ACADEMIC PROGRAM REVIEW
ESS: Adult Fitness/Cardiac Rehabilitation
Subcommittee Members
Helen Skala*(Math)
Peggy Martin(Occupational Therapy)
Ca~ol McCoy(Medical Laboratory Science)
* responsible for completed written report
Academic Program Review
no./' ~'''
UJ £If,e
Adult Fitness/Cardiac Rehabilitation Program
Department of Exercise and Sport Science
College of HPERTE
Introduction.
The Academic Program Review Committee reviewed the Adult Fitness/Cardiac Rehabilitation
Master's program on March 11,2001. This graduate program is housed within the Exercise and
Sport Science Department in the College ofHPERTE.
.
External Review.
This program was reviewed by Professor Leonard A. Kaminsky, Ph.D, FACSM, who visited the
campus on October 18-19,2001. Dr. Kaminsky is coordinator of Ball State University's Adult
Fitness/Cardiac Rehabilitation Program and serves on the Clinical Exercise Physiology Practice
Board of the American College of Sports Medicine.
.
The following strengths of the program were noted by Dr. Kaminsky:
1. The Adult Fitness/Cardiac Rehabilitation program is one of the premier programs in the
country of this type, with strong historical roots. The UW-L program along with the programs at
Ball State and Wake Forest Universities are often grouped together as top choices for students
interested in this area of study.
2. Faculty members are exceptional and provide national and international exposure to the
University.
3. The pool of applicants for the program is 30 to 50 per year. With only 15 slots available, it is
possible to select-only highly qualified candidates.
4. Laboratory facilities are adequate and equipped with necessary instrumentation.
5. The required clinical internship provided at GundersonlLutheran Medical Center and
Franciscan Skemp Health Care/Mayo Health System is an exceptional feature to the program.
6. The ACSM (American College of Sports Medicine) Exercise Specialist Certification offering
and the continuing education courses provide an important service to the professional
community.
The following challenges/concerns were noted.
1. The major challenge faced by the program at this time is to decide if the focus of the program
should be broadened to train for the new Registry for Clinical Exercise Physiology credential.
The ACSM has recently developed this credential which requires training in the additional
practice areas of musculoskeletal, neuromuscular, and immunological diseases. Moving in this
direction would require revisions to the curriculum, collaborative planning with other on-campus
programs, investigation of the possible utilization of external resources, and expansion of
laboratory equipment and instrumentation to include these new areas.
2. A second concern is the relocation of some practical training experiences from Mitchell Hall
to Wittich Hall during the second semester (January 20 to Aprill each year). The track there is
much smaller and is located on the third floor, making it inaccessible to some participants.
3. The third concern was the relatively low level offunding provided for graduate assistantships
or tuition waivers. The UW-L assistantship support is much lower than those at, for example,
Ball State and Wake Forest Universities.
.
..
Academic Program Review Self-Study Responseshy the Department
1 Purposes
a. Provide the department's Mission Statement (if extant) and a statement of the department's
overall goals and objective.
It is the mission of the department to assist individuals in the development of meaningful active
living where the benefits of physical activity are understood, valued, and integrated into daily
life. The graduate program in Adult Fitness/Cardiac Rehabilitation is specifically designed to
provide students with the necessary theoretical, laboratory research, and clinical experiences
needed for employment in a community or corporate fitness setting, or a clinical
cardiopulmonary rehabilitation environment.
b. Briefly describe the academic programs housed in the department and any interdisciplinary
programs to which the department is a major contributor. If one or more the department's
academic programs have goals and objectives not listed above, include them here.
The Exercise and. Sport Science Department houses four undergraduate programs and five
graduate programs. The undergraduate programs include: Physical Education Teacher
Certification, Fitness, Athletic Training, and Sport Management. The graduate programs
include: Adult fitness/Cardiac Rehabilitation, Human Performance, Special Physical Education,
Sport Adnrinistration, and Physical Education Teaching.
11 Curriculum
.
a. Describe whether the department's academicprogram(s) is/are typical of your discipliners),
and if they are distinctive in some ways.
