Article
Academic dishonesty among health science school students
Nursing Ethics 2016, Vol. 23(8) 919–931 ª The Author(s) 2015 Reprints and permission: sagepub.co.uk/journalsPermissions.nav 10.1177/0969733015583929 journals.sagepub.com/home/nej
¨ ztu¨rk Can, Nazan Tuna Oran, Hafize O Selmin S¸ enol and Aytu¨l Pelik Hadımlı Ege University, Turkey
Abstract 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. Keywords Academic dishonesty, cheating, education, ethics, students
Introduction In recent years, academic dishonesty, including cheating or plagiarism, has misled academic evaluations and has been one of the most problematic challenges in academic life. It has been widely witnessed at all levels of education ranging from primary to undergraduate and postgraduate levels.1,2 Storch and Storch3
Corresponding author: Nazan Tuna Oran, Izmir Ataturk School of Health, Ege University, Bornova 35100, Izmir, Turkey. Email: [email protected]
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defined academic dishonesty as ‘‘the act of giving or receiving unauthorized assistance in an academic task, or receiving credit for plagiarized work.’’ There are many factors that have led to the growth of academic dishonesty.4,5 Technology such as wireless messaging devices, MP3 players, smart phones, and the Internet make cheating easier than ever. Students can utilize both high-technology and low-technology methods to cheat on exams. Hightechnology cheating methods include texting answers, purchasing copies of exams online, using handheld devices to access the Internet, and using small cameras or camera phones to take pictures of exam pages. Students who have tendencies toward academic dishonesty include those with ambition to get high marks, are under time pressure, have low self-control, lack confidence, lack academic or social motivation, or are likely to violate principles and rules. The environment created by the faculty may also contribute to the rise of academic dishonesty.6 For example, as health sciences are becoming increasingly complex and faculty expects students to master more content within a fixed program, academic dishonesty behavior may become more pronounced.6 Academic dishonesty is not a new phenomenon; however, today it is occurring at an increasing rate. Duke University’s Center for Academic Integrity7 conducted a study in 1999 on 50,000 college and 18,000 high school students and found that, amazingly, more than 70% of the students admitted to having cheated in their studies. In a similar study conducted in 1967, the rate of students who cheated was 33%; this statistic rose to 67.8% in 1999.8 In a web-based study conducted on college students living in 68 campuses in the United States and Canada, 21% of the participants admitted to cheating on exams at least once, and 51% stated that they had plagiarized at least once while doing their homework assignments.9 The Report Card on the Ethics of American Youth, a survey which included over 40,000 high school students across the United States, demonstrated the severity of the problem. Of the students, 80.6% ‘‘copied another person’s homework,’’ 59.4% ‘‘cheated during a test at school,’’ and 33.9% ‘‘copied an Internet document to do homework.’’10 In another report released by the same institution in 2012, the rates of academic dishonesty were just as alarming, with 75% admitting to copying another person’s homework, 52% cheating during a test at school, and 32% copying an Internet document to do homework.11 According to a large-scale German study, 75% of university students admitted that they had engaged in at least one of the seven types of academic misconduct (e.g. plagiarism, falsifying data) within the past 6 months.12 Nursing in Turkey has covered a significant distance since 1920, the formal start of nursing education. Nursing education, which used to continue at the secondary and high school levels, increased to bachelor’s level in 1955. Master’s program in nursing was opened in 1968, and PhD program was opened in 1972. Although 4-year university graduates account for most of the nursing resources today, nursing education on other levels (high school and bachelor’s program) is still being continued. Midwifery education in Turkey had similar history with nursing education initially. It gained 2-year university undergraduate level in 1980s and 4-year university graduate level in 1997. Master’s program in midwifery was opened in 2003, and PhD program was opened in 2013. Currently, midwifery students in Turkey study 4-year education program either at high school or university level (approximately half of students in each). The current nutrition-dietetics education in Turkey is based on the 4-year university education program. Although the number of studies performed on this subject in Turkey is limited, some researchers have pointed out that academic dishonesty exists and that the rates are similar to those in developed countries. _ ¨ nu¨ University Akdag˘ and Gu¨nes¸ 13 found that 68.6% of students attending the Faculty of Education at Ino had cheated. In a study performed on students in their final year of studies, it was determined that 71% had cheated on exams. Students were from a variety of backgrounds and included members from the departments of Turkish Language and Literature, Sociology, Mathematics, and Biology.14 Semerci15 performed a study with students attending the Faculty of Medicine at Fırat University and determined that 57.5% of the students rarely cheated and 20.5% occasionally cheated. Kec¸eci et al.16 reported that nursing students
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displayed a tendency toward moderate academic dishonesty. The data for our country indicate similar trends to those found in other countries. Based on the literature, the following appear to account for the act of cheating: rote learning-based education systems, attitudes displayed by teachers in the class, failure of students to form appropriate study habits, personality disorders, pressure from parents, acquisition of a cheating habit, crowded classes, fear of receiving poor grades, and receiving low scores.15,17,18 Educators are supposed to provide an academic environment that diminishes opportunities for dishonesty, supports the moral development of students, and resumes the high moral standards of the nursing profession.4,6,19 The International Center for Academic Integrity (ICAI)20 defines academic integrity as ‘‘a commitment, even in the face of adversity, to five fundamental values: honesty, trust, fairness, respect, and responsibility’’ and adds an additional element: the quality of courage. Health professions deal with human subjects and are based on ethical applications and values by nature. These professions require clear standards of governance, accountability, and professionalism, and as a result, ethics remain an essential component of health professions.5 There are various standards and ethical codes regarding health professions on an international scale.21–23 The Nursing and Midwifery Council’s code of professional conduct calls for nurses and midwives to be honest, act with integrity, and uphold the reputation of their profession.24 According to the first principle of the American Dietetic Association’s (ADA)23 code of ethics, any member of a dietetics profession should conduct himself or herself with honesty, integrity, and fairness. The Turkish Association of Midwifery has implicitly accepted the International Code of Ethics for Midwives.22 Similarly, the Turkish Nurses Association uses the Code of Ethics of Nurses from the International Council of Nurses as a base while determining ethical principles and responsibilities for nurses.25 The Turkish Dietetic Association has agreed to comply with the codes of ethics determined by the International Confederation of Dietetic Associations and the European Federation of Associations of Dietitians.26 Students wishing to go into these professions will first gain ethical values in the educational setting. For students to obtain ethical codes and standards during their education in Turkey, they are offered ethics in health sciences and deontology courses in their training programs.16 In this context, it is feasible to help students adopt their profession, cultivate ethical values, and acquire a professional identity in their academic life. The purpose of this study was to determine the tendencies toward academic dishonesty in students attending the pertinent faculties of health sciences. Although some studies in the literature focus on the academic dishonesty tendencies of nursing students, there are no studies that specifically address the tendencies of midwifery and dietetic students; thus, this research will contribute to future work in this area.
Methods Participants and sampling This was a cross-sectional and descriptive study aimed toward assessing academic dishonesty among students attending The Health Science School of Ege University in Turkey. The health science school has three departments: midwifery, nursing, and nutrition-dietetics. With the exception of first-year students, there were 666 students in the three departments. Of these, 92 students did not want to participate in the study and thus did not fill out the questionnaires. On the day the study data were collected, 54 students did not come to school and 11 students were on sick leave. Therefore, 509 students completed and submitted the questionnaires. Of those submitted, 10 were not evaluated because they were not completed appropriately. Therefore, 499 questionnaires were included in the assessment. The study participation rate was 74.9%.
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Limitations First-year students were excluded because they took their basic science courses in a separate building located quite far from the main school building, which posed a problem for contacting them. Because the study sample was composed of only females, gender was not included as an independent variable. Another limitation is that the Internet was the only electronic media taken into account because the school lacked technological innovations such as a simulation room, web-based and web-enhanced classes, personal digital assistants, computer-assisted instruction, video, and webcasting. Therefore, electronic resources other than the Internet were excluded from this study.
