in appearance is similar to the considerations made for other components of the job. Proper grooming and appropriate attire conveys self-respect and an interest in how one is perceived. Presentation comprises a significant portion of impression. Therefore, personal trainers should routinely make a conscious effort to look professional. The ability to communicate is often considered an extension of social intelligence. Successful professionals maintain the ability to instill confidence in their knowledge and abilities upon others by way of physical and verbal communication. Communication skills are valuable when working with people, as they are not only used to pass information but also convey emotions. Physical and verbal communications can express care, support, empathy, interest, and enthusiasm (13). All of these features are considered central to effective personal trainer services. Professional communication should be clear, accurate, and relevant. In some cases, it is

challenging to state the facts rather than to simply say what wants to be heard. Thus, employing proper judgment and tact are part of being a good communicator. Inquiry is a characteristic that is often attributed to successful personal trainer practice. Inquiry suggests the continued pursuit of knowledge and professional development. Complacency in the professional environments negatively impacts effectiveness. Due to the extensiveness of new information, research, and protocols that are emerging within the fitness industry, knowing everything is impossible. New information is presented everyday and practices are regularly evolving to include new techniques. However, interest in improving one’s knowledge and competency is necessary to remain current in such a dynamic profession. Confidence is a quality that people look for in a professional. Although less tangible, confidence can be observed. Confidence stems from a compilation of attributes, including self-assurance, belief in one’s abilities and knowledge, self-efficacy, and experience. When someone does not have confidence in a particular environment, others perceive a deficiency or compromise in one’s abilities. This is not to suggest that something is wrong with the person but rather that others place trust in those individuals who possess confidence in themselves and their ability to perform effectively.

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The measure of professionalism encompasses more than personal characteristics and presentation, as it is also based on actions, principles, and an individual’s decision making process. Professional actions are those that demonstrate effectiveness in one’s job, convey aptitude and competency, and identify a practitioner as skilled, diligent, and resourceful (22). When a person acts in a professional manner, he or she exemplifies the traits expected of the model practitioner. Regardless of the profession, effective people present similarities within their daily routines and professional behaviors. Professional Principles Professional principles support actions and decisions and enable a practitioner to develop the appropriate behaviors pertaining to the chosen career. Each profession has a slightly different application of professional principles determined by governing bodies, employer requirements, and consumer expectations and demands. Professional principles provide the framework for conformity to an industry standard. They are used to adapt the proper behavior and attitude toward the job tasks which are relevant to the values of the profession and enable the developing professional to identify the competencies required in order to become an effective contributor to the profession. Interpersonal Relations & Communication The basic principle of communication defines the manner in which interpersonal skills are applied to maintain good relations within the work environment. They include use of professional language when speaking with clients and colleagues and the process of proper dissemination and articulation of information. Professional Compliance The principle of compliance suggests making decisions based on established norms within the profession. Providing evidence-based information and practice and acting in a manner appropriate to defined standards and guidelines falls under the principle of professional compliance. Professional Judgment & Autonomy Also based on preconceived values, this principle guides the decision-making process to protect the stakeholders of the profession, including those who receive professional services. Autonomy suggests self-governance in accordance with the highest expectations of the governing body. This principle supports professional accountability.

Professional Ethics The principle of ethics holds those acting in a professional role to make an ethical covenant with society to exercise judgment in the best interest of all others. It encompasses all the principles and standards that underlie one's responsibilities and conduct in a particular field of expertise (profession). It requires practitioners to act in a fiduciary role to fulfill the highest ideals and core values of both the profession and discipline. Self-Discipline This principle reflects the structured approach to the management of professional activity as it places expectations on premeditated and conscience-driven work ethics. Self-discipline entails both restraint and diligence. The principles of a profession embody the professional standards by which practitioners perform their trade (11). The personal trainer is held to a standardized code of conduct that, at a minimum, ensures safe and professional practice. Professional standards allow for critical evaluation and the accountability of the practitioner to all stakeholders of the profession. Most professional standards incorporate clearly articulated requirements and specific guidelines as to how to practice correctly. These requirements and guidelines are developed in accordance with evidence-based criteria, social responsibility, and uniformly accepted norms within a profession (8). Professional Standards Professional standards distill expectations of what constitutes sound and proper practices by identifying fundamental ethical considerations, while addressing more specific acts of professional conduct. Second, they may serve as a basis for judging the merit of a formal complaint pertaining to violations of professional and ethical standards. Defined standards provide guidance for professional behaviors, activities, and decision-making process and serve as a framework for self-evaluation (10). They outline the benchmark as defined by peers within the profession and should be used as the foundation by which a professional practice is built. In addition, professional standards are as evolving as the profession they serve and provide ongoing contributions to the integrity and ultimately the respect of the profession. Every day fitness professionals are required to make decisions regarding different aspects of their job responsibilities. In some cases, the decisions are rudimentary and imply minimal consequences, while other decisions may have serious repercussions if not

