Professional credentials in the health fitness industry and in clinical exercise settings, such as the American College of Sports Medicine (ACSM) certifications, play a critical role in the development of exercise professionals. In fact, ACSM certifications in conjunction with appropriate academic preparation should be viewed as a pivotal pillar of the professional development of exercise professionals. Gym owners, fitness facility managers, and hospital administrators should strive to hire ACSM certified professionals to ensure gold standard quality and reduce potential liability. ACSM develops and maintains four core, professional certifications. The ACSM certifications geared for exercise professionals in the health fitness setting are the ACSM Certified Group Exercise Instructor® (ACSM-GEI), the ACSM Certified Personal Trainer® (ACSM-CPT), and the ACSM Certified Exercise Physiologist® (ACSM-EP). The ACSM Certified Clinical Exercise Physiologist® (ACSM-CEP) was developed for those who practice in a clinical exercise environment such as cardiac and pulmonary rehabilitation. The purpose of the current communication is threefold: 1) to outline the complex and meticulous process of the development and maintenance of ACSM certifications; 2) to describe and detail the four core, professional ACSM certifications; and 3) to note recent content changes to the ACSM certifications.
ROLE AND DEVELOPMENT OF ACSM PROFESSIONAL CERTIFICATIONS
Since 1975, ACSM has developed and maintained a series of professional certifications, each with a unique population and/or programming focus. Professional certification is a voluntary process in which ACSM grants time-limited recognition and use of a credential to individuals who comply with eligibility requirements and meet a minimum level of competence (i.e., knowledge and skills) attributed to entry-level practitioners.
Professional certification is a voluntary process in which ACSM grants time-limited recognition and use of a credential to individuals who comply with eligibility requirements and meet a minimum level of competence (i.e., knowledge and skills) attributed to entry-level practitioners.
The development and process of maintaining the integrity of ACSM certifications involves four stages: design, develop, deliver, and document (see Figure 1). Each stage is pivotal in the overall process. Design refers to defining the depth and breadth of a professional role through a job task analysis (JTA); development pertains to process in how ACSM assesses job-specific knowledge and skills; delivery denotes where exams are administered and how the intellectual property is secured; and document describes the process of how ACSM specifically meets the standards of development, implementation, and maintenance for the National Commission for Certifying Agencies—an impartial, third-party accreditor of professional certifications. ACSM implements this rigorous development and continual improvement process to ensure its exams are valid, reliable, and fair for exam candidates; to ensure certificants meet the minimum expectations of employers; and, most importantly, to provide reasonable assurance to the public that ACSM certificants are safe and effective exercise professionals.
After launching an exam, ACSM’s work on the certification exams is far from over. The performance of certification exams is continually monitored and regularly revised with the latest scientific discoveries and changes to industry standards and practice. In addition, certificants must remain competent and up to date with research and professional standards through continuing professional development. ACSM recalibrates its certification exams after 5 to 7 years of test administration by performing a follow-up JTA that reviews minimum requirements, identifies substantive changes within the exercise industry, and determines if job tasks need to be revised, added, or eliminated based on current industry practice.
JTA: Defining the Exercise Professional
ACSM certification examinations are composed of a variety of items that refer to a specified body of knowledge. When new scientific discoveries come to light, techniques or methods used in practice change, and the body of knowledge changes too. The periodic evaluation of this body of knowledge occurs via a JTA; this is often referred to as a role delineation study. The use of JTA studies by ACSM was first introduced in 2009 (1). A large, representative sample of professionals and a panel of subject matter experts (SMEs) are asked to evaluate/revise ongoing knowledge and skills and, if necessary, recommend new knowledge and skills based on emerging trends in daily practice. The process also involves surveying currently practicing exercise professionals to determine the criticality of each knowledge and skill by ranking its importance and frequency of typical daily, weekly, or monthly work. By conducting a JTA, the resulting examination stays current, relevant, and valid.
ACSM certification examinations are composed of a variety of items that refer to a specific body of knowledge. When new scientific discoveries come to light, techniques or methods used in practice change, and the body of knowledge changes too.
In addition, ACSM uses criticality scores to allocate the number of exam items for each content domain. In other words, ACSM assigns more questions to areas that are frequently performed and/or that are critically important to the job. Further, the consideration of the depth, scope, and complexity for each knowledge and skill ultimately being assessed is also derived from the JTA.
In short, JTA studies are used to describe and prioritize expectations for professional practice. The results of the JTA are used to guide SMEs in developing exam blueprints, and the expected knowledge and skills are confirmed by currently practicing exercise professionals. This extensive exam development that ACSM implements is used to provide assurance to the profession at large and to the public that its exams are appropriate and defensible.
Job Task Cognitive Complexity
Starting in 2017, ACSM included descriptions of cognitive complexity in its core certification exams. Cognitive complexity describes the extent to which a candidate should know or be able to perform a task. A low level of cognitive processing is a simple recall of information, whereas a higher level of cognitive processing includes analysis, evaluations, and judgments. ACSM uses three levels to describe cognitive complexity:
A low level of cognitive processing is a simple recall of information, whereas a higher level of cognitive processing includes analysis, evaluations, and judgments.
