Croatian medical students see academic dishonesty as an acceptable behaviour: a cross-sectional multicampus study

Is there a relationship between nursing students' perceptions of dishonesty and attitudes towards medical errors?

BACKGROUND

Understanding nursing students' perceptions of dishonesty and their attitudes towards medical errors is crucial for nurse educators.

OBJECTIVES

This study aimed to examine the relationship between nursing students' perceptions of dishonesty and their attitudes towards medical errors.

DESIGN

This study is descriptive and correlational research. The sample size consisted of 230 nursing students in a Department of Nursing at Kırşehir Ahi Evran University Faculty of Health Sciences in Turkey during the 2022-2023 academic year. The data was collected between May 15-31, 2023.

RESULTS

A statistically significant correlation was observed between the total score of the Nursing Student Perceptions of Dishonesty Scale, and the Medical Errors Attitude Scale (p < 0.05). There was a positive and weak correlation between the MEAS scale score and the cheating (r = 0.284, p < 0.05), sabotage (r = 0.275, p < 0.05), perjury (r = 0.308, p < 0.05), non-compliance (r = 0.309, p < 0.05), and stealing (r = 0.359, p < 0.05) sub dimension score, and a positive and very weak correlation between the MEAS score and the sub dimension of not my problem score (r = 0.182, p < 0.05). The perceptions of dishonesty explain 15 % of the attitude towards medical errors (F = 4.563, p < 0.001).

CONCLUSIONS

In this study, a significant relationship was observed between nursing students' perceptions of dishonesty and their attitudes towards medical errors. Specifically, as the perception of dishonesty increased, there was a positive change in attitudes towards medical errors. These results offer nurse educators valuable insights into the impact of academic dishonesty on the development of medical error attitudes among student nurses throughout their nursing education and beyond.

Gender-based differences in the impact of Dark Triad traits on academic dishonesty: The mediating role of moral disengagement in college students

This study explores whether gender differences influence the components of the Dark Triad of personality and moral disengagement on the manifestations of dishonest academic behavior in Peruvian university students. Moreover, it evaluates how moral disengagement mediates the effect that the Dark Triad components have on academic dishonesty. The participants were 591 university students, aged between 18 and 40 years (women = 71.7 %; Mage = 21.5; SDage = 3.60), to whom the Dirty Dozen Dark Triad, the Propensity to Morally Disengage Scale, and the Scale of Academic Dishonesty, which has 3 dimensions (cheating on exams, plagiarism, and falsification) were applied. The results reveal that only Machiavellianism has a significant and consistent influence on all dimensions of academic dishonesty, in both men and women, while psychopathy influences the dimension of plagiarism in both men and women and falsification only in men. In addition, moral disengagement affects falsification in both groups, cheating on exams only in the men's group, and plagiarism in the women's group. Finally, the mediating role of moral disengagement between the effect of the Dark Triad and the manifestations of academic dishonesty was not demonstrated.

A structural equation model for cyber academic dishonesty in higher education: Evidence from Taiwan

With the continued spread of the rise of online teaching, and the massive use of 3C products (computer, communication, and consumer electronics), the cases of academic plagiarism or using others' works as own works caused by inappropriate use of the Internet are occurring all the time. However, very little research has been conducted on the cyber ethical climate in relation to cyber academic dishonesty. This study investigates the structural relationship between cyber ethical climate, cyber self-efficacy, cyber ethical attitude and cyber academic dishonesty, among university and graduate students, and develops a multiple mediation model. A total of 812 university and graduate students from 32 universities in Taiwan completed the online questionnaire. The results of the study show that the multiple mediation model is valid and find that the cyber ethical climate creates a favorable context for organizing members to demonstrate cyber ethical behavior, demonstrating the importance of mutual influence on cyber academic dishonesty between the cyber ethical climate created by teachers and the cyber ethical climate of class peers. Based on these results, we deeply examine the practical implications and make specific recommendations to improve the cyber ethical behavior of university and graduate students.

Machiavellian Medical Students Report More Academic Misconduct: A Cocktail Fuelled by Psychological and Contextual Factors

Purpose

Maladaptive personality traits and some psychological functioning indicators have been linked to academic misbehaviour; yet their role is still poorly explored in medical students. This study aims to assess associations of academic misconduct with dark personality traits and psychological well-being.

Methods

Five hundred and ninety-one medical students attending the first, third and fifth-year at one Portuguese medical school replied to the Dark Triad Dirty Dozen, Ryff’s Psychological Well-Being Scales and an original Academic Misconduct Questionnaire, using a cross-sectional design. Multiple linear regression was performed to assess associations.

