Exercise Physiologist Job Description Sample
The Exercise Physiologist monitors Phase II and III cardiac rehabilitation classes, may work independently as the chief of a Phase II and III class, develops exercise prescriptions, and may plan and participate in special patient events, research, and professional conferences. Works with the other staff and nursing to supervises patient admissions into the program (e.g., risk stratification), progress, physician follow-up, education and discharge. Works with the Cardiac Nurse and Exercise Specialist to provide safe, effective exercise therapy programs for a variety of patient acuities.
Under Registered Nurse supervision and according to established policies and procedures, evaluates the patient's ability and capacity for exercise, prescribes and guides patient's individualized exercise program. Assists in risk factor modification programs and educational sessions for cardiac patients.
Meets with specified cardiac patients during their hospitalization to orient them to rehabilitation program.
Conducts phase I of exercise program as indicated by Cardiac Rehabilitation Nurse.
Assists in patient teaching for selected inpatients.
Formulates safe and appropriate exercises for progressing patients and assists in developing ongoing programs to meet patient needs.
Monitors heart rate, rhythm, and blood pressure and RPE response to exercise sessions.
Demonstrates correct body position and proper use of equipment to patients to prevent injury.
Assists Registered Nurse with emergency care (i.e., CPR, etc.).
Conducts stress testing if required.
Attends conferences, planning and staff meetings and participates in projects as required.
This document represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
A. Education / Training: Requires Bachelor of Science Degree in Exercise Science or Physiology with internship in Cardiac Rehabilitation.
B. Work Experience: Requires a minimum of one year experience in a cardiac rehabilitation setting.
C. Contacts With Others: Demonstrates effective communication skills with hospital employees, professional staff, patients and families
D. Analytical Demands: Interprets stress test and EKG results to plan or prescribe a safe and efficient course of action based upon patient data.
E. Certification, Licensure, Registration: CPR and Advanced Cardiac Life Support certification. Certification as an Exercise Specialist from the American College of Sports Medicine.
The clinical and translational laboratories involve hormonal, nutritional, and behavioral and lifestyle. interventions to retard or reverse the metabolic and physical complications of aging, including sarcopenic obesity and type 2 diabetes.
The exercise physiologist will participate in research projects involving weight loss and exercise interventions in older adults. Duties include but not limited to: prepare exercise prescriptions and conduct the exercise training sessions with the team, ensure effective delivery of the exercise intervention, ensure safety of the exercise Intervention, and conduct exercise stress tests.
As research coordinator, other ·responsibilities include: submission of required regulatory documents to Investigative Review Board, preparation/update of informed consents, data collection and evaluation, recruitment of research volunteers, screening, and scheduling, conduct orientation sessions; perform study related assessments/interventions, administer study questionnaires, perform venipunctures for collection of blood samples and sample processing, collect and maintain accurate source documentation, data entry and quality control of data base, and analyze DXA and MRI. Conduct the study in accordance with the timelines as stipulated in the research grant.
Preferred: Strong background in medicine, nutritional, and lifestyle/behavioral science.
Must be motivated, enthusiastlc, careful, and think critically. Ideal candidate will have strong oral and written communication skills, ability to work effectively in a team environment, and highly organized. Experience with use of Microsoft access and phlebotomy procedures or willingness to learn.
Bachelor's degree in Exercise Science.
One year of related experience in exercise physiology.
Preferred: Master's degree in Exercise Science.
Day Shift: Hours per schedule
Weekend & Holiday Rotation: Per schedule
The Cardiac/Pulmonary Rehab Exercise Physiologist helps to maintain the operations of a comprehensive cardiopulmonary rehabilitation program, to provide high quality patient care in keeping with the standards and strategic objectives as put forth by MidMichigan Health, Rehabilitation Services; under the direction of the CR/PR medical director(s) and/or the CR/PR health system manager.
The Exercise Physiologist is responsible for the participation and decisions in daily operations within the cardiopulmonary rehabilitation environment. This includes and is not limited to the development, implementation and regulatory compliance associated with patient care and the entire range of services provided in CR/PR such as: patient evaluation/assessment, patient engagement, patient interventions as indicated, patient and community education, exercise training and treatment, psychosocial support and continued reevaluation and follow-up in conjunction with the CR/PR program's medical director.