Instruments The study data were collected using two forms. The first one included items about the socio-demographic characteristics of the students. This form also included variables pertaining to the students’ perception of school success, doing homework, the frequency of library and Internet use, self-reports of cheating, and reports of cheating behaviors in the classroom. The second form was the Academic Dishonesty Tendency Scale (ADTS), which was developed by Eminog˘lu and Nartgu¨n.27 Responses to these items were evaluated on a 5-point Likert-type scale: 1 corresponded to strongly agree and 5 corresponded to strongly disagree. The total scores received from the scale were rated as follows: very low (1.00–1.79), partly low (1.80– 2.59), medium (2.60–3.39), high (3.40–4.19), and very high (4.20–5.00). The test consisted of 22 items, which were assigned to four subscales including ‘‘tendency toward cheating,’’ ‘‘tendency toward dishonesty in homework projects,’’ ‘‘tendency toward dishonesty in research reporting,’’ and ‘‘academic dishonesty tendencies in referencing.’’ The Cronbach’s alpha reliability coefficient of the original scale was 0.71; it was 0.84 in this study.
Data analysis The dependent variables were the mean total and subscale ADTS scores. The independent variables were the departments that the students attend at school, the student’s year in school, the student’s perception of her success in school, the number of assignments, and the frequency of library and Internet use to do homework. The socio-demographic data were analyzed using descriptive statistics including means, standard deviations, frequencies, and percentages. The variables with normal distribution were the departments that the students attend at school, the number of homework assignments, and Internet use, which were compared to the ADTS subscale scores using one-way analysis of variance (ANOVA). The variables without normal distribution included the student’s year in school, the student’s perception of her success in school, and using the library while doing homework, which were compared using the Kruskal–Wallis test. Post hoc analyses were conducted with the Scheffe test. The statistical significance level was set at a ¼ 0.05, and the reliability level was set at b ¼ 0.95. Data were collected and responses entered into SPSS, Version 16.0.
Ethical considerations The study was approved by the Institutional Ethics Committee of Ege University. In addition, written permission was obtained from Eminog˘lu and Nartgu¨n to use the ADTS. The questionnaires were given to the students in a sealed envelope after they were informed about the study. They were asked to put the questionnaires in a box after responding to the items. Because participation was voluntary, some students who did not want to participate did not accept the envelopes. Particular attention has been paid to the fact that students participate in the study voluntarily and the participants have
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Table 1. Students’ perception of school success and variables related to homework preparation. N ¼ 499 Characteristics Student’s perception of school success Successful Partly successful Not successful Membership to a homework website Yes No Frequency of library use while doing homework Often Sometimes Rarely Never Frequency of Internet use while doing homeworka Often Sometimes Rarely Citing the sources consulted while doing homework in the assignmentsb Often Sometimes Never
N (%) 132 (26.5) 298 (59.7) 69 (13.8) 84 (16.8) 415 (83.2) 40 (8.0) 188 (37.7) 175 (35.1) 96 (19.2) 399 (80.0) 87 (17.4) 13 (2.6) 217 (43.5) 245 (49.1) 37 (7.4)
a
None of the students chose the option ‘‘Never.’’ None of the students chose the option ‘‘Rarely.’’
b
encouraged answering questions honestly. The researchers guaranteed students that their identities and answers would be kept confidential.
Results The mean age of the students who participated in the study was 21.33 + 1.64 (minimum ¼ 18, maximum ¼ 32) years. Of them, 51.9% (n ¼ 259) were in the midwifery department, 28.1% (n ¼ 140) were in the nursing department, and 20% (n ¼ 100) were in the nutrition-dietetics department; 30% (n ¼ 150) were secondyear, 42.5% (n ¼ 212) were third-year, and 27.5% (n ¼ 137) were fourth-year students. When the students were asked how they perceived their success at school, 59.7% of them considered themselves moderately successful. Of the students, 16.8% were members of a homework site, 37.7% sometimes used the library, 80.0% used the Internet while doing homework, and 49.1% sometimes cited the sources they consulted to do their homework assignments (Table 1). Table 2 presents the students’ opinions about cheating. According to their statements, 56.1% of the students had never cheated. More than half of the students (57.5%) indicated that some students were cheating when they were asked about cheating behaviors in the classroom. Nearly half of the students (48.1%) said the cheating method used most in the classroom was looking at another student’s paper/answer. Figure 1 illustrates the percentages of academic dishonesty tendencies. As can be seen from the grouping based on the scale scores, 33.7% of the students had partly low academic dishonesty tendencies (Figure 1). The mean total score for the ADTS was 2.44 + 0.57 (minimum ¼ 1.00, maximum ¼ 4.86).
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Table 2. Students’ views on cheating. N ¼ 499 Views on cheating
N (%)
Self-report of cheating I never cheat I sometimes cheat I always cheat Reports about the cheating behaviors in the classroom Nobody cheats Some of the students cheat Half of the students cheat Most of the students cheat Almost all of the students cheat Cheating methods Looking at a friend’s paper Talking to another student sitting next to her Preparing cheat sheets Writing notes on the wall/desk in advance Other
100 90 80 70 60 50 40 30 20 10 0
Very low 22.6
Partly low 33.7
280 (56.1) 208 (41.7) 11 (2.2) 36 (7.2) 287 (57.5) 57 (11.4) 85 (17.0) 34 (6.9) 240 (48.1) 128 (25.7) 37 (7.4) 79 (15.8) 15 (3.0)
Medium 24
High 13.2
Very high 6.4
Figure 1. Students’ academic dishonesty tendencies.
Table 3 compares the students’ ADTS scores and mean subscale scores according to some variables. The scores obtained from the ADTS and its four subscales were used to perform statistical analysis on variables such as student’s year in school, student’s perception of her success in school, number of assignments, frequency of library use, and Internet use to do homework assignments. When the students’ mean subscale scores were compared in terms of the departments they attended (midwifery, nursing, nutrition-dietetics), a statistically significant difference was seen in the tendency toward cheating subscale (p < 0.05) (Table 3). This difference was due to the difference in scores between the students from the midwifery and nutrition-dietetics departments. The mean scores were highest for students in the nutrition-dietetics department (Table 3). When the students were compared respective to their year at school, a statistically significant difference was found between the mean scores obtained from the ADTS and its subscales (p < 0.05). According to the results of the Scheffe test, the difference observed between the mean scores of the basic scale and those of
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Table 3. Comparison of the students’ ‘‘Academic Dishonesty Tendency Scale’’ scores in terms of some variables. Subscales of ADTS
Independent variables Department
Midwifery Nursing Dietetic
Student’s year in school
2nd year 3rd year 4th year
Student’s Successful perception of Moderately school successful successa Not successful
Tendency toward cheating
M + SD
M + SD
M + SD
M + SD
M + SD
259 2.4 + 0.6 140 2.5 + 0.5 100 2.4 + 0.5 p 0.112 150 2.31 + 0.6 212 2.5 + 0.6 137 2.4 + 0.5 p 0.000 132 2.3 + 0.5 298 2.4 + 0.5
2.5 + 0.8 2.7 + 0.9 2.8 + 0.9 0.005 2.5 + 0.9 2.6 + 0.9 2.7 + 0.8 0.014 2.4 + 0.9 2.7 + 0.9
2.3 + 0.7 2.4 + 0.7 2.3 + 0.6 0.196 2.2 + 0.7 2.4 + 0.7 2.3 + 0.9 0.012 2.2 + 0.6 2.4 + 0.7
2.3 + 0.8 2.5 + 0.8 2.3 + 0.7 0.096 2.2 + 0.8 2.5 + 0.7 2.3 + 0.8 0.003 2.2 + 0.7 2.4 + 0.7
2.4 + 0.6 2.5 + 0.6 2.3 + 0.7 0.057 2.2 + 0.7 2.5 + 0.6 2.4 + 0.6 0.000 2.3 + 0.7 2.4 + 0.6
2.7 + 0.5
2.9 + 0.0
2.6 + 0.7
2.6 + 0.8
2.7 + 0.7
N
69 p
Frequency of Internet use while doing homeworkb
1–2 172 3–4 178 5–6 93 7 and higher 56 p Often 399 Sometimes 87 Rarely 13 p
Frequency of library use while doing homework
Often Sometimes Rarely Never
The number of homework assignments
Total
Tendency toward Tendency toward Academic dishonesty dishonesty in dishonesty in tendencies in research homework referencing reporting project
Academic Dishonesty Tendency Scale
0.001
0.001
0.035
0.002
0.036
2.4 + 0.5 2.5 + 0.6 2.3 + 0.5 2.3 + 0.5 0.074 2.4 + 0.5 2.5 + 0.5 2.8 + 0.6 0.029
2.6 + 0.9 2.7 + 0.9 2.5 + 0.8 2.4 + 0.8 0.241 2.6 + 0.8 2.6 + 0.9 3.1 + 1.2 0.099
2.4 + 0.6 2.3 + 0.7 2.3 + 0.6 2.2 + 0.6 0.257 2.3 + 0.7 2.4 + 0.6 2.8 + 0.6 0.041
2.3 + 0.7 2.4 + 0.8 2.2 + 0.7 2.2 + 0.7 0.197 2.3 + 0.7 2.4 + 0.8 2.6 + 0.8 0.376
2.4 + 0.6 2.4 + 0.6 2.3 + 0.5 2.2 + 0.6 0.129 2.4 + 0.6 2.5 + 0.6 2.7 + 0.7 0.186
2.1 + 0.5 2.3 + 0.6 2.3 + 0.6 2.5 + 0.8 0.069 2.36 + 0.69
2.1 + 0.7 2.2 + 0.7 2.3 + 0.7 2.6 + 0.9 0.001 2.37 + 0.79
2.3 + 0.7 2.3 + 0.6 2.4 + 0.6 2.5 + 0.6 0.085 2.43 + 0.65
40 2.2 + 0.5 2.4 + 0.9 188 2.3 + 0.5 2.5 + 0.8 175 2.4 + 0.5 2.6 + 0.9 96 2.6 + 0.6 2.8 + 0.9 p 0.002 0.032 499 2.44 + 0.57 2.63 + 0.90
SD: standard deviation; M: Mean. Bold values represent statistically significant p values (p < 0.05). a It refers to the student’s statement how she perceives her ‘‘school success.’’ b None of the students marked the option ‘‘Never.’’