.
The Adult Fitness/Cardiac Rehabilitation program is reasonably similar to like programs across
the United States. The program is patterned to provide students with the core competencies
deemed essential for cardiopulmonary rehabilitation professionals. The program is distinctive in
that it is designed as a I5-month program, with both a thesis and 3-month internship required.
Most programs around the country are 2 years in length. (This is deceiving in that our program
. is a four semester program, just like the two year programs, but it runs for four consecutive
semesters, including summers). All students in the program.are full-time.
.
b. Briefly summarize how the curriculum and instruction of your department reflects the
contemporary emphases and trends of your disciplines(s).
The curriculum places a high emphasis on the application of learned material through a variety
of both on and off campus experiences. Students take the courses in a pre-set order that is
designed so.that materialleamed in one semester is basically a prerequisite for courses the next
semester (e.g., students must know the material taught in ESS 780 - Electrocardiography before
they can understand and apply it to ESS 783 - Graded Exercise Testing and Prescription which is
taught the following semester). All students are required to complete a 6-month rotation in both
the Adult Fitness and Cardiac Rehabilitation Units of the La Crosse Exercise and Health
Program, an on-campushealth and fitness program availableto faculty and staff as well as
community members. In addition, students are required to take a class that gives them hands-on
experiences in Phase I and II cardiac rehabilitation, as well as graded exercise testing at two local
hospitals. A major focus of the curriculum is to prepare students to sit for the American College
of Sports Medicine Exercise specialist examination, which is the most applicable certification for
professionalsworkingin a clinicalcardiopulmonaryrehabilitationsetting.
.
c. State the minimum total (including general education, major, and minor) number of credits
required to earn the baccalaureate degree in your academic program, providing justification in
the minimum total exceeds 120 credits. Explain any significant difference between the minimum
total number of credits stated and the credits at time of graduation reported under line 4(b) of
the Unit Data Sheet.
The curriculum is very structured; with all classes required. Students may take additional
electives if they so desire. The minimum number of credits required for graduation is 43.
IlL Degree of Program Success
a. Describe the extent to which the department is meeting the goals and objective8 of its
academic program. Explain what measurements you are using to determine how well these
goals and objectives are being met. Report on any attempts to improve the academic program
through curricular/programmatic changes or other means, indicating how you determined if the
desired improvement was realized. For the results reported in this section explain how your
findings are base on informationgathered:
1. from program assessment based on the measurement of student learning outcomes,
and/or assessment using measures of student leaning in General Education courses;
.
2. in the process of advising students;
3. form any alumni surveys or employer surveys that may have been completed;
4. from any other relevant sources or studies you wish to include.
The Adult Fitness/Cardiac Rehabilitation is extremely successful in attaining its major goal of
preparing practitioners who are ready to enter the workforce upon graduation. The best
measuring stick we have as to how our graduates compare nationally is their performance on the
American College of Sports Medicine Exercise Specialist examination. Averaged over the past 3
years, we have had an annual pass rate of 91%. The national pass rate is 47%. Much of this
success, as well as the ability for all students to complete a thesis, can be attributed to the quality,
work ethic, and professional involvement of the program faculty. John Porcari, Ph.D., Program
Director, is the President-elect of the American AssociatIon of Cardiovascular and Pulmonary
Rehabilitation. Carl Foster, Ph.D. is the exercise physiologist of the U.S. Men's and Women's
Olympic Speed Skating teams and one of the Associate Editors of Medicine and Science in
Sports and Exercise, the official journal of ACSM. Kristi Cadwell, R.N. is a Certified Instructor
for Advanced Cardiac Life Support (ACLS). Thus, the faculty are on the cutting edge of what is
happening nationally in all aspects of their respective fields. Additionally, some of the program
success can be attributable to the fact that it is a very focused curriculum which all of the
students go through together as a group. The added social support of having a cohort to study
and work with make for a very dynamic learning environment.