(50%)* Daily operations and patient treatment consisting of supervised monitored exercise for the cardiovascular and pulmonary patient, under the direct supervision of the CR/PR medical director(s). The Exercise Physiologist informs patients of their rights and responsibilities as a patient in CR/PR while maintaining the preservation of patient confidentiality; as the individual participates in their decision regarding acceptance or refusal of medical treatment.
The Exercise Physiologist facilitates appropriate patient referrals for CR/PR services, assists with the development and 30-day reevaluation of the patient's individualized exercise prescription and treatment plan throughout the patient's course of therapy; as well as patient assessment/re-evaluation, interpretation of ECG's rhythms and monitoring of patient vital signs in the outpatient environment during exercise treatment.
(25%)* Performs patient self-management education in the acute care and outpatient environment and addresses the needs of the individual through case-management interventions. This includes: patient self-management education; development and fostering patient engagement in their care; risk factor assessment and behavior modification counseling; and community benefit participation/education, for the communities in which we serve.
(25%)* Maintains patient's chart and performs chart auditing. Performs patient outcome assessments pre/post treatment and as indicated.
Performs outcome data collection and interpretation for national program certification and national program registry. Leads and/or participates in Health System, Rehabilitation Services, and CR/PR program performance improvement initiatives to maintain the highest level of program quality and patient safety. Actively participates in the Rehabilitation Shared Governance model and the CR/PR Shared Governance Work-Groups.
OTHER DUTIES AND RESPONSIBILITIES
Regular communication/reporting with the CR/PR medical director(s), CR/PR health system manager, the CR/PR Shared Governance Work Groups, and any designated CR/PR lead person.
Responsible for obtaining: patient history, physical assessment measurements during exercise treatment, such as: exertion, dyspnea, pain, blood pressure, heart rate, oximetry reading, heart sounds, blood glucose levels and Interpretation of ECG rhythms.
Performs patient monitoring for inappropriate responses to exercise, discontinuation of treatment and appropriate reporting, as indicated to the CR/PR supervising physician, medical director and/or the patients referring physician.
Responsible for participation in CR/PR patient emergent situations and the initiation of appropriate emergency responses according to the CR/PR Emergency Procedures and national regulatory guidelines for cardiopulmonary rehabilitation. Will participates in annual emergency preparedness training and mock codes per CR/PR program. Provides and/or participates in at least 4 emergency in-services per year.
Assists in the establishment and maintenance of the student internships and job shadows for the CR/PR multi-disciplinary professionals.
Management of Electronic Medical Records (EMR) Work Queues: 1) patient referrals, 2) billing, revenue capture, 3) insurance authorization, 4) patient scheduling and 5) provider and/or intradepartmental communication. 6) Performs all necessary documentation and enters daily assessment data into patient records.
Demonstrates competency in Infection Prevention/Control practices: 1) control measures designed to prevent the spread of infectious diseases, 2) implements and maintains isolation techniques, and 3) follows hand hygiene policies and utilizes personal protective equipment as indicated.
Assists with maintenance, calibration, infection prevention and cleaning of CR/PR equipment.
Performs other duties and/or functions as assigned by the CR/PR manager or designee.
MidMichigan Health is a technology driven organization and employees need to demonstrate competency in Microsoft® Windows.
An employee may be required to participate in further learning as designated by the health system, Rehabilitation Services, and/or the CR/PR manager.
- Bachelors Degree
in Education specialization:
- Exercise Physiology
Education equivalent experience:
- Experience in diagnostic stress testing in both regular and Nuclear Medicine preferred. Working knowledge of oxygen therapy preferred.
Advanced Cardiac Life Support
Basic Life Support
- Am College of Sports Medicine
EXPERIENCE, TRAINING AND SKILLS:
Experience in assessment of cardiac and pulmonary patients, the development of individualized exercise prescriptions and individualized treatment plans, and the design of intividual exercise regimens for patients receiving treatment in CR/PR.