‘‘tendency toward dishonesty in homework projects,’’ ‘‘tendency toward dishonesty in research reporting,’’ and ‘‘academic dishonesty tendencies in referencing’’ subscales stemmed from differences between the second-year and third-year students’ scores. The highest score was achieved by third-year students. In comparing the mean scores for tendency toward cheating between second-year and fourth-year students, fourthyear students had higher scores (Table 3). A statistically significant difference was observed between the students’ mean scores obtained from the ADTS and its subscales for students’ perceptions of success in school (p < 0.05). Students who
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considered themselves not successful obtained the highest mean scores from both the ADTS and its subscales (Table 3). While the difference for the number of homework assignments was not statistically significant (p > 0.05), it was statistically significant for the frequency of library use while doing homework assignments (p < 0.05). The mean scores of students using the library frequently were lower. Further analysis revealed that the difference resulted from the options ‘‘often,’’ ‘‘never,’’ and ‘‘sometimes’’ (Table 3). When the students’ mean scores obtained from the ADTS and its subscales for frequency of Internet use while doing homework were compared, a statistically significant difference was found for the ‘‘tendency toward dishonesty in homework projects’’ subscale (p < 0.05); the difference was found between the options ‘‘often’’ and ‘‘occasionally’’ (Table 3).
Discussion Recent studies on academic dishonesty have one common finding: a tendency toward academic dishonesty that is rapidly increasing, albeit for different reasons.28,29 A review of the pertinent literature revealed that independent variables such as age, gender, departments students attend at school, student’s year in school, type of cheating, high technology device use, number of homework assignments, and attitude displayed by the instructors or the family have an impact on academic dishonesty tendency.15,16,30,31 In the first study of this kind conducted at our institution, the mean ADTS score was found to be slightly low (Figure 1). Another point discussed in this study was the relationship between mean ADTS scores and its subscales and the following variables: department that students attend at school, student’s year in school, student’s perception of success in school, number of assignments, and frequency of the library and Internet use. Is a students’ perception of her success in school one of the factors prompting them to have a tendency toward academic dishonesty? Do students who consider their success insufficient display a greater tendency toward academic dishonesty? With reference to the aforementioned questions, students were asked how they perceived their success in school. Only 26.5% of participants considered themselves successful (Table 1). The comparison of the mean scores obtained from the ADTS and its subscales for the variable ‘‘perceptions of school success’’ revealed that the differences among those who considered themselves successful, moderately successful, and not successful enough were statistically significant (p < 0.05, Table 3). The mean ADTS score of the students who defined themselves as not successful enough was higher than that of the other groups. McCabe and Trevino32 and Jensen et al.33 have underlined that when the students’ grade point average (GPA) is low, academic dishonesty tendency gets higher. Also, Odabas¸ ı et al.34 stated that the students’ low school success is one of the personal factors that increase the tendency for academic dishonesty. According to the statements of the students regarding cheating, 43.9% have cheated on exams (Table 2). The results reported in this study were not very different from results found in the literature. Arhin and Jones5 indicated that the majority of nursing students did not consider academic dishonesty something immoral or unusual. Woith et al.6 stressed that there was a shift in nursing students’ perception of academic integrity and that students have started to consider academic dishonesty as normal. The results of a study conducted on students attending faculties of medicine and pharmacy in New Zealand were similar to those of the above-mentioned studies.35 According to the students’ statements in our study, the cheating rate was found to be 92.8%. Of the students surveyed, 57.5% said that some students cheated, 11.4% said half of the students cheated, 17.0% said most of the students cheated, and 6.9% said almost all of the students cheated. The percentage of students who said that no one cheated was 7.2% (Table 2). Kukolja Taradi et al.36 have found that, among third- and fifth-year medical school students, 97% of them cheated. The authors defined this as
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a strong indication of peer support for academic dishonesty. Underwood and Szabo37 stated that peer support against cheating behavior should be considered one of the major strategies to prevent cheating. The cheating methods used in this study included traditional methods such as looking at someone else’s paper, talking to another student sitting next to them, preparing cheat sheets, and writing notes on the wall/desk in advance. Today, there are many studies indicating that technological methods of cheating are widely used.15,36 Whitley and Starr38 reported that pharmacy students had poor perceptions of academic dishonesty, and students regarded cheating with technological tools as an indispensable part of life. However, in this study, the utilization of technological tools in academic dishonesty was not investigated. As stated in the ‘‘Limitations’’ section of the study, the school’s infrastructure lacks these technological facilities. Furthermore, cell phones and electronic devices were not allowed in the examination hall. In terms of their tendency toward academic dishonesty, a comparison among students in the midwifery, nursing, and nutrition-dietetics departments found that the ADTS scores from students of the nutritiondietetics department were significantly higher in the ‘‘tendency toward cheating’’ subscale compared to other departments (p < 0.05, Table 3), although the difference was not statistically significant. Similarly, nursing students obtained higher mean scores from the three subscales (‘‘tendency toward dishonesty in homework projects,’’ ‘‘tendency toward dishonesty in research reporting,’’ ‘‘academic dishonesty tendencies in referencing’’); however, these differences were also not statistically significant (p > 0.05, Table 3). This result was likely related to the curriculum of the nursing department. Nursing deals with healthy and unhealthy individuals of all ages and includes theoretical and clinical applications in internal medicine and surgery. The higher tendency of nursing students toward cheating might result from the fact that they had a more intensive curriculum and a wider area of clinical practices compared to students in the other departments. Some studies drew attention to this issue in nursing education and reported that students must prepare for more than one exam and do more homework. This may predispose them toward academic dishonesty and force them to display dishonest behaviors.6,39 Our literature review revealed a gap in work related to midwifery and nutrition-dietetics students’ tendency toward academic dishonesty. We found statistically significant differences between students’ mean ADTS scores and its subscales when the students were compared in relation to their years at school (p < 0.05). This difference stemmed from the scores of the second-year and third-year students. The scores of third-year students were the highest, which can be attributed to the fact that the number of theoretical courses was highest in the curriculum of third-year students in all departments. Kec¸eci et al.16 found that the mean scores for the ‘‘tendency toward dishonesty in homework projects’’ and ‘‘tendency toward dishonesty in research reporting’’ subscales were high among the third-year students. As the amount of homework, projects, and relevant assignments increases, students exhibit a greater inclination toward academic dishonesty and cheating in particular.39,40 The students in our study were assigned homework for only some of their courses. The students were given assignments such as writing case scenarios, designing a plan of care most beneficial to patients, preparing and presenting seminars, and preparing leaflets and posters on health education. While some of these assignments were completed individually, some of them were completed in groups. No statistically significant differences were found when comparing academic dishonesty and the mean scores for the ADTS and its four subscales when the effects of the annual number of projects given to the students were taken into account (p > 0.05, Table 3). However, it was found that those who were given more than five annual homework assignments obtained low mean scores for the ‘‘tendency toward dishonesty in homework projects,’’ ‘‘tendency toward dishonesty in research reporting,’’ and ‘‘academic dishonesty tendencies in referencing’’ subscales. This suggests that students may have increasingly done homework ethically as the number of annual homework assignments increased. Considering the contributions of homework to students, it may be ideal to conduct future studies with more focus on this issue.