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made with prudent deliberation. The ability to make the right decision in a situation is based on several factors that stem from the aforementioned composite of what makes a quality professional. Professional decision making is actually a formatted cognitive process, which uses analytical and critical thinking to determine the ideal conclusion for a situation, conflict, or problem (14). Professional decision making requires one to evaluate a problem, gather information, develop alternative solutions, weigh each alternative objectively, and select the best choice based on the facts presented. Essentially, the decision-making process leads to the selection of a course of action among the alternatives. Decision making is a process of reasoning based on known and potential factors and assumptions. Structured, rational decision making is an important part of all science-based professions. This identifies why adequate competency is necessary. One must apply one’s knowledge in a given area when making informed decisions. As one’s level of expertise increases, intuitive decision making may replace a more structured approach because the professional is better able to recognize a set of indicators from experience in similar situations (6). Expertise suggests the ability to define a course of action without weighing all the alternatives, secondary to accrued knowledge and experience.

The Professional Decision-Making Process

1) Identify the problem – Is it a goal, challenge, or opportunity?

2) Gather information – Collect facts and data; differentiate opinion and assumptions; consider professional boundaries; identify the stakeholders.

3) Develop alternatives – Establish criteria, consider all the aspects, and look at precedence.

4) Weigh the alternatives - Identify the advantages and disadvantages, benefits and consequences of each option.

5) Select the best course of action – Rank by appropriateness, suitability, and benefit vs. consequence relationship.

6) Implement the solution – Premeditate a plan, properly communicate; adapt to the situation or individual.

7) Monitor the effect – Analyze the process or the result, could anything be improved upon?

8) Analyze the outcome – Learn from your actions.

9) Record your findings – Use for future decision-making.


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Following this process will help to create the best solution for the problems presented in professional situations. As one gains experience, the rapidity of the process and implementation of pre-learned actions to common problems creates an increased level of professional proficiency and expertise. Experts are those who have dealt with many situations, deliberated upon all of the alternatives and learned from the outcomes. This suggests that the decision-making process is a combination of both on-the-job learning, as well as more traditional knowledge attainment. This explains why inquiry is a fundamental component of effective professionalism. The decision-making process calls on many aspects of cognitive function. One inherent component that is always applied within a professional decision is one’s ethics. Personal ethics and professional ethics may differ, but they are linked by a single foundation. Ethics is defined as the enterprise of disciplined reflection on moral intuitions and moral choices, or, more simply put, a system of moral principles within each person (19). Professional ethics are the moral principles defined within a profession, which determine acceptable practices, including actions, communications, and behaviors. In most cases, governing organizations will define ethical conduct based on peer determined criteria which are intended to protect the primary stakeholders of the profession. Ethics help to formulate the standards of practice and therefore, are often categorized into specific components of the profession. In personal training, professional ethics include the following: Representation of Expertise Professional Client Relationship Aspiration of the Profession Professional Competence Conflicts of Interest Societal Responsibilities Representation of Expertise Personal trainers are expected to be honest and trustworthy. This includes factually representing one’s academic background and degrees, validly measured knowledge, and experience. It has been suggested that nearly one-third of the resumes presented for American jobs are not accurate representations of the individual or have been falsified in some manner (16). Professional ethics suggest being truthful in all forms of communication. A common occurrence within the fitness industry that weighs on the ethics of representation is the assignment of a credential or distinction without valid assessment of one’s competency. Taking a weekend course that provides a