Results

Fifth-year medical students who scored higher in Machiavellianism and psychological well-being and perceived greater peer fraud and lower penalty for cheating reported more academic misconduct. The explanatory power of the model was 16.6%. Machiavellianism showed the strongest associations with cheating, while sex and age were not significant predictors.

Conclusion

This study offers relevant insights into how maladaptive personalities influence academic misconduct in medical students, and how this relationship is moulded by psychological and contextual factors. These findings can help guide institutional actions to foster academic integrity in future physicians.

Exploration of Students' Perception of Academic Misconduct: Do Individual Factors, Moral Philosophy, Behavioral Intention, and Judgment Matter?

Using Reidenbach and Robin's Multidimensional Ethics Scale, this study designs three scenarios related to academic dishonesty (AD) dilemmas to explore students' moral philosophies, behavioral intentions, and ethical judgments and further examines whether students with different individual factors (i.e., culture of place, gender, and educational level) have differences in the above variables. A total of 605 students from two areas, Taiwan and Mainland China, participated in this study. The results indicated that Taiwanese students had stricter moral equity, relativism, and contractualism philosophies in the duplicate submission scenario than Mainland China students. They also had stricter moral equity and relativism philosophies in the incomplete citation scenario. Similarly, relatively harsh relativism and contractualism philosophies accompanied by a low level of willingness to be a perpetrator in the failure to cite research published in other countries scenario were found. In addition, females applied relatively harsh moral equity and utilitarianism to all scenarios, reporting that they and their peers were less likely to engage in all AD activities. Graduates had a stricter egoism attitude toward duplicate submission and had stricter moral equity, relativism, and contractualism philosophies toward the behavior of incomplete citation. Graduate students also had strict moral equity, relativism, egoism, and contractualism beliefs in the failure to cite the foreign research scenario. Finally, regression analysis showed that moral equity, contractualism, and self-behavioral intention are significant predictors of students' ethical evaluations in the three scenarios.

Students' perception of educational environment based on Dundee Ready Education Environment Measure and the role of peer mentoring: a cross-sectional study

OBJECTIVE

The curricular reform at Tehran University of Medical Sciences (TUMS), Iran, has been implemented since 2011 when peer mentoring program started. The program is believed to have a crucial role in students' perception of the educational environment (EE). We aimed to determine how students perceive the educational environment and compared the mentees and non-mentees' perception of EE.

METHODS

A cross-sectional descriptive study was conducted among 190 first-year medical students enrolling at Tehran University of Medical Sciences from March to September 2019. A questionnaire was used to collect information on students' age, gender, marital status, dormitory status, and their mentoring status including satisfaction of mentor-mentee relationship. The study also employed Dundee Ready Education Environment Measure (DREEM). The collected data were then entered and analysed using SPSS version 20. To compare the perception of EE between mentees and non-mentees, we used independent t-test.

RESULTS

The mean (SD) for total DREEM score for EE was 144.1 (19.3), which signifies a more positive than negative educational environment perception. Nonetheless, the mean scores of total DREEM was not significantly different between students with or without mentors (P =0.390). The overall mean score for student perceptions of learning for mentees was 32.47 (4.5) while for those without a mentor, the score was 31.70 (4.9) (P =0.491). The items concerned with "emphasizing factual learning" and "teacher-based teaching" were rated the least. The item "having an appropriate support system" was scored significantly different between students with or without mentors (P =0.009).

CONCLUSIONS

Since having an appropriate support system was significantly different between groups, we suggest curriculum designers focus on the above-mentioned issue under caption for improvement during the reform programs.

Psychopathic Traits, Academic Fraud, and the Mediating Role of Motivation, Opportunity, Rationalization and Perceived Capability

Abstract. This study provides initial insights on the relation between psychopathic traits (disinhibition, meanness, and boldness) and academic fraud (prevalence and severity), while considering important mediators of fraud (perceived capability, opportunity, motivation, and rationalization). Based on a large sample of university students ( N = 967), two structural equation models (test and replication) were built to test the study’s main hypothesis and probe the robustness of the results. A direct link from disinhibition to prevalence was found, suggesting that disinhibition is associated with social deviance in the academic context. Higher motivation for cheating exclusively mediated this path. In meanness, rationalization explained lower rates of perceived severity of academic fraud, indicating that cognitive self-justifications trigger dishonest behavior in meanness. Boldness explained the prevalence of academic fraud via perceived capability, suggesting that low-fear, although adaptive in evaluation contexts, may increase the perceived capability for cheating. The reported significant associations support that academic fraud is part of the nomological network of psychopathy and unveil the complexity of the phenomenon.