- Recall: recall of basic facts, information, or steps in a process
- Application: comprehend and implement processes, interpret simple results, and summarize information
- Synthesis: differentiate, relate parts of a system, make judgments on new information based on given criteria, critique a process or product, and make recommendations.
The Last Step: JTA-Derived Certification Exam
The Committee on Certification and Registry Boards (CCRB) is responsible for the oversight of ACSM’s certification programs and includes the credentialing groups (subcommittees) of each of the four core, professional certifications. One of the most important roles of the credentialing committees is maintaining the integrity of ACSM exams through continual process improvement. This process includes the following steps: 1) develop and manage the examination item banks; 2) review item performance through psychometric analysis; 3) review examination blueprints; 4) assure content validity; and 5) develop criteria for passing point standards.
CERTIFICANTS CONTINUING COMPETENCE AND UNSCHEDULED UPDATES
To maintain an ACSM certification, certificants are required to provide proof of continuing competence by continuing education or by retesting. The purpose of continuing education is to first protect the public. By completing continuing education that advances knowledge and skills, certificants demonstrate that they are current with the latest research, professional standards, and guidelines in the fitness industry, health care, and allied health. This helps the health fitness professional to be better prepared to provide and implement a safe and effective exercise program. Health fitness professionals are strongly encouraged to complete continuing education on a regular basis. ACSM has set a 3-year term for each certification period to help ensure that certificants are completing continuing education to remain current.
When industry standards or professional practices become widely adopted, ACSM informs exam candidates and related stakeholders when this information will be reflected on ACSM examinations via the ACSM web site, email; and social media channels. An example is the 2017 American College of Cardiology (ACC) and the American Heart Association (AHA) blood pressure guidelines (2,3). When the AHA blood pressure guidelines were changed, ACSM informed the candidates of the change and when each of the exams would be affected (3).
Four Core, Professional Certifications
The ACSM Certified Group Exercise Instructor®
The ACSM-GEI is tasked with enhancing the fitness of those who are defined as apparently healthy individuals and those with controlled health challenges who have been given permission by their primary health care professional to engage in physical activity without supervision. Specifically, the job description of the ACSM-GEI includes the following:
- Works in a group exercise setting with apparently healthy individuals and those with health challenges who can exercise independently to enhance quality of life, improve health-related physical fitness, manage health risk, and promote lasting health behavior change.
- Develops and leads safe and effective exercise programs using a variety of leadership techniques to foster group camaraderie, support motivation to enhance muscular strength and endurance, flexibility, cardiorespiratory fitness, body composition, and any of the motor skills related to the domains of health-related physical fitness.
ACSM Certified Personal Trainer®
Similar to the ACSM-GEI, the ACSM-CPT is tasked with enhancing the fitness of those who are defined as apparently healthy individuals and those with controlled health challenges who have been given permission by their primary health care professional to engage in physical activity without supervision. Specifically, the job description of the ACSM-CPT includes the following:
- Works primarily with apparently healthy individuals to enhance fitness.
- Works with individuals who have stable health challenges and are cleared to exercise independently.
- Conducts basic preparticipation health screenings, lifestyle inventories, and fitness assessments for health and skill-related components of fitness.
- Uses a variety of behavior change techniques to offer guidance in the development of realistic, client-centered goals related to health, fitness, and wellness.
- Develops and administers programs designed to promote optimal cardiorespiratory fitness, muscular strength, muscular endurance, flexibility, and body composition, as well as agility, balance, coordination, power, speed, and reaction time.
- Facilitates client motivation and adherence and honors client confidentiality.
ACSM Certified Exercise Physiologist®
The ACSM-EP is tasked with enhancing the fitness of those who are defined as apparently healthy individuals and those who possess medically controlled diseases. Specifically, the ACSM-EP is responsible for the following:
- Works with apparently healthy clients, children to older adults, and those with medically controlled diseases to establish safe and effective exercise and healthy lifestyle behaviors to optimize both health and quality of life.
- Conducts preparticipation health screenings, submaximal graded exercise tests, strength, flexibility, and body composition assessments.
- Provides client education and develops and administers programs designed to enhance cardiorespiratory fitness, muscular strength and endurance, balance, and range of motion.
The ACSM Certified Clinical Exercise Physiologist®
The ACSM-CEP is tasked with providing primary and secondary prevention strategies designed to improve, maintain or attenuate declines in fitness and health in a variety of clinical populations. Specifically, the ACSM-CEP is responsible for the following:
- Designs exercise prescription, utilizes basic health behavior interventions, and promotes physical activity for individuals with chronic diseases or conditions; examples include, but are not limited to, individuals with cardiovascular, pulmonary, metabolic, orthopedic, musculoskeletal, neuromuscular, neoplastic, immunologic, and hematologic diseases.
- Provides primary and secondary prevention strategies designed to improve, maintain, or attenuate declines in fitness and health in populations ranging from children to older adults.