While preparing practitioners is our major goal, one to two students per year go on to pursue
doctoral work. Thus, we value the thesis process as not only an opportunity for guided research,
but also as an avenue for professional changes for acceptance into a doctoral institution. In 2000,
every one of our students presented their theses at either the AACVPR or ACSM national
conventions. In 2001, 12/14 student theses were accepted for presentation at these same
meetings. Each year approximately 4-5 students have papers from their thesis work accepted for
publication as full manuscripts in peer-reviewed journals.
Evaluation of the program is an on-going process, with changes being made constantly. These
changes are basedon the following:
.
1. An Advisory Board, consisting of faculty who teach in the curriculum as well as the
Directors. of the Adult Fitness and Cardiac Rehabilitation Units of the La Crosse Exercise and
Health Program, meet several times per year to discuss student performance, changes in the field,
and new federal or state mandates, etc. which need to be addressed.
2. The application and acceptance process for the Adult Cardiac Rehabilitation program
is highly competitive. Students must have a 3.00 undergraduate GPA to be eligible for the
program. Typically 30-50 applicants apply for 15 openings per year. Since the inception of the
program in 1978, we have had students from all 50 states and 9 foreign countries. Five to six
graduate assistantships are also offered on a higWy competitive basis. Packets of infonnation are
mailed to prospective students and students are urged to visit campus to observe our programs in
progress and to meet and talk with students and staff.
3. A survey of alumni working in the field was conducted in 1997, asking questions
about curriculum offerings and specifically asking whether or not alumni felt that the thesis
should be retained as a program requirement. Over 75% of respondents felt that the thesis
should be retained. Since all stUdents must also complete an internship, we are constantly
monitoring student perfonnance and supervisor evaluations to make sure that students are
adequately prepared for the job market. This year we also added a mid-year evaluation to the
internship process to foster more communication between the students and their internship
supervisors.
.
4. Each year students fi.llout an end-or-the-year evaluation concerning all class offerings
and outside experiences (Appendix B). We fmd student perceptions about course content and
experiences interesting and enlightening, and take their feedback into account whenever
curricular or experiential changes are made.
b. Identify and .describe the single most significant strength of the academic program in the
department.
.
.
.
The Adult Fitness/Cardiac Rehabilitation has several major strengths. One area that cannot be
overlooked is the. long-standing reputation and history of the program. Quoting from the
External Program Review: "This program was one of the few that existed when it started
preparing students for work in the field of Cardiac Rehabilitation when it began in 1978. It
remains today as one of the premier programs in the country for this type of academic training.
The value of this attribute (strong historical roots) should not be overlooked or under
appreciated. "
--..
Another significant strength of the Adult Fitness/Cardiac Rehabilitation program lies in the
amount of practical experience that students get 'while earning their degree. Students participate
in a number of well-designed practicum classes while on campus. Thus, employers know that
when they get a La Crosse graduate, that person can step into the job setting and functions as a
well-trained team member.
c. IdentifY and describe in the department's academic program the single area requiring the
most significant improvement. Discuss you plans for accomplishing this improvement.
The biggest challenge facing,our program has to do with meeting the requirements of a new
certification process (Registered Clinical Exercise Physiologist) being undertaken by the
American College of Sports Medicine. This new initiative involves expanding the current role of
the clinical exercise physiologist to include the treatment and care of patients with orthopedic,
neuromuscular, and immunological diseases. Traditionally, the'role of the exercise physiologist
has been in caring for patients with cardiopulmonary disease and associated co-morbidities. The
current faculty does not have specific training in many of these new areas. oUr current plans are
.to slowly include some of these diseased populations into our curriculum by (1) teaming with
faculty in the Physical Therapy department and (2) bringing in external speakers to train-current
faculty members in the requisite areas.
IV. Previous Academic Program Review and New Program Initiatives
a. Describe the actions that were taken in response to the recommendations of the most recent
previous Academic Program Review, and the results of those actions.
