How and Why Do Examinees Cheat, and Can We Remediate Them?

• In Event: Practical Issues in Testing and Assessment

Abstract

The relationship between the medical profession and society, and between individual doctors and patients, is based on trust. Behaviour that compromises that relationship damages not only the standing of the medical profession but potentially harms individual patients. The General Medical Council (GMC) explicitly underlines the centrality of trust in its publication Good medical practice (GMP).In the area on ‘probity’ there is a subsection dealing with ‘Being honest and trustworthy’ which states:
56. Probity means being honest and trustworthy, and acting with integrity: this is at the heart of medical professionalism.
57. You must make sure that your conduct at all times justifies your patients’ trust in you and the public's trust in the profession.
Any attempt to
 cheat in examinations would breach clearly both of these exhortations. Cheating by college students is not uncommon in a study carried out in the US in the 1970s 93% of students questioned answered Yes when asked whether ‘cheating in exams was a way of life’. But if we think that in view of the moral obligations placed on medical students exemplified by publications like GMP we would be sadly mistaken. Studies in both the US and the UK have shown that significant proportions of medical students have either participated in cheating activities or would consider doing so.
Behavioural studies on cheating suggest students commonly engage in cheating for one or more of three reasons. Firstly, the student does not perceive the behaviour to be wrong – the ‘no- one was harmed’ defence. Secondly, cheating is common at this institution/in this area – the ‘everyone does it’ defence and lastly, the pressure to succeed – the ‘I’m not able to get the grade I need without cheating’ defence. It is possible, with the greater emphasis on assessment and its influence on the intense competition to get on to a training pathway, that current students feel under more pressure to succeed.
Although cheating is the behaviour that is detected, it is the underlying attitude leading to this behaviour that needs to be addressed. Changing attitudes is difficult and probably requires the individual to change their underlying belief with regard to cheating. How to remediate such an individual is a difficult question with no definite answer.
However, perhaps a way forward would be to directly address the commonly stated reasons for cheating which are:
• it does not impact on patient care
• 
everyone does it
• 
passing the assessment is not possible without it.
Addressing these issues directly in statements on cheating might go some way to dissuading would-be cheaters of any mitigation of their actions. After all, the prevention of cheating is a much better outcome than just being better at detecting its occurrence. Whatever future developments occur in the detection of cheating probably the most important message the medical profession needs to make loud and clear is one which says ‘that’s not the way we do things here!’.

Author

• Trudie Elizabeth Roberts, University of Leeds