- Provides exercise screening, exercise and fitness testing, exercise prescriptions, exercise and physical activity counseling, exercise supervision, exercise and health education/promotion, and measurement and evaluation of exercise and physical activity-related outcome measures.
- May receive referrals from a referring health care provider to implement exercise protocols.
Recent JTA-Derived Content-Specific Changes
To compare JTA-derived content-specific changes from one cycle to the next, ACSM introduced the crosswalk document in 2017. This document provides a side-by-side comparison chart of how content domains and job tasks may have changed over time.
ACSM-GEI (Updated December 2018)
There were several substantive changes to the ACSM-GEI certification as a result of the 2018 ACSM-GEI JTA. The 2010 “Domain III: Leadership and Instruction” was split into two performance domains. In addition, “Domain I: Participant and Program Assessment” was eliminated from the exam (see Table 1). ACSM industry SMEs eliminated 2010 Domain A, B to be consistent with employer expectations. The assessment of client risk (including preparticipation screening) would be determined by a facility’s policies and procedures. The ACSM-GEI would be accountable for identifying and responding to emergencies (2018, Domain IV). The complete 2010–2018 ACSM-GEI crosswalk document is described and may be downloaded from the ACSM web site (4).
ACSM-CPT (Updated December 2017)
There were several substantive changes to the ACSM-CPT certification as a result of the 2017 ACSM-CPT JTA. Content weighting increased for “Domain I: Exercise Programming and Implementation” and decreased in both “Domain III: Exercise Leadership and Client Education” and “Domain IV: Legal and Professional Responsibilities,” whereas “Domain I: Initial Client Consultation and Assessment” remained relatively flat (refer to Table 2).
In addition, certain content, which includes but is not limited to business, marketing, and credential maintenance, were removed from the ACSM-CPT as a result of the 2017 ACSM-CPT JTA. The complete 2012–2017 ACSM-CPT crosswalk document is described and may be downloaded elsewhere (5).
ACSM-EP (Updated December 2017)
There were several substantive changes to the ACSM-EP certification as a result of the 2017 ACSM-EP JTA. Content weighting increased for “Domain I: Health and Fitness Assessment,” “Domain II: Exercise Programming and Implementation,” “Domain III: Exercise Counseling and Behavior Modification,” and content weighting decreased in “Domain IV: Risk Management and Professional Responsibilities.” It should be noted that “Domain V: Management” was eliminated (see Table 3).
In addition, certain content was reclassified within the ACSM-EP as a result of the 2017 ACSM-EP JTA. The complete 2012–2017 ACSM-EP crosswalk document is described and may be downloaded elsewhere (6).
ACSM-CEP (New Program December 2018)
After significant research and deliberation, the ACSM CCRB developed a single clinical exercise physiologist certification exam, ACSM-CEP, and launched the new certification in December 2018. The minimum educational and practical requirements for the ACSM-CEP are either 1) master’s degree in Clinical Exercise Physiology or equivalent and 600 hours of hands-on clinical experience or 2) bachelor’s degree in Exercise Science, Exercise Physiology, or equivalent and 1,200 hours of hands-on clinical experience. A complete list of requirements can be downloaded from the ACSM web site (7). In addition, the 2018 ACSM-CEP certification exam increases the scope of diseases and conditions covered to include, but not be limited to, individuals with cardiovascular, pulmonary, metabolic, orthopedic, musculoskeletal, neuromuscular, neoplastic, immunologic, and hematologic diseases. The list of the 2018 ACSM-CEP performance domain can be found in Table 4. The complete ACSM-CEP exam content outline is described and may be downloaded elsewhere (8).
ACSM Specialty Certifications and Credentials
It is important to note that ACSM also offers several specialty credentials and certifications, which allows practitioners to expand the knowledge and skill of the base professional certification. ACSM’s specialty certifications are described in more detail elsewhere (9) and include the Exercise is Medicine® Credential, ACSM/ACS Certified Cancer Exercise TrainerSM, ACSM/NCHPAD Certified Inclusive Fitness TrainerSM, and ACSM/NPAS Physical Activity in Public Health SpecialistSM.
This short article introduces the reader to the systematic approach to the development and maintenance of ACSM’s core certification exams. The primary purpose, minimum requirements, and substantive changes are provided for each certification. Lastly, readers will have a broad understanding of how ACSM certification is an integral interface between exercise professionals, employers, and, most importantly, the public.
BRIDGING THE GAP
Professional certification touches three important stakeholder groups: 1) candidates, 2) employers, and 3) the public. For candidates, ACSM needs to ensure that its exams are valid, reliable, and fair. ACSM achieves this through the application of psychometric best practices and continual process improvement. For employers, ACSM certificants demonstrate a minimum level of job competency, which, in turn, reduces the potential liability risk. Lastly, and most importantly, ACSM certification plays a vital role as the interface between exercise professionals and their clients/patients. Success on a professional certification provides reasonable assurance to clients and patients that an exercise professional has enough knowledge and skill to provide their services safely and effectively.
A special thanks to all the members of the ACSM CCRB, past and present, for their selfless commitment to the profession and their diligent work on behalf of and for all ACSM certified professionals.