certification does not represent the attainment of expertise. Often, the distinction of “specialist” or “certified” is used to make the education course more marketable, but unless the credential is backed by a validly-constructed, psychometrically-analyzed,proctored examination, the document is simply a certificate of completion for a continued education course. The course may provide some valuable information on a subject, but it is inappropriate to represent oneself as an expert from a weeklong or weekend course. It is appropriate to market oneself as having taken educational course work in that particular area within the discipline. Professional Client Relationship Within the professional role, the personal trainer makes an ethical covenant with all stakeholders of the profession to act in the best interest of all others. This suggests placing the welfare of others central to all considerations within the professional domain. The client/professional relationship, in particular, has an ethical basis and is built on confidentiality, trust, and honesty (17). This requires the establishment of boundaries. Boundaries are the limits that allow for safe connection between individuals. With defined boundaries, appropriate levels of human intimacy and the maintenance of trust are possible. Unclear boundaries can lead to inappropriateness within the relationship. The professional is in a position of power because the expectation of trust rests on the assumption that the professional will operate in the context of the best interest of the client. Boundary violations occur when the power of trust is misused. If, at any time, ethics may be compromised by the dynamics of the client/professional relationship, the personal trainer has the responsibility to withdraw from providing professional services. Aspiration of the Profession In addition to the responsibility a personal trainer has to the client, he or she also has responsibilities to the profession. The ethics of aspiration represent one’s effort to attain a level of aptitude consistent with the defined professional standards and to represent the profession based on the ideals and core values of the discipline. Compliance with the professional standards and code of conduct is an ethical responsibility of all personal trainers. When the members of a profession strive to reach a higher standard, the entire profession reaches a new benchmark, leading to advancement. Performing at a sub-par level by not complying with accepted standards is unethical with regard to personal responsibility to the profession.


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Professional Competence Professional aspiration is consistent with the ethical responsibility of a personal trainer to remain current in the skills and knowledge of the profession. Personal trainers owe it to the stakeholders of the profession to attain appropriate competency and to maintain the defined acceptable level throughout one’s career. Individuals who possess professional credentials are mandated by the governing body to earn continued education credits to maintain their certified or licensed status. With regard to considerations for professional ethics, personal trainers should identify their deficiencies and focus their efforts on improving their competency within those areas. Taking coursework that provides new challenges and leads to improved skill and comprehension is the ethical path, whereas collecting continued education credits in other manners, such as through professional contacts, or falsification of professional activities in any way, constitutes unethical practice (1). Conflicts of Interest It is the personal trainer’s ethical responsibility to avoid conflicts of interest. A conflict of interest is defined by an influence that compromises the objectivity in one’s professional decision making, based on self interest (18). When acting in a professional role, personal trainers have a duty to serve the stakeholders of the profession above serving self interest. Conflicts of interest interfere with objective professional judgment and may lead to concessions that are not in the best interest of others (3). Potential conflicts of interest may arise from commercial promotions of fitness or health related products and services which may generate bias unrelated to product merit, creating, or appearing to create, an inappropriate, undue influence. The trainer should be aware of this potential conflict of interest and offer fitness advice that is as accurate, balanced, complete, and devoid of bias. When the trainer receives anything of substantial value, including royalties, from companies in the healthcare industry, such as a manufacturer of supplements and fitness devices, this fact should be disclosed to clients and colleagues. Societal Responsibilities Responsibility to society is also of ethical concern to the personal trainer profession. Personal trainers should support and participate in those health programs, practices, and activities that contribute positively and in a meaningful and effective way to the welfare of individual clients, the health and fitness community, or the public good. Personal trainers who provide expert testimony in courts of law recognize their duty to testify truthfully. The trainer should not testify concerning matters about which he or she is not knowledgeable.