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The relationship between the frequency of Internet use while doing homework assignments and the mean scores obtained from the ADTS and its ‘‘tendency toward dishonesty in homework projects’’ subscale was found to be statistically significant (p < 0.05; Table 3). This difference was between groups that used the Internet ‘‘often’’ and ‘‘rarely.’’ In the group that often used the Internet, the mean scores for the ‘‘tendency toward dishonesty in research reporting’’ and ‘‘academic dishonesty tendencies in referencing’’ subscales were found to be lower than those of the other groups. Perhaps if ‘‘guidelines on the accurate and efficient use of the Internet’’ were prepared and submitted to both students and educators by the educational institutions, or if the first-year curriculum included a course on how to properly and effectively use the Internet under ethical principles, the students’ awareness of academic dishonesty would be higher. The Internet not only makes it possible to acquire a huge amount of information quickly but also leads to information pollution. One needs to be careful about using the Internet to access correct information and to eliminate unreliable information. Otherwise, one might consider incorrect and unsafe information to be correct and safe. If one uses all of the obtained information without questioning it, one may become a victim of ignorance. This prediction has been emphasized in some studies.41,42 Students who use the Internet frequently during their education gain experience in obtaining accurate and reliable information over the years. Uc¸ak et al.42 indicated that the more frequently one uses the Internet, the more accurately and effectively he or she makes use of it, and as a result, he or she will develop behaviors that comply with ethical principles. On the other hand, those who rarely use the Internet will not be able to develop efficient and accurate use skills, which might cause them to display tendencies of academic dishonesty. In our study, students who rarely used the Internet while doing homework achieved high ADTS scores, which suggests that they fell into this trap. Analysis of the frequency of students’ library use while doing homework indicated that the ADTS scores of those who never used the library were higher than those of other groups, and the difference was statistically significant (p < 0.05, Table 3). This result indicates that the students who frequently used the library did not display academic dishonesty-related behaviors. Instead, they tended to use information with ethical principles. Burke43 indicated the importance of library use in the prevention of students’ tendency toward academic dishonesty and stated that libraries and librarians should undertake a new mission to combat academic dishonesty. Caravello44 reported that library use raised awareness of academic dishonesty among students. Sciammarella45 pointed out that library use enabled students to appropriately use the resources in their academic studies and discouraged them from partaking in academic dishonesty.
Conclusion and recommendations Unfortunately, students’ tendencies toward academic dishonesty have been steadily increasing in recent years.28,29 It is well known that health science students have an especially difficult educational process. In this study, participating students were observed committing academic dishonesty during this process. The fact that students tend to commit academic dishonesty raises concerns that this behavior might persist. To prevent students from committing academic dishonesty, the following is recommended: (1) Create programs that are aimed toward strengthening ethical values such as honesty in students; (2) Educational institutions should take comprehensive measures against academic fraud, declare their academic integrity policies, clearly define acceptable and unacceptable behaviors, and inform students about all measures in writing; (3) Educators should clearly tell students to not only use the Internet but also use the library while completing assignments and projects; (4) Universities should install computer software programs to confirm that homework assignments and projects are completed in compliance with the ethics of science, and educators should accept homework assignments and projects through these software programs; and finally, and (5) Educational institutions should implement
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policies that encourage academic integrity, and impose effective sanctions in case academic dishonesty is detected. Acknowledgements We would like to extend our sincere thanks to the Department of Biostatistics and Medical Informatics, Ege University, for their invaluable contribution to the analysis of the data. We also thank the students who participated in the study for their sincere responses. The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, please see: http://www.textch eck.com/certificate/iT5W26 Conflict of interest The authors declare no conflicts of interest. Funding This research received no specific grant from any funding agency in the public, commercial, or not-forprofit sectors. References 1. Guthrie CL. Plagiarism and cheating: a mixed methods study of student academic dishonesty. Unpublished Master of Social Sciences, The University of Waikato, 2009, http://hdl.handle.net/10289/4282 (accessed 11 June 2013). 2. Jurdi R, Hage HS and Chow HPH. Academic dishonesty in the Canadian classroom: behaviours of a sample of university students. Can J High Educ 2011; 41(3): 1–35. 3. Storch EA and Storch JB. Fraternities, sororities and academic dishonesty. Coll Student J 2002; 36(2): 247–251. 4. Kolanko KM, Clark C, Heinrich KT, et al. Academic dishonesty, bullying, incivility, and violence: difficult challenges facing nurse educators. Nurs Educ Perspect 2006; 27(1): 34–43. 5. Arhin AO and Jones KA. A multidiscipline exploration of college students’ perceptions of academic dishonesty: are nursing students different from other college students? Nurse Educ Today 2009; 29(7): 710–714. 6. Woith W, Jenkins SD and Kerber C. Perceptions of academic integrity among nursing students. Nurs Forum 2012; 47(4): 253–259. 7. The Center of Academic Integrity. The fundamental values of academic integrity, http://www.academicintegrity. org/icai/assets/FVProject.pdf (1999, accessed 20 June 2013). 8. Altschuler GC. Battling the cheats. The New York Times (Education Life Supplement), 2001, http://www.nytimes. com/2001/01/07/education/college-prep-battling-the-cheats.html?pagewanted¼all&src¼pm (accessed 26 May 2013). 9. McCabe D. It takes a village: academic dishonesty and educational opportunity. Liberal Educ 2005; 91(3): 26–31. 10. Josephson Institute of Ethics. Josephson Institute’s 2010 Report Card on the Ethics of American Youth, http://charactercounts.org/pdf/reportcard/2010/ReportCard2010_data-tables.pdf (2011, accessed 27 May 2013). 11. Josephson Institute of Ethics. 2012 Report Card on the Ethics of American Youth, http://charactercounts.org/pdf/ reportcard/2012/ReportCard-2012-DataTables.pdf (2012, accessed 21 May 2014). 12. Patrzek J, Sattler S, van Veen F, et al. Investigating the effect of academic procrastination on the frequency and variety of academic misconduct: a panel study. Stud High Educ 2014, http://dx.doi.org/10.1080/03075079.2013. 854765 13. Akdag˘ M and Gu¨nes¸ H. Kopya c¸ekme davranıs¸ ları ve kopya c¸ekmeye ilis¸ kin tutumlar [Cheating behaviors and attitudes toward cheating]. Kuram ve Uygul Eg˘it Yo¨net 2002; 8: 330–343 (in Turkish). 14. Mert EL. Temel is¸ levi bilim insanı yetis¸ tirmek olan bazı bo¨lu¨mlerde kopya [Cheating at some department whose basic function is to train academician]. Turk Stud: Int Period Lang Lit Hist Turk Turk 2012; 7(3): 1813–1829 (in Turkish).