Physical/Mental Requirements and Working Conditions
PHYSICAL/MENTAL REQUIREMENTS AND TYPICAL WORKING CONDITIONS:
Exposure to stressful situations, including those involving public contact, as well as, trauma, grief and death.
Able to wear personal protective equipment that includes latex materials or appropriate substitute if required for your position.
Is able to move freely about facility with or without an assisted device and must be able to perform the functions of the job as outlined in the job description.
Overall vision and hearing is necessary with or without assisted device(s).
Frequently required to sit/stand/walk for long periods of time. May require frequent postural changes such as stooping, kneeling or crouching.
Some exposure to blood borne pathogens and other potentially infectious material. Must follow MidMichigan Health bloodborne pathogen and TB testing as required.
Ability to handle multiple tasks, get along with others, work independently, regular and predictable attendance and ability to stay awake.
Overall dexterity is required including handling, reaching, grasping, fingering and feeling. May require repetition of these movements on a regular to frequent basis.
Physical Demand Level: Medium. Must be able to occasionally (0-33% of the workday) lift or carry 21-50 lbs., frequently 34-66% of the workday 20 lbs. and or Walk/Stand/Push/Pull of Arm/Leg controls and constantly (67-100% or the workday) 10 lbs.
The cardiac rehabilitation staff exercise physiologist (EP) is a professional caregiver who performs patient assessment, and develops, implements, and evaluates effectiveness of an exercise prescription for patients. The EP provides education to patients, families, and caregivers regarding risk factor modification, lifestyle changes, nutrition guidelines, stress management, medication understanding and compliance, and exercise guidelines. The EP may assist in the supervision of student interns and volunteers, as needed by the department. The EP works with other staff members to deliver safe, goal-oriented exercise sessions, teaches strength training classes, leads chair yoga and meditation classes, and other clinical activities of the program. The EP provides services in a manner consistent with TCMC's mission and values, and demonstrates awareness and sensitivity to patients'/caregivers' rights, as identified within the institution.
Major Position Responsibilities:
Develop patient exercise prescription and parameters based on clinical information and assessment
ECG monitoring and interpretation.
Educates patients and significant others regarding exercise theories and guidelines, nutrition guidelines, healthful lifestyle changes, stress management, and risk factor modification.
Oversees exercise sessions and adapts exercise prescription appropriately.
Assists with patient enrollment, billing, attendance, discharge planning, communication with other healthcare professionals, and outcome measures.
Assists with adherence of AACVPR certification guidelines and re-certification process.
Teaches group strength training, yoga, and meditation classes to all levels of participants in program.
Safety and Infection Control Responsibilities
- Responsible to maintain a safe and clean work environment, including unit based specific safety and infection control requirements.
ESSENTIAL COMPETENCIES, KNOWLEDGE, & EXPERIENCE
Tele monitoring experience/rhythm recognition experience, preferred (Proficiency required within 1 year).
Certification, experience, or training equivalent in group exercise, personal training, and/or lifestyle and wellness coaching, preferred.
Experience in exercise program planning, supervision, and counseling, required.
ECG monitoring experience/rhythm recognition, preferred (proficiency required within one year).
Bachelor's degree from an accredited university in Exercise Science, Exercise Physiology, or related field, required.
Master's Degree, preferred.
Current BLS, required.
Current ACSM - Exercise Specialist certification, preferred.
Current ACLS certification, required within 6 months of hire.
Each new hire candidate who is offered employment must pass a physical evaluation, urine drug screen and pre-employment background checks before starting work.
Canyon Ranch® has been a trailblazer and an industry-leading proponent of the wellness lifestyle and real estate living for nearly 40 years, operating the world's most celebrated collection of life-enhancement properties. Canyon Ranch has wellness destinations in Tucson, Arizona and Lenox, Massachusetts.
In addition, Canyon Ranch operates the world's largest day spa at The Venetian® & The Palazzo® hotels in Las Vegas, Nevada and 22 Canyon Ranch at Sea® wellness facilities across four luxury cruise lines: Cunard Cruise Line, Oceania® Cruises, Regent Seven Seas Cruises®, and on Celebrity Cruises®. Canyon Ranch is a 13-time winner of Travel + Leisure's Best Spa Award, an 11-time recipient of the Condé Nast Traveler Best Destination Spa Award, is honored by Town & Country as one of the 'Best Luxury Spas in the World' in their 2017 Spa Awards and is recognized as the 'Best Wellness Program' by Virtuoso's 'Best of the Best' 2017 awards.