The last program review was completed in the fall of 1997. Unfortunately the specific
recommendations of that review cannot be located. However, since that time, several curricular
changes have taken place. Two new courses have been added: ESS 77r:> Practicum in Adult
Fitness (2 credits) and ESS 776 - Practicum in Phase III/IV Cardiac Rehabilitation (3 credits). In
addition, one credit was shifted fTbmESS 780 - Philosophy and Organization of Preventative and
Rehabilitative Programs (3 credits to 2 credits) and added to ESS 774 - Clinical Practicum in
Cardiopulmonary Rehabilitation (1 credit to 2 credits). All of these changes were designed to
maximize practical experiences for students while they are here on campus.
-
.
b. Note any continuing or new concerns related to your department's ability to achieve its goals.
Continued concerns for program success are threefold. Currently, the AFtCR is provided with 1
o:ut-of-state tuition waiver and the equivalent of 3 graduate assistantships per year. All students
must pay in-state tuition. In the External Program Review, it was stated "the Wake Forest
program fully funds (tuition waiver and a stipend) 14 graduate students each year (7 in each
class) and the Ball State program fully funds 9-12 gradate students each year (6 in each class)."
The graduate programs at Wake Forest and Ball State are arguably the other top programs in the
country preparing students in the areas of adult fitness and cardiac rehabilitation. Thus a major
concern for future academic program success has to do with the lack of out-of-state tuition
waivers available to attract top students to La Crosse, who may be lost to these other high profile
programs.
development. The department merit evaluation is based upon 200 points. A faculty member can
earn up to 30 points for professional development activities.
b. the relative emphases that your department places on teaching, scholarly achievements and
service when making recommendations regarding retention and promotion;
For a tenure-track position, the faculty member is expected to perform well in all three areas. If
the person meets minimum service expectations, he/she would satisfy department needs. The
individual needs to have good teaching assessments to achieve tenure and promotion. The
individual needs to show on-going scholarly activity to be considered for tenure. While there are
not absolute numbers required, individuals will have to achieve significant scholarly outcomes
for their specific areas to be recommended for promotion. Thus, in a relative sense, teaching and
scholarship are weighted about 2 to 1 to service.
For academic staff scholarship is weighted less. The primary focus is on teaching with service
and scholarship (depending on specificjob description) weighted less regarding retention.
c. the departmental staffing plan, includingyour estimate of the number of faculty to be hired in
the next five years. Describe the procedure the department will use to link ongoing
curriculum/program development to the recruitment and hiring of new faculty..
.
All faculty hiring is based upon FTEs that are made available to our department. If there are any
retirements or resignations, that faculty position will be replaced. At this tie we have sufficient
faculty to accomplish our current curriculum. The program needs to assess if it wants to make
changes to qualify students for .the ACSM Registered Clinical Exercise Physiology certification.
If the program makes those changes, there will be some curricular changes. We would first try
to meet the new faculty expertise needed by collaborating with faculty in the College of SAH. If
this cannot be done, then the Dean's office and the' department would have to discuss possible
solutions. Any possible additional staffing needs would most likely be only .25 to .3 FTE.
VI Support for Achieving Academic Program Goals
Describe the impact each of thefollowing has on your ability to achieve program goals:
a. physical facilities;
.
A variety of practical experiences for students in the AFfCR program are obtained in the la
Crosse Exercise and Health Program (LEHP), which is conducted in facilities on campus.
Because the LEHP is basically a companion program to the academic mission of the AFfCR
program, these facilities are utilized free of charge. While the facilities themselves are
outstanding, access to the facilities becomes limited during inClement weather and during various
athletic seasons. For instance, the afternoon program gets moved to Wittich Hall from
approximately January 20 to April 1 each year. The track is much smaller (21 laps per mile) and
is on the third floor, which is inaccessible to many of our participants.
A second concern for the AF/CR program is the long-term viability of the La /Crosse Exercise
and Health Program, which provides the on-campus experiences for students. The primary
source of staffing (and hence expense) for the program is provided in the way of graduate
assistantships. As mentioned, three assistantships are provided per academic year (2 are funded
by the Exercise and Sport Science Department and 2, one-half assistantships are cost-shared with
the Dean's office). The remaining graduate assistantships and staff must be paid out of revenue
generatedby the program.