Predatory Journals, Fake Conferences and Misleading Social Media: The Dark Side of Medical Information

We live in an age of information revolution, where trends in informing physicians and the lay public bring new challenges that must be faced by healthcare professionals. Predatory journals and fake conferences are common. Social media is full of false information, which results in serious public health damage. Therefore, it is important that health professionals communicate properly with the public and patients and that they address the education of both the public and other health professionals.

Promoting anti-corruption, transparency and accountability in the recruitment and promotion of health workers to safeguard health outcomes

Background: Human Resources for Health are a core building block of a health system, playing a crucial role in improving health outcomes. While the existing literature has examined various forms of corruption that affect the health sector, few articles have examined the role and impact of corruption in the recruitment and promotion of health-workers.Objectives: This study reviews the role of corrupt practices such as nepotism, bribery and sextortion in health-worker recruitment and promotion and their implications for health systems.Methods: The study is based on an interdisciplinary non-systematic review of peer-reviewed journal articles in the public health/medicine and political science literature, complemented with the 'grey' literature such as technical reports and working papers.Results: Political and personal ties, rather than merit are often factors in the recruitment and promotion of health-workers in many countries. This results in the employment or promotion of poorly qualified or unsuitable workers, with negative implications for health outcomes.Conclusion: Corrupt practices in health-worker recruitment and promotion 'set the tone' for other forms of corruption such as absenteeism, embezzlement, theft and bid-rigging to flourish, as those recruited corruptly can collude for nefarious purposes. On the other hand, merit-based recruitment is important for curbing corruption. Corrupt recruitment practices have deleterious effects on health-worker motivation and retention, quality and competency, citizens' trust in health services and health outcomes. Whereas international law and policy such as the United Nations Convention Against Corruption and the WHO Handbook on Monitoring and Evaluation of Human Resources for Health state that recruitment of public officers and health workers respectively should be done in a transparent and accountable manner, more research is needed to inform policies on merit-based recruitment.

Levelling the playing field: students' motivations to contribute to an amnesty of assessment materials

BACKGROUND

'Exam recall' is a recognised phenomenon whereby students recall and record questions after leaving the examination hall. This poses two main problems. First, as these questions are only available to peers of the students who recall the questions, these individuals have an unfair advantage. Secondly, the distribution of these recalled questions poses a threat to the validity and defensibility of assessments. To address the first of these problems, we developed an amnesty enabling students to submit assessment material to an on-line site. This study sought to explore which factors influence students' contributions to an amnesty of assessment material.

METHODS

We conducted a qualitative study using semi-structured focus groups. We used convenience sampling and recruited participants from all years of our undergraduate medical programme. The focus groups were facilitated by a medical student peer to reduce the power imbalance and encourage participants to discuss candidly. The focus groups were audio recorded and transcribed verbatim. Two researchers independently analysed all transcripts using thematic analysis and the research team met regularly to discuss emergent findings. Nvivo was used to assist with thematic analysis of the transcripts.

RESULTS

Twenty-six individuals participated in six focus groups. Six themes were identified through the analysis, which were categorised into motivating factors and de-motivating factors. Motivating factors were a perception that this would overcome inequity, a fear of repercussions, and the perceived usefulness of resources. Factors that prevented students contributing were a culture of competition, a lack of incentives, and mistrust of the medical school.

CONCLUSIONS

The establishment of an amnesty was acceptable to students and they were motivated to contribute materials. The competitive nature of medical careers and the stakes of summative assessments meant that students felt that some peers might still not contribute their materials. Students felt that the school were listening to their concerns and this led to a better dialogue between students and faculty.

Violation of digital and analog academic integrity through the eyes of faculty members and students: Do institutional role and technology change ethical perspectives?

This study aimed to address the gap in the literature through a comprehensive comparison of different types of violations of academic integrity (VAI), cheating, plagiarism, fabrication and facilitation (Pavela in J College Univ Law 24(1):1-22, 1997), conducted in analog versus digital settings, as well as students' and faculty members' perceptions regarding their severity. The study explored differences in perceptions regarding students' VAI and penalties for VAI among 1482 students and 42 faculty members. Furthermore, we explored the impact of socio-demographic characteristics (ethnic majority vs. minority students), gender, and academic degree on the perceived severity of VAI. Presented with a battery of scenarios, participants assessed the severity of penalties imposed by a university disciplinary committee. Furthermore, participants selected the penalties they deemed appropriate for violations engaged in by students, including: reprimanding, financial, academic, and accessibility penalties. All participants tended to suggest more severe penalties for VAI conducted in traditional analog environments than for the same offenses in digital settings. Students perceived all four types of penalties imposed by the disciplinary committee to be significantly more severe than faculty members. Moreover, findings demonstrated a significant difference between faculty and students in both perceptions of the severity of VAI and in relation to suggested punishments. Consistent with the Self-Concept Maintenance Model (Mazar et al. in J Mark Res 45(6):633-644, 2008) and Neutralizing Effect (Brimble, in: Bretag (ed) Handbook of academic integrity, SpringerNature, Singapore, pp 365-382, 2016), ethnic minority students estimated cheating, plagiarism, and facilitation violations as more severe than majority students. The theoretical and practical implications of the findings are discussed.