Canyon Ranch is looking for an Exercise Physiologist at our Lenox, MA location.
Exercise Physiologists work with guests to create the optimal exercise experience for the individual guests. This is a highly skilled professional who is responsible for providing quality guest consultations, guest lectures and participating in departmental meetings to include input into the development of new lectures and services.
Provide professional guest consultations which may include fitness testing such as indirect calorimetry, Dexa scans, caliper body composition and spirometry following established protocols. WIth this information, the Exercise Physiologist will formulate home exercise programs for enhanced health and performance, interpret medical and exercise physiology evaluations, make referrals for services at Canyon Ranch consistent with company standards and communicate and collaborate with other H&H practitioners for continuity of care for guest.
Successful candidates are required to have a Master' Degree in Exercise Physiology. We would like to see 2-3 years clinical experience with a current working knowledge of Exercise Physiology testing such as indirect calorimetry, Dexa scans, caliper body composition and spirometry is preferred. Current CPR certification or ability to acquire it within the first weeks of employment.
Education: Master's Degree in Exercise Physiology required
St. Luke's is proud of the skills, experience and compassion of its employees, students, nursing school instructors and volunteers.
Together, they are our most valuable asset! Individually and together, our employees, students, nursing school instructors and volunteers are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses, and other health care providers; and improves access to care in the communities we serve, regardless of a patient's ability to pay for health care.
St. Luke's offers many opportunities for our student population.
We hope you will find these opportunities equally fulfilling and rewarding. Prior to starting your student internship or your nursing school instructor assignment at St. Luke's, it will be necessary for you to complete specific requirements and orientation materials, which you will need to provide during the student/nursing school instructor application process.
The Exercise Physiologist participates in the implementation of policy, programmatic and management goals. The Exercise Physiologist is responsible for the day-to-day planning and conducting of specific exercise and lifestyle management assessment and intervention for individuals participating in the Cardiac Rehabilitation program.
JOB DUTIES AND RESPONSIBILITIES:
Maintains established hospital and departmental policies and procedures, objectives, quality standards, programs, safety, environmental and infection control standards.
Plans, conducts and demonstrates specific exercise and lifestyle assessment and interventions including: nutrition, weight control, lipid management, stress management, and smoking cessation.
Designs and implements individualized goal oriented exercise prescription for cardiac rehabilitation clients.
Conducts new patient interviews which include but not limited to: medical history, functional status, short and long-term goals, nutritional assessment, and emotional status.
Provides patient education as it applies to cardiovascular disease risk factor modification.
Designs individualized treatment plans for clients entering cardiac rehab and provides 30 day updates to the referring physician and/ or cardiac rehab. Medical Director.
Assists cardiac rehabilitation nurse with ECG monitoring and rhythm interpretation.
Participates in training medical and nursing personnel and allied health student interns.
PHYSICAL AND SENSORY REQUIREMENTS:
Ability to stand for the greater part of 8 hours. Occasional handling, grasping, twisting and turning while aiding clients and setting up equipment.
The possibility of lifting clients weighing up to 300 pounds with assistance. The possibility of pushing clients weighing up to 300 pounds in a wheelchair. Occasional stooping, bending, squatting, crouching, and reaching above shoulder level.
Touching as it relates to patient assessment, attaching heart monitors, and auscultation of lungs. Hearing as it relates to normal conversation, BP evaluation, and auscultating lung sounds. Seeing as it relates to general close-up and distant vision. Must be able to use finger dexterity, grasping, and holding as it relates to documentation an assisting with machinery setup.
Master's Degree in Exercise Physiology required.
TRAINING AND EXPERIENCE:
ACSM Certified Exercise Specialist® or ACSM Registered Clinical Exercise Physiologist® or AACVPR Certified Cardiac rehabilitation Specialist. BLS Certification required.