The trainer should be prepared to have testimony given in any judicial proceeding subjected to peer review by an institution or professional organization to which he or she belongs. It is unethical for a trainer to accept compensation that is contingent upon the outcome of litigation. Risk Management Ethics, standards, and guidelines are established to provide the framework for professional practices. In addition to accounting for the homogenous delivery of service, the peer-defined minimal acceptable standards are used as a guide for risk management, particularly as they pertain to litigation (5). The protection of the stakeholders is the primary objective of health and fitness professionals. This is accomplished through the anticipation, recognition, and control of risk in occupational environments. Similar to decision making, consideration for the existence of risk and how to manage it requires a structured process. The comprehensive framework for risk assessment and management includes several stages of analysis. It is simply a process of reviewing historical precedence related to the outcome of different strategies, looking at the probability of incidence, analyzing the factors that contribute to risk, and identifying control mechanisms that affect the probability of occurrence (15). The first step to risk management is to be aware of possible risk factors and areas where they commonly exist. There are generally three categories of risk with which a personal trainer must contend. They include participant risk, environmental risk, and professional risk (2). Within these categories exists internal and external risk factors. External risks are sources of risk that a trainer has no direct control over but may be able to predict. This may have to do with changes in business dynamics, such as the reduction in training hours over the holiday season, or be related to the risk of your client getting hit by an object dropped by a third party in the weight room. Although there exists no direct control over the risk, analyzing the situation and predicting the possibility of a circumstance arising allows one to better reduce the risk of the negative event occurring by being proactive. Internal risks are those over which a personal trainer has a level of control. The effect or level of control over the risk is based on all the activities incurred in a risk management program. Participant Risk Participant risk is of significant concern because, of the three categories of risk, it is most commonly linked with direct liability and legal action. Injury is inherent to physical activity and, therefore, risk for an injury occurring exists on a daily basis. Personal trainers must


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contend with this risk by implementing appropriate risk management behaviors. Screening participants, using client-appropriate protocols, maintaining safe work environments, and instructing proper technique all contribute positively to this goal. Environmental Risks Environmental risks are those that affect your business. Changes in the business environment can lead to financial shifts; for instance, poor economy may reduce consumer spending and those who once had expendable income for personal training may not be able to afford the service. A hurricane or long period of inclement weather, a car accident, or an injury may all be forms of environmental risks that can adversely affect a personal trainer’s ability to successfully participate in his or her trade. The degree of risk and the ratio of external to internal risk factors can be analyzed to determine what actions can be used to reduce the effect of any issues arising from environment risk. Professional Risks Professional risks are those that directly relate to one’s professional activity. Every employee has a risk of being fired for one reason or another, but by performing at a high standard, the risk is well-managed and may never become an issue. Professional risks may come from employers, competition in a business environment, or changes within the profession. Forgetting to renew one’s personal trainer or CPR certification may increase professional risk by removing the mechanisms which protect against a particular risk. Likewise, not maintaining professional liability coverage may increase susceptibility to a negative outcome. Each area of risk presents different and unique situations that must be managed. In some cases, the risk is related to an independent and relatively rare circumstance and therefore, may not require ongoing effort to manage. In other cases, the risk may be experienced everyday, requiring a structured and consistent action or behavior as a staple to one’s daily

professional activities. When risk management planning occurs, the goal is to identify, prevent, and minimize problems. Assessing each situation will help identify any and all risks, as well as the level of risk and related circumstances that increase the prevalence of a particular risk so that a management plan to adequately address each possible problem is created. This process serves as an internal audit of one’s business activities and commonly leads to dramatic improvements in the overall delivery of service, more efficient use of resources, better business management, and an improved grasp on one’s professional career or business. The six steps of risk management should be applied to each facet of one’s professional career. In doing so, the actual extent of risk that exists becomes quantified. Many personal trainers do not realize the potential risks they experience every day because they are not aware the risk exists and do not fully understand the magnitude of the risk and the associated consequences. The more educated a person becomes as a professional and about the environment he or she works in, the more the risks become evident. Professional governing bodies are most often comprised of individuals with high levels of expertise in the field of practice. Part of that expertise lies in understanding the dynamics of the profession and the risks associated with practicing within the trade. Standards and protocols are formed by peer committees as a way of helping the profession contend with risk by implementing standardized practices. Personal trainers should become proficient in the standards of conduct and practice, as well as the skill-set protocols defined by the profession as necessary for delivery of safe and effective professional activities. In the context of the personal training profession, numerous strategies can reduce risk and aid in effective delivery of services. For most situations, there are clearly defined best approaches that have been developed from a historic perspective but have strong relevance in today’s personal training environments. Other situations may require a level of resourcefulness

and research to find an effective management strategy used by other professions for similar situations (9). The following recommendations will aid in the development of a comprehensive risk management plan and are in compliance with the minimum expectations of the professional personal trainer.