The impact of gender and academic achievement on the violation of academic integrity for medical faculty students, a descriptive cross-sectional survey study

PURPOSE

The aim of this study is to determine the characteristics of medical faculty students about violations of academic integrity.

METHOD

From the whole population of the 572 students of the Muğla Sıtkı Koçman University Faculty of Medicine, 271 students participated voluntarily in a descriptive cross-sectional survey. Descriptive data were recorded in the survey and a five-point Likert-type instrument, namely the Tendency towards Academic Dishonesty Scale, was used as the data collection tool in the study. The scale included 22 items' means that are considered to evaluate "Tendency towards academic dishonesty" (TTAD) score. In addition, four subscales, namely "Tendency towards cheating", "Dishonesty in works such as assignments and projects", "Tendency towards dishonesty in research and reporting processes" and "Tendency towards citation dishonesty" scores were evaluated separately.

RESULTS

Of the participants, 138 (53.3%) were male. TTAD scores were 2.15 ± 0.61, showing a slight tendency towards academic dishonesty, according to the scale. TTAD scores and standard deviations (SD) were 2.26 ± 0.65 and 2.04 ± 0.55 for men and women, respectively (P = 0.005). There was no difference in the TTAD scores for students whether they had read the ethics code. Significant differences were observed in the TTAD scores for students with gender, different academic achievements and in different academic years. However, when multivariate analysis was performed, the significance shown in the results disappeared.

CONCLUSION

In our study, a slight tendency to academic dishonesty was found for medical faculty students and there were no differences between all of the recorded individual factors of students.

Attitudes and Knowledge About Plagiarism Among University Students: Cross-Sectional Survey at the University of Split, Croatia

Plagiarism is one of the most severe academic integrity issues. This study examined students' knowledge of and attitudes towards plagiarism, tested their ability to recognize plagiarism, and explored the association of study levels and attendance in courses dealing with referencing rules and plagiarism with students' attitudes and knowledge. A cross-sectional online survey was conducted at the University of Split, comprising the students of all schools and study levels (n = 388). Overall, results indicate the students were not very familiar with referencing rules and did not perform well on either theoretical questions or practical examples. However, they demonstrated positive attitudes towards plagiarism avoidance as well as towards compliance with academic integrity with respect to the correct use of research publications. Students' self-reported attendance in courses dealing with referencing rules and plagiarism avoidance was not associated with their knowledge of and attitudes toward plagiarism. These findings are important for a general understanding of students' attitudes, and the relation of practical and theoretical knowledge of plagiarism. Furthermore, the academic community addresses plagiarism not only as an ethical and regulatory violation but also as a direct consequence of a lack of knowledge, and of academic illiteracy. Study programs should be adjusted and long-term policies developed at all academic levels to promote a positive climate among students towards responsible academic writing.

Self-reported cheating among medical students: An alarming finding in a cross-sectional study from Saudi Arabia

Academic misconduct/dishonesty has become widespread behavior among many university students across the globe, and medical education is not an exception. Until recently, few efforts have been made to study the dishonest behavior in Middle-Eastern universities. This study examined the prevalence and predisposing factors of cheating among medical students in Saudi Arabia and suggests suitable preventive measures. A cross-sectional survey-based study was conducted at a government medical college during the 2014–2015 academic year. The response rate was 58.5% (421/720). The overall cheating behavior practiced by the participants was 29%, predominantly by male students. High GPA scoring students were the least likely to cheat. The participants living with their families were more likely to cheat compared to those who were living apart from their families. The reasons participants gave to justify their cheating behavior included getting better grades, passing the course, and lacking preparation while still recognizing that cheating is a ‘mistake.’ Overall, significant academic misconduct concerning cheating was found among the Saudi medical students; this misconduct is alarming in a reputable government institution. The implementation of strict punishments, requiring ethical courses and creating ethical awareness by exploiting the potential of Islamic religious belief might help to control this problem.