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15. Semerci C ¸ . Tıp faku¨ltesi o¨g˘rencilerinin kopya c¸ekmeye ilis¸ kin tutum ve go¨ru¨s¸ leri [Attitudes and ideas towards cheating of medicine faculty students]. Firat Univ Med J Health Sci 2004; 18(3): 139–146 (in Turkish). 16. Kec¸eci A, Bulduk S, Oruc¸ D, et al. Academic dishonesty among nursing students: a descriptive study. Nurs Ethics 2011; 18(5): 725–733. 17. Brent E and Atkisson C. Accounting for cheating: an evolving theory and emergent themes. Res High Educ 2011; 52(6): 640–658. 18. Schiphorst ATK. Students’ justifications for academic cheating and empirical explanations of such behavior. Soc Cosm 2013; 4(1): 57–63. 19. McCabe DL, Trevino LK and Butterfield KD. Cheating in academic institutions: a decade of research. Ethics Behav 2001; 11(3): 219–232. 20. International Center for Academic Integrity (ICAI). Fundamentals values project, http://www.academicintegrity. org/icai/assets/FV2013.pdf (2013, accessed 9 July 2013). 21. American Nursing Association (ANA). Code of ethics for nurses, http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html (2015, accessed 20 April 2015). 22. International Confederation of Midwives (ICM). International code of ethics for midwives, http://www.internationalmidwives.org/assets/uploads/documents/CoreDocuments/CD2008_001%20ENG%20Code%20of%20Ethics% 20for%20Midwives.pdf (2008, accessed 9 July 2013). 23. American Dietetic Association (ADA). American Dietetic Association/Commission on Dietetic Registration code of ethics for the profession of dietetics and process for consideration of ethics issues. J Am Diet Assoc 2009; 109(8): 1461–1467. 24. Nursing and Midwifery Council (NMC). The code: professional standards of practice and behaviour for nurses and midwives, http://www.nmc-uk.org/Documents/NMC-Publications/revised-new-NMC-Code.pdf (2015, accessed 9 March 2015). 25. Turkish Nurses Association (TNA). Hems¸ ireler ic¸in etik ilke ve sorumluluklar [Ethics principles and responsibilities for nurses], http://www.turkhemsirelerdernegi.org.tr/Upload/hemsire%20brosur.pdf (2009, accessed 30 April 2014) (in Turkish). 26. European Federation of the Associations of Dietitians (EFAD). European Dietetic Competences and their Performance Indicators attained at the point of qualification and entry to the profession of Dietetics, http://www.efad.org/ downloadattachment/1653/European%20Dietetic%20Competences%20and%20Performance%20Indicators%20%20English.pdf (2009, accessed 30 April 2014). ¨ niversite o¨g˘rencilerinin akademik sahtekarlık eg˘ilimlerinin o¨lc¸u¨lmesine yo¨nelik 27. Eminog˘lu E and Nartgu¨n ZA. U bir o¨lc¸ek gelis¸ tirme c¸alıs¸ ması [Study of a scale related to academic dishonesty tendencies of university students]. Int J Hum Sci 2009; 6(1): 215–240. 28. Spear JA and Miller AN. The effects of instructor fear appeals and moral appeals on cheating-related attitudes and behavior of university students. Ethics Behav 2012; 22(3): 196–207. 29. Williams MWM and Williams MN. Academic dishonesty, self-control, and general criminality: a prospective and retrospective study of academic dishonesty in a New Zealand University. Ethics Behav 2012; 22(2): 89–112. 30. Rabi SM, Patton LR, Fjortoft N, et al. Characteristics, prevalence, attitudes, and perceptions of academic dishonesty among pharmacy students. Am J Pharm Educ 2006; 70(4): 73. 31. Babu TA, Joseph NM and Sharmila V. Academic dishonesty among undergraduates from private medical schools in India. Are we on the right track? Med Teach 2011; 33(9): 759–761. 32. McCabe DL and Trevino LK. Individual and contextual influences on academic dishonesty: a multi-campus investigation. Res High Educ 1997; 38(3): 379–396. 33. Jensen LA, Arnett JJ, Feldman SS, et al. It’s wrong, but everybody does it: academic dishonesty among high school and college students. Contemp Educ Psychol 2002; 27(2): 209–228. 34. Odabas¸ ı HF, Birinci G, Kılıc¸er K, et al. Bilgi iletis¸ im teknolojileri ve internetle kolaylas¸ an akademik usulsu¨zlu¨k [Academic dishonesty: getting easier with Internet and ICT]. J Soc Sci 2007; 7(1): 503–518 (in Turkish).
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35. Henning MA, Ram S, Malpas P, et al. Academic dishonesty and ethical reasoning: pharmacy and medical school students in New Zealand. Med Teach 2013; 35(6): 1211–1217. 36. Kukolja Taradi S, Taradi M and Dogas Z. Croatian medical students see academic dishonesty as an acceptable behaviour: a cross-sectional multicampus study. J Med Ethics 2012; 38(6): 376–379. 37. Underwood J and Szabo A. Academic offences and e-learning: individual propensities in cheating. Br J Educ Tech 2003; 34(4): 467–477. 38. Whitley HP and Starr J. Academic dishonesty among pharmacy students: does portable technology play a role? Curr Pharm Teach Learn 2010; 2(2): 94–99. 39. Balik C, Sharon D, Kelishek S, et al. Attitudes towards academic cheating during nursing studies. Med Law 2010; 29(4): 547–563. 40. Harper MG. High tech cheating. Nurse Educ Today 2006; 26(8): 672–679. ¨ zden M. O ¨ g˘retmen adaylarının o¨devlerinde internetten intihal yapmalarında o¨g˘retim elemanının 41. Ersoy M and O rolu¨ne ilis¸ kin go¨ru¨s¸ leri [The views of teacher candidates regarding the role of instructor in plagiarizing from Internet in their assignments]. Elem Educ Online 2011; 10(2): 608–619. ¨ , Kurbanog˘lu S, S¸encan I, et al. Hacettepe U ¨ niversitesi Bilgi ve Belge Yo¨netimi Bo¨lu¨mu¨ o¨g˘rencileri u¨zer42. Uc¸ak NO ine bir aras¸ tırma [A survey on students of Department of Information Management at Hacettepe University]. Turk Librariansh 2012; 26(2): 329–348 (in Turkish). 43. Burke M. Deterring plagiarism: a new role for librarians. Libr Philos Pract 2005, http://digitalcommons.unl.edu/ libphilprac (accessed 27 May 2014). 44. Caravello PS. The literature on academic integrity and graduate students: issues, solutions, and the case for a librarian role. Publ Serv Q 2008; 3(3–4): 141–171. 45. Sciammarella S. Making a difference: library and teaching faculty working together to develop strategies in dealing with student plagiarism. Commun Jr Coll Libr 2009; 15(1): 23–34.