.
The third concern regarding program viability and vitality lies in a lack of expertise in some of
the new areas that may become mandatory if the Registered Clinical -Exercise Physiology
becomes the required certification level in the field. While much of the expertise needed to
fulfill this knowledge gap does exist on campus, it will take a great deal of interdisciplinary,
collaborative planning to pool these resources. Our plan is to offer a course in Special
Populations (i.e., neuromuscular disorders, spinal cord patients, etc.) in conjunction with the
Physical Therapy Department, as well as the Special Populations graduate program on campus.
Additionally, ACSM has jw;t started to investigate the possibility of offering coursesvia distance
education, as may programs around the country are in a similar situation (i.e., not having trained
staff to teach these additional diagnoses). Our goal is to provide some of this information to
students over the course of the next year or two by infusing special lectures into existing courses,
and formally change the curriculum by the year 2004 or 2005.
c. Identify any program. initiatives included in the current university strategic plan budget
document. Report on the status of these initiatives.
Based on our current knowledge, there are no plans to dramatically alter the AF/CR program in
the current university strategic plan.
d Describe any plans for new program initiatives.
Current program initiatives center on continuing to expand program and course content to
include exercise training guidelines for some of the new diagnoses outlined in the RCEP.
v: Personnel
The Office of Institutional Research organizes and provides the data on faculty, instructional
academic staff and workload Additionally, please describe:
a. professional development opportunities and expectations for faculty members in your
department;
All faculty are expected to regularly participate in professional development activities. If faculty
are presenting papers, the department/college will provide up to $2,500 to cover travel funds.
This will allow faculty to participate in two major conferences per year from which they can
receive new information. The department also helps fund participation in 1-3 day workshops on
specific topics. Part of each faculty member's review process for PTR is related to professional
b. supplies and equipment;
Supplies and equipment are very adequate for teaching and conducting research projects
involving student theses.
c. personnel;
Personnel is generally adequate for conducting the program. The program capitalizes on the
expertise of many professionals at the two local hospital/clinic facilities to help educate the
students.
d external funding.
In order to attract quality students and staff the la Crosse Exercise and Health Program, faculty
actively seek external grant funding for their research and conduct workshops on topics relatedto
cardiopulmonary rehabilitation.
Academic Program Review Unit Data Sheet
Unit: ESS
Department Data For The Academic Program Review
-AF/CR
UDDS:
Year: 11996-97 11997-98 I 1998-99 11999-00 I 2000-01 I
1.
2.
3.
Instructional Workload (FallTermlFTE)
a. Number of Course Credits
Group Instruct lower Div
Group Instruct Upper Div
Group Instruct Graduate
Group Instruct Tot
Individual Study
General Education
b. Number of Contact Hours
Group Instruct lower Div
Group Instruct Upper Div
Group Instruct Graduate
Group Instruct Tot
Individual Study
General Education
c. Number of Student Credit Hours
Group Instruct lower Div
Group Instruct Upper Div
Group Instruct Graduate
Group Instruct Tot
Individual Study
General Education
2.0
3
3
3
2
2.0
3
3
3
2
2.0
3
2
3
2
2.0
3
3
3
2
2.0
3
3
3
2
NA.
NA
6
6
3
0
NA
NA
6
6
4
0
NA
NA
6
6
4
0
NA
NA
6
6
6
0
NA
NA
6
6
4
0
NA
NA
84
84
42
0
NA
NA
84
84
56
0
NA
NA
84
84
56
0
NA
NA
84
84
84
0
NA
NA
84
84
56
0
NA
NA
84
84
79
0
NA
NA
84
84
57
0
NA
NA
84
84
52
0
NA
NA
. 84
84
90
0
NA
NA
87
87
14
14
14
14
14
14
14
14 ba
Financial Support (FY expenses)
a. Supply and Expenses
b. Capital Equipment Expenditures
c. Non-GPR Funding (grants)
4.
.