Descriptors for unprofessional behaviours of medical students: a systematic review and categorisation

BACKGROUND

Developing professionalism is a core task in medical education. Unfortunately, it has remained difficult for educators to identify medical students' unprofessionalism, because, among other reasons, there are no commonly adopted descriptors that can be used to document students' unprofessional behaviour. This study aimed to generate an overview of descriptors for unprofessional behaviour based on research evidence of real-life unprofessional behaviours of medical students.

METHODS

A systematic review was conducted searching PubMed, Ebsco/ERIC, Ebsco/PsycINFO and Embase.com from inception to 2016. Articles were reviewed for admitted or witnessed unprofessional behaviours of undergraduate medical students.

RESULTS

The search yielded 11,963 different studies, 46 met all inclusion criteria. We found 205 different descriptions of unprofessional behaviours, which were coded into 30 different descriptors, and subsequently classified in four behavioural themes: failure to engage, dishonest behaviour, disrespectful behaviour, and poor self-awareness.

CONCLUSIONS

This overview provides a common language to describe medical students' unprofessional behaviour. The framework of descriptors is proposed as a tool for educators to denominate students' unprofessional behaviours. The found behaviours can have various causes, which should be explored in a discussion with the student about personal, interpersonal and/or institutional circumstances in which the behaviour occurred. Explicitly denominating unprofessional behaviour serves two goals: [i] creating a culture in which unprofessional behaviour is acknowledged, [ii] targeting students who need extra guidance. Both are important to avoid unprofessional behaviour among future doctors.

A preliminary survey of professionalism teaching practices in anatomy education among Indian Medical Colleges

Professionalism and ethics have gained widespread recognition as competencies to be fulfilled, taught, and assessed within medical education. The role of the anatomy course in developed nations has evolved over time and now encompasses multiple domains, including knowledge, skills, and the inculcation of professionalism and ethics. The Medical Council of India recently recommended the integration of professionalism teaching in undergraduate medical curricula. The authors investigated whether the initial orientation lectures and instructions given by faculty at the outset of undergraduate medical anatomy courses throughout India served a "hidden curriculum" regarding professionalism practices, and whether these orientation messages could serve as an early exposure to medical professionalism and ethics for medical students. An online survey was carried out among 102 anatomy faculty members across India requesting details about specific professionalism protocols and instructions regarding behavior in the dissection hall that are routinely given to preclinical students, as well as the importance that they placed on professional behavior. It was found that most faculty members regularly instruct students regarding expected behavior during the anatomy course, including dissection practices. These instructions stress attributes of professionalism like humanism, accountability, and honesty. However, there needs to be a more concentrated effort by educators to prohibit such unprofessional practices like dissection hall photography, and better information is required regarding biomedical waste disposal. Despite the absence of clear guidelines for professionalism teaching in medical education in India, the existing framework of anatomy education provides an opportunity to introduce the concept of professionalism to the first-year medical student. This opportunity may provide an early foundation for designing a professionalism-integrated curriculum. Anat Sci Educ 10: 433-443. © 2017 American Association of Anatomists.

Research Misconduct in the Croatian Scientific Community: A Survey Assessing the Forms and Characteristics of Research Misconduct

The prevalence and characteristics of research misconduct have mainly been studied in highly developed countries. In moderately or poorly developed countries such as Croatia, data on research misconduct are scarce. The primary aim of this study was to determine the rates at which scientists report committing or observing the most serious forms of research misconduct, such as falsification , fabrication, plagiarism, and violation of authorship rules in the Croatian scientific community. Additionally, we sought to determine the degree of development and the extent of implementation of the system for defining and regulating research misconduct in a typical scientific community in Croatia. An anonymous questionnaire was distributed among 1232 Croatian scientists at the University of Rijeka in 2012/2013 and 237 (19.2 %) returned the survey. Based on the respondents who admitted having committed research misconduct, 9 (3.8 %) admitted to plagiarism, 22 (9.3 %) to data falsification, 9 (3.8 %) to data fabrication, and 60 (25.3 %) respondents admitted to violation of authorship rules. Based on the respondents who admitted having observed research misconduct of fellow scientists, 72 (30.4 %) observed plagiarism, 69 (29.1 %) observed data falsification, 46 (19.4 %) observed data fabrication, and 132 (55.7 %) respondents admitted having observed violation of authorship rules. The results of our study indicate that the efficacy of the system for managing research misconduct in Croatia is poor. At the University of Rijeka there is no document dedicated exclusively to research integrity, describing the values that should be fostered by a scientist and clarifying the forms of research misconduct and what constitutes a questionable research practice. Scientists do not trust ethical bodies and the system for defining and regulating research misconduct; therefore the observed cases of research misconduct are rarely reported. Finally, Croatian scientists are not formally educated about responsible conduct of research at any level of their formal education. All mentioned indicate possible reasons for higher rates of research misconduct among Croatian scientists in comparison with scientists in highly developed countries.