Academic dishonesty among health science school students
Nursing Ethics 2016, Vol. 23(8) 919–931 ª The Author(s) 2015 Reprints and permission: sagepub.co.uk/journalsPermissions.nav 10.1177/0969733015583929 journals.sagepub.com/home/nej
¨ ztu¨rk Can, Nazan Tuna Oran, Hafize O Selmin S¸ enol and Aytu¨l Pelik Hadımlı Ege University, Turkey
Abstract 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. Keywords Academic dishonesty, cheating, education, ethics, students
Introduction In recent years, academic dishonesty, including cheating or plagiarism, has misled academic evaluations and has been one of the most problematic challenges in academic life. It has been widely witnessed at all levels of education ranging from primary to undergraduate and postgraduate levels.1,2 Storch and Storch3
Corresponding author: Nazan Tuna Oran, Izmir Ataturk School of Health, Ege University, Bornova 35100, Izmir, Turkey. Email: [email protected]
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defined academic dishonesty as ‘‘the act of giving or receiving unauthorized assistance in an academic task, or receiving credit for plagiarized work.’’ There are many factors that have led to the growth of academic dishonesty.4,5 Technology such as wireless messaging devices, MP3 players, smart phones, and the Internet make cheating easier than ever. Students can utilize both high-technology and low-technology methods to cheat on exams. Hightechnology cheating methods include texting answers, purchasing copies of exams online, using handheld devices to access the Internet, and using small cameras or camera phones to take pictures of exam pages. Students who have tendencies toward academic dishonesty include those with ambition to get high marks, are under time pressure, have low self-control, lack confidence, lack academic or social motivation, or are likely to violate principles and rules. The environment created by the faculty may also contribute to the rise of academic dishonesty.6 For example, as health sciences are becoming increasingly complex and faculty expects students to master more content within a fixed program, academic dishonesty behavior may become more pronounced.6 Academic dishonesty is not a new phenomenon; however, today it is occurring at an increasing rate. Duke University’s Center for Academic Integrity7 conducted a study in 1999 on 50,000 college and 18,000 high school students and found that, amazingly, more than 70% of the students admitted to having cheated in their studies. In a similar study conducted in 1967, the rate of students who cheated was 33%; this statistic rose to 67.8% in 1999.8 In a web-based study conducted on college students living in 68 campuses in the United States and Canada, 21% of the participants admitted to cheating on exams at least once, and 51% stated that they had plagiarized at least once while doing their homework assignments.9 The Report Card on the Ethics of American Youth, a survey which included over 40,000 high school students across the United States, demonstrated the severity of the problem. Of the students, 80.6% ‘‘copied another person’s homework,’’ 59.4% ‘‘cheated during a test at school,’’ and 33.9% ‘‘copied an Internet document to do homework.’’10 In another report released by the same institution in 2012, the rates of academic dishonesty were just as alarming, with 75% admitting to copying another person’s homework, 52% cheating during a test at school, and 32% copying an Internet document to do homework.11 According to a large-scale German study, 75% of university students admitted that they had engaged in at least one of the seven types of academic misconduct (e.g. plagiarism, falsifying data) within the past 6 months.12 Nursing in Turkey has covered a significant distance since 1920, the formal start of nursing education. Nursing education, which used to continue at the secondary and high school levels, increased to bachelor’s level in 1955. Master’s program in nursing was opened in 1968, and PhD program was opened in 1972. Although 4-year university graduates account for most of the nursing resources today, nursing education on other levels (high school and bachelor’s program) is still being continued. Midwifery education in Turkey had similar history with nursing education initially. It gained 2-year university undergraduate level in 1980s and 4-year university graduate level in 1997. Master’s program in midwifery was opened in 2003, and PhD program was opened in 2013. Currently, midwifery students in Turkey study 4-year education program either at high school or university level (approximately half of students in each). The current nutrition-dietetics education in Turkey is based on the 4-year university education program. Although the number of studies performed on this subject in Turkey is limited, some researchers have pointed out that academic dishonesty exists and that the rates are similar to those in developed countries. _ ¨ nu¨ University Akdag˘ and Gu¨nes¸ 13 found that 68.6% of students attending the Faculty of Education at Ino had cheated. In a study performed on students in their final year of studies, it was determined that 71% had cheated on exams. Students were from a variety of backgrounds and included members from the departments of Turkish Language and Literature, Sociology, Mathematics, and Biology.14 Semerci15 performed a study with students attending the Faculty of Medicine at Fırat University and determined that 57.5% of the students rarely cheated and 20.5% occasionally cheated. Kec¸eci et al.16 reported that nursing students
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displayed a tendency toward moderate academic dishonesty. The data for our country indicate similar trends to those found in other countries. Based on the literature, the following appear to account for the act of cheating: rote learning-based education systems, attitudes displayed by teachers in the class, failure of students to form appropriate study habits, personality disorders, pressure from parents, acquisition of a cheating habit, crowded classes, fear of receiving poor grades, and receiving low scores.15,17,18 Educators are supposed to provide an academic environment that diminishes opportunities for dishonesty, supports the moral development of students, and resumes the high moral standards of the nursing profession.4,6,19 The International Center for Academic Integrity (ICAI)20 defines academic integrity as ‘‘a commitment, even in the face of adversity, to five fundamental values: honesty, trust, fairness, respect, and responsibility’’ and adds an additional element: the quality of courage. Health professions deal with human subjects and are based on ethical applications and values by nature. These professions require clear standards of governance, accountability, and professionalism, and as a result, ethics remain an essential component of health professions.5 There are various standards and ethical codes regarding health professions on an international scale.21–23 The Nursing and Midwifery Council’s code of professional conduct calls for nurses and midwives to be honest, act with integrity, and uphold the reputation of their profession.24 According to the first principle of the American Dietetic Association’s (ADA)23 code of ethics, any member of a dietetics profession should conduct himself or herself with honesty, integrity, and fairness. The Turkish Association of Midwifery has implicitly accepted the International Code of Ethics for Midwives.22 Similarly, the Turkish Nurses Association uses the Code of Ethics of Nurses from the International Council of Nurses as a base while determining ethical principles and responsibilities for nurses.25 The Turkish Dietetic Association has agreed to comply with the codes of ethics determined by the International Confederation of Dietetic Associations and the European Federation of Associations of Dietitians.26 Students wishing to go into these professions will first gain ethical values in the educational setting. For students to obtain ethical codes and standards during their education in Turkey, they are offered ethics in health sciences and deontology courses in their training programs.16 In this context, it is feasible to help students adopt their profession, cultivate ethical values, and acquire a professional identity in their academic life. The purpose of this study was to determine the tendencies toward academic dishonesty in students attending the pertinent faculties of health sciences. Although some studies in the literature focus on the academic dishonesty tendencies of nursing students, there are no studies that specifically address the tendencies of midwifery and dietetic students; thus, this research will contribute to future work in this area.
Methods Participants and sampling This was a cross-sectional and descriptive study aimed toward assessing academic dishonesty among students attending The Health Science School of Ege University in Turkey. The health science school has three departments: midwifery, nursing, and nutrition-dietetics. With the exception of first-year students, there were 666 students in the three departments. Of these, 92 students did not want to participate in the study and thus did not fill out the questionnaires. On the day the study data were collected, 54 students did not come to school and 11 students were on sick leave. Therefore, 509 students completed and submitted the questionnaires. Of those submitted, 10 were not evaluated because they were not completed appropriately. Therefore, 499 questionnaires were included in the assessment. The study participation rate was 74.9%.
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Limitations First-year students were excluded because they took their basic science courses in a separate building located quite far from the main school building, which posed a problem for contacting them. Because the study sample was composed of only females, gender was not included as an independent variable. Another limitation is that the Internet was the only electronic media taken into account because the school lacked technological innovations such as a simulation room, web-based and web-enhanced classes, personal digital assistants, computer-assisted instruction, video, and webcasting. Therefore, electronic resources other than the Internet were excluded from this study.
Instruments The study data were collected using two forms. The first one included items about the socio-demographic characteristics of the students. This form also included variables pertaining to the students’ perception of school success, doing homework, the frequency of library and Internet use, self-reports of cheating, and reports of cheating behaviors in the classroom. The second form was the Academic Dishonesty Tendency Scale (ADTS), which was developed by Eminog˘lu and Nartgu¨n.27 Responses to these items were evaluated on a 5-point Likert-type scale: 1 corresponded to strongly agree and 5 corresponded to strongly disagree. The total scores received from the scale were rated as follows: very low (1.00–1.79), partly low (1.80– 2.59), medium (2.60–3.39), high (3.40–4.19), and very high (4.20–5.00). The test consisted of 22 items, which were assigned to four subscales including ‘‘tendency toward cheating,’’ ‘‘tendency toward dishonesty in homework projects,’’ ‘‘tendency toward dishonesty in research reporting,’’ and ‘‘academic dishonesty tendencies in referencing.’’ The Cronbach’s alpha reliability coefficient of the original scale was 0.71; it was 0.84 in this study.
