Prevalence of Cheating and Its Trajectory

• In Event: Practical Issues in Testing and Assessment

Abstract

The purpose of this study was to review the prevalence of cheating among medical and pharmacy students as reported in the literature, and discuss effects of cheating behavior on students’ competencies in knowledge, patient care, and professionalism.

Rabi et al. (2006) surveyed third year pharmacy students from four institutions, finding that 36% agreed that cheating is very common in pharmacy school; 42% agreed that cheating is a part of life today. Baldwin et al. (1996), surveyed medical students from 40 schools, finding that 45% agreed that cheating is a normal outgrowth of the competitive nature of medical schools, and 59% agreed that cheating is impossible to eliminate. In a survey of first and fourth year medical students, Simpson et al. (1989) found that 14% of seniors and 4% of freshmen medical students agreed with a statement that ‘you have to cheat sometimes to get ahead’ (p. 222). Dyrbye et al. (2010) found that medical students who reported burnout cheated significantly more on examinations and in clinical settings than students who did not report burnout; students reported physical examination finding as normal when it was not actually performed (43%) and lab results and x-rays as pending when not sure if ordered or not (7%). This raises concerns about the possible negative impact of cheating behavior on patient care. Surveys of faculty have found they perceive cheating as more serious behavior than students (Austin et al. 2005). However, faculty often do not follow institutional procedures to handle cheating (McCabe et al., 2001).

Studies that addressed prevalence of cheating in medical and pharmacy schools for the period of last 30 years were searched on PubMed. Criteria for studies’ inclusion were students’ self-reports of cheating behavior on examinations and in clinical settings.

Self-reported cheating at least once in medical school among American students varied from 58% (Sierles et al., 1980), 4.7% Baldwin et al. (1996), to 1.5% Dyrbye et al. (2010). Cheating on examinations and dishonest clinical behavior in patient care from different studies were presented. Results of studies from other countries were included and discussed.

Self-reports might not accurately present prevalence of cheating in medical schools. Lack of questions’ consistency in surveys allowed only observation of results but not an accurate comparison of prevalence of cheating over time. Rapid use of technology that created new ways of cheating needs to be addressed in future research. Results about at least one cheating behavior varied depending on the list of cheating behaviors included in the study. Studies in pharmacy schools addressed students’ perceptions and attitudes toward cheating behavior but not actual prevalence of cheating.

The study presented reports of prevalence of cheating behavior in medical schools over time and emphasized potential effects of cheating on patient care and professional behavior in the real world practice.

Author

• Jasna Vuk, University of Arkansas for Medical Sciences