No difference in the intention to engage others in academic transgression among medical students from neighboring countries: a cross-national study on medical students from Bosnia and Herzegovina, Croatia, and Macedonia

Aim

To asses if the level of intention to engage others in academic transgressions was comparable among medical students from five schools from neighboring Southern-European countries: Croatia, Bosnia and Herzegovina, and Macedonia; and medical students from western EU studying at Split, Croatia.

Methods

Five medical schools were surveyed in 2011, with ≥87% of the targeted population sampled and a response rate of ≥76%. Students’ intention to engage a family member, friend, colleague, or a stranger in academic transgression was measured using a previously validated the Intention to Engage Others in Academic Transgression (IEOAT) questionnaire and compared with their intention to ask others for a non-academic, material favor. Data on students’ motivation measured by Work Preference Inventory scale, and general data were also collected. Multiple linear regression models of the intention to engage others in a particular behavior were developed.

Results

The most important determinants of the intention to engage others in academic transgression were psychological factors, such as intention to ask others for a material favor, or students’ motivation (median determinant’s β of 0.18, P ≤ 0.045 for all), whereas social and cultural factors associated with the country of origin were either weak (median β of 0.07, P ≤ 0.031) or not relevant. A significant proportion of students were aware of the ethical violations in academic transgressions (P ≤ 0.004 for all transgressions), but a large proportion of students also perceived academic cheating as a collective effort and were likely to engage people randomly (P ≤ 0.001 for all, but the most severe transgression). This collective effort was more pronounced for academic than non-academic behavior.

Conclusion

Culture differences among neighboring Southern-European countries were not an important determinant of the intention to engage others in academic cheating.

Academic dishonesty among health science school students

BACKGROUND

Academic dishonesty has become a serious problem at institutions of higher learning.

RESEARCH QUESTION

What is the frequency of academic dishonesty and what factors affect the tendency of dishonesty among Turkish health science school students?

RESEARCH DESIGN

This descriptive and cross-sectional study aims to evaluate academic dishonesty among university nursing, midwifery, and dietetic students. Participants and research context: The study sample consisted of 499 health science students in Turkey. The tendency toward academic dishonesty was investigated using the Academic Dishonesty Tendency Scale. Ethical considerations: Institutional review board approved the study. Written permission was obtained from the researcher to use Turkish version of the Academic Dishonesty Tendency Scale.

FINDINGS

Of all the students, 80.0% claimed to refer to Internet during homework preparation and 49.1% of students reported to cite the references at the end of article on some instances. Of the students, 56.1% claimed never to have cheated in the exams. It was found that academic dishonesty was partly low (1.80-2.59) in students. For students using a library while doing their homework, mean scores were significantly lower ( p < 0.05). There were also statistically significant difference between mean scores and student's year in school, student's perception of school success, and frequency of Internet use while doing homework ( p < 0.05).

DISCUSSION

The tendency of academic dishonesty was lower among students who use Internet and library more frequently. These findings are consistent with previous studies.

CONCLUSION

Measurements to take against academic dishonesty should be directed toward not only students but institutions and instructors as well.

Medical professionalism across cultures: a challenge for medicine and medical education

BACKGROUND

The recognition of medical professionalism as a complex social construct makes context, geographical location and culture important considerations in any discussion of professional behaviour. Medical students, medical educators and practitioners are now much more on the move globally, exposing them to cultural and social attitudes, values and beliefs that may differ from their own traditional perceptions of professionalism.

AIMS AND METHODS

This paper uses the model of the intercultural development continuum and the concept of "cultural fit" to discuss what might transpire when a student, teacher or doctor is faced with a new cultural environment. Using our own experiences as medical educators working abroad and supported by evidence in the literature, we have developed four anecdotal scenarios to highlight some of the challenges that different cultural contexts bring to our current (Western) understanding of professionalism.

RESULTS AND CONCLUSIONS

The scenarios highlight some of the potentially different regional and/or cultural perspectives and nuances of professional behaviours, attitudes or values that many of us either take for granted or find difficult, depending on our training and socio-cultural upbringing. With this paper, we hope to start a long overdue conversation about global professionalism amongst medical educators, identify potential areas for research and highlight a need for medical schools to embrace a "global" approach to how professionalism is embedded in their curricula.