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Scope of Practice Although no licensure exists in personal training, the scope of practice has been defined to acknowledge acceptable and unacceptable activities based on credentialed qualifications and education. A personal trainer’s emphasis is on improving health and physical fitness while acting to prevent disease, premature aging, and the onset of health problems. Personal trainers are not able to diagnose medical problems or serve the role of any other defined health care provider, including physical therapists, athletic trainers, registered dietitians, and rehabilitation therapists. Acting outside the scope of the profession is unethical and in many cases illegal. Standard Protocols Personal trainers must become proficient in the standardized protocols and guidelines used by the profession. These standards and guidelines have been established for safe and effective practice in the best interest of the client. Forgoing a standardized approach is within the rights of a professional when justified by adequate evidence. However, any time activities fall outside the norm, the risk for negative consequences increases. The actual risk and extent of the consequences should be evaluated before making a professional decision. Emergency/Safety Procedures Personal trainers owe their clients a duty of care. This duty is often what is called into question during litigation. To satisfy their legal requirements, personal trainers must comply with established safety protocols and implement the necessary safety and emergency procedures, as warranted by a given situation. Although the highest degree of safety should be the goal, personal trainers are held responsible to an acceptable level as defined by what a sensible person would do in the same situation. Taking the time to ensure a client’s safety and defining emergency procedures in the event of a serious situation contributes greatly to reducing risk for liability. Documentation In any health-related profession, documentation is required and necessary for effective delivery of services. Documenting test outcomes, tracking program activities, and maintaining client files are all requisite acts of the personal trainer. This allows for optimal use of the data as criteria for program decision making. If an incident occurs that requires evidence to the nature of the professional activities, personal trainers must present their documentation during a legal preceding. Improperly documenting activities, or not documenting

at all, will dramatically increase related risk. Some common documents used by personal trainers to manage risk and effectively deliver services include informed consent, screening forms, screening notes and findings, program documents and tracking records, accident reporting forms, emergency plans, and equipment safety check forms. Documents should be maintained for one year past the statute of limitations of the state where the services were rendered. Program Implementation It is expected that personal trainers comply with standard operational procedures to initiate client participation in an exercise program. This includes following the guidelines for screening, program decision making, physical evaluation, and program activity management. The everyday activities supervised by personal trainers should be performed with the highest regard for client safety. This includes instruction, supervision, and spotting, as well as implementing components such as warm-up and cool down protocols. Taking short cuts or not focusing on the job at hand may lead to increased risk. Liability Coverage Personal trainers should maintain an appropriate amount of personal liability insurance in the event that a lawsuit is filed and the verdict is not favorable. A general rule of thumb is to maintain enough coverage that one’s professional practice will not be disabled due to a temporary loss of coverage related to aggregate limits. Validly credentialed professionals can purchase $2 million of coverage for about $200 per year. Although the utopian situation in any profession is never to experience any negative consequences associated with one’s job, inevitably some risk factors will create a situation that must be managed. When risk management evolves into situational management, the goal should be to minimize the effects of the problem. Taking the right steps during and immediately following an occurrence will aid in diffusing the problem or limiting the extent of the damage. Personal trainers should establish a plan to deal with each situation that has a high probability of occurring or which will have the greatest impact on a professional career. When things go wrong, the following recommendations may assist in several different types of situations.

Caution

Take a cautious approach in the face of uncertainty. Waiting for more information or a better emotional state


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will help with rational decision making. Jumping quickly to act may be a poor decision.

Communicate Maintain open channels of communication and communicate effectively with all parties involved. Always be as respectful and genuine as possible and emphasize listening.

Follow-up Follow-up on each aspect of the situation and with all parties involved. People are likely to react far more passively if they feel their interests are attended to.

Document Document the situation as soon as possible to maintain the integrity of the facts; use witnesses whenever possible.

Evaluate Evaluate the potential extent of the damage and identify controls that may limit the overall magnitude of damage.

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