ACLS Certification preferred. Proficiency in ECG rhythm recognition. Prior clinical experience in Cardiac rehabilitation.
Please complete your student/nursing school instructor application using your full legal name and current home address in addition to any other personal information. You will also be required to upload specific documents for your internship/assignment.
Thank you for your interest in St. Luke's.
Bachelors Degree Required
BLS for Healthcare Providers required
Works with cardiac and pulmonary patients in a variety of settings. This job encompasses a variety of responsibilities of cardiac imaging and rehabilitation services.
Determines exercise prescription on an individual basis for each patient. Promotes exercise and activity aimed at assisting patients to return to pre-event level of conditioning.
All team members are responsible for bringing life to our Purpose Statement – Inspire health. Serve with compassion. Be the difference – through every action and every interaction at work.
Provides fitness and lifestyle assessment. Responsible for development of exercise prescription, instructions and ongoing re-evaluation of activity until discharge.
May provide classroom education to patients regarding importance of exercise and increased activity, how to monitor activity, indications, and contraindications.
Responsible for monitoring patients during exercise, assessing equipment needs and providing recommendations to manager.
Performs pertinent chart reviews to determine appropriate activity levels. Communicates plan to other care providers.
Recognizes the need for and makes appropriate interdisciplinary referrals.
Documents patient's physical activity as well as documenting vitals and clinical response.
Provides patient with self monitoring tools as appropriate.
May perform a variety of stress tests to include routine treadmill stress tests, nuclear stress tests and stress echocardiography.
May prepare studies for interpretation and assign studies to correct physician.
Participates in interdisciplinary team meetings, including discharge planning. Participates in collection of outcome data.
Perform other duties as assigned.
Education: Bachelor's degree in Exercise Science
Experience: 2 years of experience preferred
Licensure, Registry, or Certification: Certification may be required depending on job duties; BLS required.
Special Training: Demonstrates clinical competency based on patient's age
How have you impacted someone's life today? At Hackensack Meridian Health our healthcare teams are focused on changing the lives of our patients by providing the highest level of care each and every day. From our hospitals, rehab centers and occupational health teams to our long-term care centers and at-home care capabilities, our complete spectrum of services will allow you to apply your skills in multiple settings while building your career all within New Jersey's premier healthcare system
Provision of initial fitness assessments for new clients
Progression and adaptation of exercise regimens
Maintenance of statistical data as assigned
Performance of graded exercise testing
Participation in leading group exercise sessions
Provision of guidance to exercise specialist
Participation in program development and facility/department initiatives as assigned.
One year of experience in a clinical medical environment preferred
Previous experience working in cardiac and pulmonary rehabilitation or with individuals with disabilities preferred
Graduate of an accredited program with a masters degree in exercise physiology
Current Advanced Cardiac Life Support certification
Current Basic Life Support certification
As the internal staffing (registry) provider for Banner Health, Banner Staffing Services (BSS) provides opportunities within one of the country's leading health systems. The BSS team is dedicated to providing personal attention and professional support for its employees.
Registry opportunities are a great way to market your skills within Banner Health. As a BSS employee, you are eligible to apply (at any time) as an internal applicant to any regular full-time or part-time opportunities within Banner Health.
Located at North Colorado Medical Center in Greeley, Colorado!
BLS required. ACSM or CCRP preferred
In addition, registry employment through BSS offers:
Flexible Schedules (select positions)
Fewer Shifts Cancelled
403(b) Pre-tax retirement plan
Employee Assistance Program
Employee wellness program
Discount Entertainment tickets
Auto Purchase Plan
BSS Registry positions do not have guaranteed hours and no medical benefits package is offered. BSS requires: Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes; employment, criminal and education).
About Banner Staffing Service WR
Supporting Banner Health, Banner Staffing Services offers a world of opportunities to make an impact on one of the country's leading health systems. In addition, Staffing Services provides the best training in the business, so you can hit the ground running as you enjoy unequaled clinical variety, professional flexibility and lifestyle choices.
We provide registry and travel assignments throughout the western United States. The registry allows you to create your own schedule by offering opportunities in a variety of hospital, home care and primary care settings. Banner Travel offers short-term assignments of three twelve-hour shifts per week.