Who would students ask for help in academic cheating? Cross-sectional study of medical students in Croatia

BACKGROUND

Academic cheating does not happen as an isolated action of an individual but is most often a collaborative practice. As there are few studies that looked at who are collaborators in cheating, we investigated medical students' readiness to engage others in academic dishonest behaviours.

METHODS

In a cross-sectional survey study in Zagreb, Croatia, 592 medical students from the first, 3rd and 6th (final) study year anonymously answered a survey of readiness to ask family, friends, colleagues or strangers for help in 4 different forms of academic cheating or for 2 personal material favours. Stepwise multiple linear regression models (MLR) were used to evaluate potential factors influencing propensity for engaging others in these two types of behaviour.

RESULTS

Many students would ask another person for help in academic cheating, from 88.8% to 26.9% depending on a cheating behaviour. Students would most often ask a family member or friend for help in academic cheating. The same "helpers" were identified for non-academic related behaviour - asking for personal material favours. More respondents, however, would include three or four persons for asking help in academic cheating than for routine material favours. Score on material favours survey was the strongest positive predictor of readiness for asking help in academic cheating (stepwise MLR model; beta = 0.308, P < 0.0001) followed by extrinsic motivation (compensation) and male gender, whereas intrinsic motivation, year of study and grade point average were weak negative predictors.

CONCLUSIONS

Our study indicates that medical students are willing to engage more than one person in either close or distant relationships in academic cheating. In order to develop effective preventive measures to deter cheating at medical academic institutions, factors surrounding students' preference towards academic cheating rather than routine favours should be further investigated.

Reasons for academic honesty and dishonesty with solutions: a study of pharmacy and medical students in New Zealand

This paper presents students' views about honest and dishonest actions within the pharmacy and medical learning environments. Students also offered their views on solutions to ameliorating dishonest action. Three research questions were posed in this paper: (1) what reasons would students articulate in reference to engaging in dishonest behaviours? (2) What reasons would students articulate in reference to maintaining high levels of integrity? (3) What strategies would students suggest to decrease engagement in dishonest behaviours and/or promote honest behaviours? The design of the study incorporated an initial descriptive analysis to interpret students' responses to an 18-item questionnaire about justifications for dishonest action. This was followed by a qualitative analysis of students' commentaries in reference to why students would engage in either honest or dishonest action. Finally a qualitative analysis was conducted on students' views regarding solutions to dishonest action. The quantitative results showed that students were more likely to use time management and seriousness justifications for dishonest actions. The qualitative findings found that students' actions (honest or dishonest) were guided by family and friends, the need to do well, issues of morality and institutional guidelines. Students suggested that dishonest action could be ameliorated by external agencies and polarised views between punitive and rewards-based mechanisms were offered. These results suggest that these students engaged in dishonest action for various reasons and solutions addressing dishonest action need to consider diverse mechanisms that likely extend beyond the educational institution.

Cheating on examinations and its predictors among undergraduate students at Hawassa University College of Medicine and Health Science, Hawassa, Ethiopia

BACKGROUND

Cheating on examinations in academic institutions is a worldwide issue. When cheating occurs in medical schools, it has serious consequences for human life, social values, and the economy. This study was conducted to determine the prevalence of cheating and identify factors that influence cheating among students of Hawassa University College of medicine and health science.

METHODS

A cross sectional study was conducted from May through June 2013. A pre-tested self-administered, structured questionnaire was used to collect self-reported data regarding cheating. Data were entered and analyzed using SPSS version 20. Descriptive statistics were used for data summarization and presentation. Degree of association was measured by Chi Square test, with significance level set at p = 0.05. Bivariate and multivariate logistic regression analyses were used to assess associations.

RESULTS

The prevalence of self-reported cheating was found to be 19.8% (95% CI = 17.4-21.9). About 12.1% (95% CI = 10.2-13.9) of students disclosed cheating on the entrance examination. The majority of students (80.1% (95% CI = 77.9-82.3) disclosed that they would not report cheating to invigilators even if they had witnessed cheating. Analysis by multiple regression models showed that students who cheated in high school were more likely to cheat (adjusted OR = 1. 80, 95% CI = 1. 01-3.19) and that cheating was less likely among students who didn't cheat on entrance examinations (adjusted OR = 0. 25, 95% CI = 0. 14-0.45). Dining outside the university cafeteria and receiving pocket money of Birr 300 or more were strongly associated with cheating (adjusted OR = 3.08, 95% CI = 1.54-6.16 and adjusted OR = 1.69 (95% CI = 1.05-2.72), respectively. The odds of cheating among students were significantly higher for those who went to private high school, were substance users, and didn't attend lectures than for those who attended government schools, were not substance abusers, and attended lectures.