Data analysis The dependent variables were the mean total and subscale ADTS scores. The independent variables were the departments that the students attend at school, the student’s year in school, the student’s perception of her success in school, the number of assignments, and the frequency of library and Internet use to do homework. The socio-demographic data were analyzed using descriptive statistics including means, standard deviations, frequencies, and percentages. The variables with normal distribution were the departments that the students attend at school, the number of homework assignments, and Internet use, which were compared to the ADTS subscale scores using one-way analysis of variance (ANOVA). The variables without normal distribution included the student’s year in school, the student’s perception of her success in school, and using the library while doing homework, which were compared using the Kruskal–Wallis test. Post hoc analyses were conducted with the Scheffe test. The statistical significance level was set at a ¼ 0.05, and the reliability level was set at b ¼ 0.95. Data were collected and responses entered into SPSS, Version 16.0.
Ethical considerations The study was approved by the Institutional Ethics Committee of Ege University. In addition, written permission was obtained from Eminog˘lu and Nartgu¨n to use the ADTS. The questionnaires were given to the students in a sealed envelope after they were informed about the study. They were asked to put the questionnaires in a box after responding to the items. Because participation was voluntary, some students who did not want to participate did not accept the envelopes. Particular attention has been paid to the fact that students participate in the study voluntarily and the participants have
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Table 1. Students’ perception of school success and variables related to homework preparation. N ¼ 499 Characteristics Student’s perception of school success Successful Partly successful Not successful Membership to a homework website Yes No Frequency of library use while doing homework Often Sometimes Rarely Never Frequency of Internet use while doing homeworka Often Sometimes Rarely Citing the sources consulted while doing homework in the assignmentsb Often Sometimes Never
N (%) 132 (26.5) 298 (59.7) 69 (13.8) 84 (16.8) 415 (83.2) 40 (8.0) 188 (37.7) 175 (35.1) 96 (19.2) 399 (80.0) 87 (17.4) 13 (2.6) 217 (43.5) 245 (49.1) 37 (7.4)
a
None of the students chose the option ‘‘Never.’’ None of the students chose the option ‘‘Rarely.’’
b
encouraged answering questions honestly. The researchers guaranteed students that their identities and answers would be kept confidential.
Results The mean age of the students who participated in the study was 21.33 + 1.64 (minimum ¼ 18, maximum ¼ 32) years. Of them, 51.9% (n ¼ 259) were in the midwifery department, 28.1% (n ¼ 140) were in the nursing department, and 20% (n ¼ 100) were in the nutrition-dietetics department; 30% (n ¼ 150) were secondyear, 42.5% (n ¼ 212) were third-year, and 27.5% (n ¼ 137) were fourth-year students. When the students were asked how they perceived their success at school, 59.7% of them considered themselves moderately successful. Of the students, 16.8% were members of a homework site, 37.7% sometimes used the library, 80.0% used the Internet while doing homework, and 49.1% sometimes cited the sources they consulted to do their homework assignments (Table 1). Table 2 presents the students’ opinions about cheating. According to their statements, 56.1% of the students had never cheated. More than half of the students (57.5%) indicated that some students were cheating when they were asked about cheating behaviors in the classroom. Nearly half of the students (48.1%) said the cheating method used most in the classroom was looking at another student’s paper/answer. Figure 1 illustrates the percentages of academic dishonesty tendencies. As can be seen from the grouping based on the scale scores, 33.7% of the students had partly low academic dishonesty tendencies (Figure 1). The mean total score for the ADTS was 2.44 + 0.57 (minimum ¼ 1.00, maximum ¼ 4.86).
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Table 2. Students’ views on cheating. N ¼ 499 Views on cheating
N (%)
Self-report of cheating I never cheat I sometimes cheat I always cheat Reports about the cheating behaviors in the classroom Nobody cheats Some of the students cheat Half of the students cheat Most of the students cheat Almost all of the students cheat Cheating methods Looking at a friend’s paper Talking to another student sitting next to her Preparing cheat sheets Writing notes on the wall/desk in advance Other
100 90 80 70 60 50 40 30 20 10 0
Very low 22.6
Partly low 33.7
280 (56.1) 208 (41.7) 11 (2.2) 36 (7.2) 287 (57.5) 57 (11.4) 85 (17.0) 34 (6.9) 240 (48.1) 128 (25.7) 37 (7.4) 79 (15.8) 15 (3.0)
Medium 24
High 13.2
Very high 6.4
Figure 1. Students’ academic dishonesty tendencies.
Table 3 compares the students’ ADTS scores and mean subscale scores according to some variables. The scores obtained from the ADTS and its four subscales were used to perform statistical analysis on variables such as student’s year in school, student’s perception of her success in school, number of assignments, frequency of library use, and Internet use to do homework assignments. When the students’ mean subscale scores were compared in terms of the departments they attended (midwifery, nursing, nutrition-dietetics), a statistically significant difference was seen in the tendency toward cheating subscale (p < 0.05) (Table 3). This difference was due to the difference in scores between the students from the midwifery and nutrition-dietetics departments. The mean scores were highest for students in the nutrition-dietetics department (Table 3). When the students were compared respective to their year at school, a statistically significant difference was found between the mean scores obtained from the ADTS and its subscales (p < 0.05). According to the results of the Scheffe test, the difference observed between the mean scores of the basic scale and those of
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Table 3. Comparison of the students’ ‘‘Academic Dishonesty Tendency Scale’’ scores in terms of some variables. Subscales of ADTS
Independent variables Department
Midwifery Nursing Dietetic
Student’s year in school
2nd year 3rd year 4th year
Student’s Successful perception of Moderately school successful successa Not successful
Tendency toward cheating
M + SD
M + SD
M + SD
M + SD
M + SD
259 2.4 + 0.6 140 2.5 + 0.5 100 2.4 + 0.5 p 0.112 150 2.31 + 0.6 212 2.5 + 0.6 137 2.4 + 0.5 p 0.000 132 2.3 + 0.5 298 2.4 + 0.5
2.5 + 0.8 2.7 + 0.9 2.8 + 0.9 0.005 2.5 + 0.9 2.6 + 0.9 2.7 + 0.8 0.014 2.4 + 0.9 2.7 + 0.9
2.3 + 0.7 2.4 + 0.7 2.3 + 0.6 0.196 2.2 + 0.7 2.4 + 0.7 2.3 + 0.9 0.012 2.2 + 0.6 2.4 + 0.7
2.3 + 0.8 2.5 + 0.8 2.3 + 0.7 0.096 2.2 + 0.8 2.5 + 0.7 2.3 + 0.8 0.003 2.2 + 0.7 2.4 + 0.7
2.4 + 0.6 2.5 + 0.6 2.3 + 0.7 0.057 2.2 + 0.7 2.5 + 0.6 2.4 + 0.6 0.000 2.3 + 0.7 2.4 + 0.6
2.7 + 0.5
2.9 + 0.0
2.6 + 0.7
2.6 + 0.8
2.7 + 0.7
N
69 p
Frequency of Internet use while doing homeworkb
1–2 172 3–4 178 5–6 93 7 and higher 56 p Often 399 Sometimes 87 Rarely 13 p
Frequency of library use while doing homework
Often Sometimes Rarely Never
The number of homework assignments
Total
Tendency toward Tendency toward Academic dishonesty dishonesty in dishonesty in tendencies in research homework referencing reporting project
Academic Dishonesty Tendency Scale
0.001
0.001
0.035
0.002
0.036
2.4 + 0.5 2.5 + 0.6 2.3 + 0.5 2.3 + 0.5 0.074 2.4 + 0.5 2.5 + 0.5 2.8 + 0.6 0.029
2.6 + 0.9 2.7 + 0.9 2.5 + 0.8 2.4 + 0.8 0.241 2.6 + 0.8 2.6 + 0.9 3.1 + 1.2 0.099
2.4 + 0.6 2.3 + 0.7 2.3 + 0.6 2.2 + 0.6 0.257 2.3 + 0.7 2.4 + 0.6 2.8 + 0.6 0.041
2.3 + 0.7 2.4 + 0.8 2.2 + 0.7 2.2 + 0.7 0.197 2.3 + 0.7 2.4 + 0.8 2.6 + 0.8 0.376
2.4 + 0.6 2.4 + 0.6 2.3 + 0.5 2.2 + 0.6 0.129 2.4 + 0.6 2.5 + 0.6 2.7 + 0.7 0.186
2.1 + 0.5 2.3 + 0.6 2.3 + 0.6 2.5 + 0.8 0.069 2.36 + 0.69
2.1 + 0.7 2.2 + 0.7 2.3 + 0.7 2.6 + 0.9 0.001 2.37 + 0.79
2.3 + 0.7 2.3 + 0.6 2.4 + 0.6 2.5 + 0.6 0.085 2.43 + 0.65
40 2.2 + 0.5 2.4 + 0.9 188 2.3 + 0.5 2.5 + 0.8 175 2.4 + 0.5 2.6 + 0.9 96 2.6 + 0.6 2.8 + 0.9 p 0.002 0.032 499 2.44 + 0.57 2.63 + 0.90
SD: standard deviation; M: Mean. Bold values represent statistically significant p values (p < 0.05). a It refers to the student’s statement how she perceives her ‘‘school success.’’ b None of the students marked the option ‘‘Never.’’