Our pay rates are highly competitive, and we offer training in the country's most advanced simulation center. You will also enjoy the stability only an organization as large and successful as Banner Health can offer.
About Banner Health
Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.
This position provides assessment, treatment, and education to cardiac patients and their families during rehabilitation. This position writes exercise prescriptions to progress patients through rehabilitation.
Evaluates patients functional abilities and limitations to determine appropriate intervention. Develops a plan of care and exercise goals, as ordered by physician or other referral source.
Implements individualized exercise plans that consider patients physical and age-specific needs and abilities. Ensures that treatment plans are supported by standard practices and/or current literature. Re-evaluates treatment plans, as needed, to ensure safety and maximum patient benefit.
Educates patients, family, and other care providers to promote patient participation and attainment of exercise program goals. Provides individualized home programs with clear instructions. Instructs patients and families in pathology, discharge guidelines, risk factor modification, and exercise individually and through classes.
Documents patient treatment according to professional and regulatory standards.
Participates in the provision of training to other staff and students.
Requires a level of clinical knowledge as normally obtained through the completion of a Bachelors degree in exercise/physiology or related field.
Requires the ability to work collaboratively with physicians and other healthcare providers. Must have strong interpersonal communications and human relation skills.
Advanced Cardiac Life Support (ACLS).
Additional related education and/or experience preferred.
The Exercise Physiologist develops and implements individualized exercise programs in accordance with established policies, procedures and protocols. The Exercise Physiologist participates in all center activities and assures a safe and effective exercise environment.
1.Demonstrates ability to work with others to achieve and support the mission of the medical center. 2.
Performs fitness testing and exercise orientations in a safe and effective manner. 3. Evaluates and interprets patient's health history prior to development of patient exercise plan. 4. Uses clinical knowledge of disease management programming and multiple co-morbidities in development of safe, appropriate exercise programming designed to meet individual patient needs. 5. Applies appropriate restrictions or limitations as indicated by any physical or medical conditions. 6. Recognizes symptom changes/signs of problems and knows the appropriate medical response and processes. 7. Respond immediately to any and all emergency situations in the exercise area. 8. Assists or administers cardiopulmonary resuscitation when necessary. 9. Reviews and writes exercise prescriptions based on stress test results and sub-maximal fitness tests. 10. Adheres to the standards of American College of Sports Medicine and the American Association of Cardiovascular and Pulmonary Rehabilitation. 11. Provides education and collaborates and communicates with nursing staff on exercise programming. 12. Interacts with patients and staff in a friendly, understanding and professional manner while providing appropriate supervision at all times. 13. Reviews patient's exercise programs on a daily / weekly basis and adjusts accordingly to ensure a safe, effective and progressive exercise program. 14. Documents variances, incidences, and performs follow-up as per protocol. 15. Provides patient education and counseling on risk reduction and documents same. 16. Identifies the needs of the patients served and modifies and delivers care that is specific to those needs (e.g., age, culture, language, hearing and/or visually impaired, etc.). This process includes communicating with the patient, parent, and/or primary caregiver(s) at their level (developmental/age, educational, literacy, etc.). 17. Adheres to the standards identified in the Medical Center's Organizational Competencies.
Education, Knowledge, Skills and Abilities Required: 1. Master's Degree in exercise physiology / exercise science. 2.
Previous experience (1-2 years) in the exercise profession. 3. Comprehensive understanding of the principles of exercise: cardiorespiratory, resistance and flexibility training; skills to perform a variety of exercise tests. 4. Thorough understanding of all exercise modalities, including proper application and positioning in order to assure the correct form and technique with all exercises.
Education, Knowledge, Skills and Abilities Preferred: 1. Cardiac Rehabilitation experience (includes an internship) 2.
Professional membership with ACSM, American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) or NSCA Licenses and Certifications Required: 1.
AHA Basic Health Care Life Support HCP Certification. Licenses and Certifications Preferred: 1. Certified Personal Trainer, Exercise Specialist, Clinical Exercise Specialist. 2. Certified Strength and Conditioning Specialist.
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