CONCLUSION

Our findings have important implications for development of an institution's policies on academic integrity. By extension, they affect the policies of high schools. Increased levels of supervision during entrance examination, mandated attendance at lectures, and reduction of substance use are likely to reduce cheating. No significant association was found with background, level of parental education, grade point average, and interest in field of study.

Academic misconduct among students in medical colleges of Karachi, Pakistan

Objective: To determine the trends of academic misconduct in undergraduate students of different private and government section medical institutes.

Methodology: This cross sectional study was conducted at three medical colleges of Karachi, Pakistan. The students were evaluated by giving a self reported questionnaire containing various questions assessing their educational dishonesty and cheating behaviors.

Results: A total of 274 students from different years completed the questionnaire. Mean age was 21.48 ± 1.89 years. Most of the students were in 4^th year (n=86; 31.3%). There were 182 (66.5%) females and 92 (33.5%) males. Majority of the students (n=155; 55.1%) accepted that they have cheated at least once. There was no significant difference regarding acceptance of cheating among different years of study (p=0.23) however females were found to accept cheating more as compared to males (p=0.036). First year students were found more to ask teachers for answers during OSCE (p=0.01). A large number of students accepted that they mark proxy for their friends (85.7%) and also ask their friends to mark proxy for them (85.03%). Nearly half (44.02%) of the students rotating in wards also admitted to write fake histories.

Conclusion: A large number of medical students admitted cheating and involvement in other academic misconduct. We need to improve our educational system, formally add professional session and strict disciplinary action should be taken against those who are found guilty.

Development of an inventory assessing medical students' attitudes towards academic misconduct

PURPOSE

Identifying medical students' perceptions of and experiences with unprofessional behavior in school can help them develop and maintain higher standards of professional ethics. The aim of this study was to develop an instrument that assesses medical students' attitudes toward academic misconduct.

METHODS

A draft version of the questionnaire form was developed, based on an extensive literature review and iterative discussions. The validity of the content of this draft form was evaluated by medical students, physicians, and education specialists. A total of 803 medical students answered the questionnaire. Exploratory factor analysis was performed using principal axis factoring and Varimax rotation. A confirmatory factor analysis was also conducted by root mean square error of approximation (RMSEA) and comparative fit index (CFI). The internal consistency of the scales was calculated using the Cronbach alpha statistic.

RESULTS

The exploratory factor analysis generated 6 factors with 29 items: scientific misconduct (8 items); irresponsibility in the class (6 items); disrespectful behavior in patient care (5 items); dishonesty in clerkship tasks (4 items); free-riding on group assignments (4 items); and irresponsibility during clerkship (2 items). After adding a single item that addressed cheating on examinations, a 30-item inventory was developed. A confirmatory factor analysis demonstrated a favorable RMSEA (0.082) and reasonable fit (CFI, 0.844). The coefficient alpha for each factor varied between 0.80 and 0.90.

CONCLUSION

Our instrument is useful in identifying students' ethical standards with regard to academics and examining the prevalence of unprofessional behavior in medical students.

Pressures and interventions imposed on medical school teachers regarding students' examination grades

OBJECTIVES

This study was designed to investigate the pressures and interventions experienced by medical school teachers in relation to grades awarded in assessments of students' knowledge.

METHODS

Of 124 tenured teachers at the University of Split School of Medicine, 91 (73%) participated in the study through the anonymous completion of a questionnaire administered during the 2011-2012 academic year.

RESULTS

A total of 42 (46%) teachers reported having experienced some kind of pressure or intervention imposed by students, students' parents or colleagues that was intended to ensure the student obtained a pass or a better grade on an examination. The most common forms of pressure imposed by students were persistent pleading, 'friendly' requests and crying. Students' parents and staff colleagues mostly used 'friendly' requests or indicated that they would like to discuss a student's results. Colleagues who contacted teachers about students' examination results included doctors who did not work at the school and other teachers at the School of Medicine. As a method of preventing the imposition of such pressures and interventions in relation to examination results, teachers suggested that students should be warned against these practices before their courses started and that appropriate policies should be initiated. Some of the teachers rated some specific pressures or interventions as fully or partially acceptable; these included the making of 'friendly' requests, persistent pleading, crying and yelling. Most of the teachers stated that they would report some instances of such interventions to the school management, but 15 (17%) teachers stated that they would not report any type of pressure.

CONCLUSIONS

It is necessary to raise awareness of the unacceptability of such pressures and interventions in relation to examination results, and to change the current professional culture in which the imposition of such pressures by students, their parents and staff colleagues is considered acceptable and common.