Staffing (Fall Term)
Instructional FTE (unclassified)
Number of Full-time Faculty
Number of Tenured Faculty
Number of Graduate Faculty
Number of Support Staff (classified)
4.1
Student Enronment & Degrees Granted by Major
Major: AF/CR
a. Number of Majors (1st&z>dtotal)
Freshmen
Sophomores
Juniors
Seniors
Undergraduate Majors
Undergraduate Specials
Graduate Students
b. Number of Graduates (annual)
Baccalaureate
Credits at Time of Graduation
Masters
1081
0
~
14
I
Conclusions from the APR Committee
The APR was impressed by the external reviewer's (Professor Leonard Kaminsky) comments on
the high quality of the UW-L Adult Fitness/Cardiac Rehabilitation program. As director of a
similar program at Ball State University, as a well-recognized researcher in this field with many
publications, and as a respected leader in the American College of Sports Medicine, Dr.
Kaminsky has the expertise to review cardiac rehabilitation programs and offer worthwhile
advice. The APR Committee agrees with his comment that "with a 25th anniversary on the
horizon, it would be an ideal time to strongly recognize this program."
The APR Committee felt that this program demonstrated a high level of success. There is a 91%
pass rate (compared to the national 47% pass rate) on the American College of Sports Medicine
Exercise specialist examination. In the past two years, nearly all student theses were accepted
for presentation at either the ACSM or AACVPR national conventions. Furthermore each year
approximately 4-5 students have papers from their thesis work accepted for publication as full
manuscriptsin peer-reviewedjournals.
.
The AF/CR program has evaluation and assessment processes in place. An Advisory Board
meets several times per year to discuss student performance and changes in the field which may
need to be addressed. Also, each year students fill out end-of-the year evaluations concerning all
class offerings and outside experiences. This year the program added a mid-year evaluation to
the internship process to foster more communication between the students and their internship
advisors.
The new initiative by the American College of Sports Medicine to expand the current role of the
clinical exercise physiologist to include the treatment and care of patients with orthopedic,
neuromuscular, and immunological diseases will need to be addressed by the departme.nt. Since
current faculty do not now have specific training in some of these new areas, a plan should be
developed to include these new areas in the curriculum. Some suggestions given were: (1) team
with faculty in the Physical Therapy department, (2) bring in external speakers to train current
faculty, (3) utilize distance education provided by the ACSM, or (4) obtain additional staffmg
(.25 to .3 FTE).
Concerns.
There were no major concerns expressed by the APR Committee regarding the current AF/CR
program. The principal challenge for the AF/CR program in the near future, however, is
incorporation of the Registry for Clinical Exercise Physiology into the program. This. will
require curriculum planning, staff development, and a great deal of interdisciplinary,
collaborative efforts. It may also require the acquisition of laboratory equipment and
instrumentation related to the new areas required by RCEP.
Two other issues mentioned by the external reviewer and the department warrant further
consideration.
First, the low level of funding provided for graduate assistantships may result in losing top
students to other high profile programs. It also may jeopardize the La Crosse Exercise and
Health Program which relies on graduate assistants for staffing.
Secondly, limited access to exercise facilities during the second semester may have serious longterm implications for the viability of the La Crosse Exercise and Health Program, which provides
the on-campus experiences for students in the AFfCRprogram.
Recommendations.
The APR Committee recommends:
1. that the department devise and implement a plan to modify the AFfCR program so that
graduates would be qualified to sit for the RCEP exam;
-
2. that the department discuss with UW L administration the possibility of increased support for
graduate assistantships;
3. that the department discuss with UW-L administration ways to enable the La Crosse Exercise
and Health Program to have better access to exercise facilities during the winter:months.
Furthermore, the APR Committee recommends, for the next program review, that the AFfCR
program keep summary records of the end-of-the-year student evaluations to include in their
report. Perhaps a fmal question to rate student overall satisfaction of the program could be added,
which could easily be averaged and reported. It .would also be useful to the Committee if
employment data were available - e.g., how many studentsfound employment aftergraduation,
how soon they were employed, whether they were employed full-time or part-time, etc.