‘‘tendency toward dishonesty in homework projects,’’ ‘‘tendency toward dishonesty in research reporting,’’ and ‘‘academic dishonesty tendencies in referencing’’ subscales stemmed from differences between the second-year and third-year students’ scores. The highest score was achieved by third-year students. In comparing the mean scores for tendency toward cheating between second-year and fourth-year students, fourthyear students had higher scores (Table 3). A statistically significant difference was observed between the students’ mean scores obtained from the ADTS and its subscales for students’ perceptions of success in school (p < 0.05). Students who
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considered themselves not successful obtained the highest mean scores from both the ADTS and its subscales (Table 3). While the difference for the number of homework assignments was not statistically significant (p > 0.05), it was statistically significant for the frequency of library use while doing homework assignments (p < 0.05). The mean scores of students using the library frequently were lower. Further analysis revealed that the difference resulted from the options ‘‘often,’’ ‘‘never,’’ and ‘‘sometimes’’ (Table 3). When the students’ mean scores obtained from the ADTS and its subscales for frequency of Internet use while doing homework were compared, a statistically significant difference was found for the ‘‘tendency toward dishonesty in homework projects’’ subscale (p < 0.05); the difference was found between the options ‘‘often’’ and ‘‘occasionally’’ (Table 3).
Discussion Recent studies on academic dishonesty have one common finding: a tendency toward academic dishonesty that is rapidly increasing, albeit for different reasons.28,29 A review of the pertinent literature revealed that independent variables such as age, gender, departments students attend at school, student’s year in school, type of cheating, high technology device use, number of homework assignments, and attitude displayed by the instructors or the family have an impact on academic dishonesty tendency.15,16,30,31 In the first study of this kind conducted at our institution, the mean ADTS score was found to be slightly low (Figure 1). Another point discussed in this study was the relationship between mean ADTS scores and its subscales and the following variables: department that students attend at school, student’s year in school, student’s perception of success in school, number of assignments, and frequency of the library and Internet use. Is a students’ perception of her success in school one of the factors prompting them to have a tendency toward academic dishonesty? Do students who consider their success insufficient display a greater tendency toward academic dishonesty? With reference to the aforementioned questions, students were asked how they perceived their success in school. Only 26.5% of participants considered themselves successful (Table 1). The comparison of the mean scores obtained from the ADTS and its subscales for the variable ‘‘perceptions of school success’’ revealed that the differences among those who considered themselves successful, moderately successful, and not successful enough were statistically significant (p < 0.05, Table 3). The mean ADTS score of the students who defined themselves as not successful enough was higher than that of the other groups. McCabe and Trevino32 and Jensen et al.33 have underlined that when the students’ grade point average (GPA) is low, academic dishonesty tendency gets higher. Also, Odabas¸ ı et al.34 stated that the students’ low school success is one of the personal factors that increase the tendency for academic dishonesty. According to the statements of the students regarding cheating, 43.9% have cheated on exams (Table 2). The results reported in this study were not very different from results found in the literature. Arhin and Jones5 indicated that the majority of nursing students did not consider academic dishonesty something immoral or unusual. Woith et al.6 stressed that there was a shift in nursing students’ perception of academic integrity and that students have started to consider academic dishonesty as normal. The results of a study conducted on students attending faculties of medicine and pharmacy in New Zealand were similar to those of the above-mentioned studies.35 According to the students’ statements in our study, the cheating rate was found to be 92.8%. Of the students surveyed, 57.5% said that some students cheated, 11.4% said half of the students cheated, 17.0% said most of the students cheated, and 6.9% said almost all of the students cheated. The percentage of students who said that no one cheated was 7.2% (Table 2). Kukolja Taradi et al.36 have found that, among third- and fifth-year medical school students, 97% of them cheated. The authors defined this as
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a strong indication of peer support for academic dishonesty. Underwood and Szabo37 stated that peer support against cheating behavior should be considered one of the major strategies to prevent cheating. The cheating methods used in this study included traditional methods such as looking at someone else’s paper, talking to another student sitting next to them, preparing cheat sheets, and writing notes on the wall/desk in advance. Today, there are many studies indicating that technological methods of cheating are widely used.15,36 Whitley and Starr38 reported that pharmacy students had poor perceptions of academic dishonesty, and students regarded cheating with technological tools as an indispensable part of life. However, in this study, the utilization of technological tools in academic dishonesty was not investigated. As stated in the ‘‘Limitations’’ section of the study, the school’s infrastructure lacks these technological facilities. Furthermore, cell phones and electronic devices were not allowed in the examination hall. In terms of their tendency toward academic dishonesty, a comparison among students in the midwifery, nursing, and nutrition-dietetics departments found that the ADTS scores from students of the nutritiondietetics department were significantly higher in the ‘‘tendency toward cheating’’ subscale compared to other departments (p < 0.05, Table 3), although the difference was not statistically significant. Similarly, nursing students obtained higher mean scores from the three subscales (‘‘tendency toward dishonesty in homework projects,’’ ‘‘tendency toward dishonesty in research reporting,’’ ‘‘academic dishonesty tendencies in referencing’’); however, these differences were also not statistically significant (p > 0.05, Table 3). This result was likely related to the curriculum of the nursing department. Nursing deals with healthy and unhealthy individuals of all ages and includes theoretical and clinical applications in internal medicine and surgery. The higher tendency of nursing students toward cheating might result from the fact that they had a more intensive curriculum and a wider area of clinical practices compared to students in the other departments. Some studies drew attention to this issue in nursing education and reported that students must prepare for more than one exam and do more homework. This may predispose them toward academic dishonesty and force them to display dishonest behaviors.6,39 Our literature review revealed a gap in work related to midwifery and nutrition-dietetics students’ tendency toward academic dishonesty. We found statistically significant differences between students’ mean ADTS scores and its subscales when the students were compared in relation to their years at school (p < 0.05). This difference stemmed from the scores of the second-year and third-year students. The scores of third-year students were the highest, which can be attributed to the fact that the number of theoretical courses was highest in the curriculum of third-year students in all departments. Kec¸eci et al.16 found that the mean scores for the ‘‘tendency toward dishonesty in homework projects’’ and ‘‘tendency toward dishonesty in research reporting’’ subscales were high among the third-year students. As the amount of homework, projects, and relevant assignments increases, students exhibit a greater inclination toward academic dishonesty and cheating in particular.39,40 The students in our study were assigned homework for only some of their courses. The students were given assignments such as writing case scenarios, designing a plan of care most beneficial to patients, preparing and presenting seminars, and preparing leaflets and posters on health education. While some of these assignments were completed individually, some of them were completed in groups. No statistically significant differences were found when comparing academic dishonesty and the mean scores for the ADTS and its four subscales when the effects of the annual number of projects given to the students were taken into account (p > 0.05, Table 3). However, it was found that those who were given more than five annual homework assignments obtained low mean scores for the ‘‘tendency toward dishonesty in homework projects,’’ ‘‘tendency toward dishonesty in research reporting,’’ and ‘‘academic dishonesty tendencies in referencing’’ subscales. This suggests that students may have increasingly done homework ethically as the number of annual homework assignments increased. Considering the contributions of homework to students, it may be ideal to conduct future studies with more focus on this issue.
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The relationship between the frequency of Internet use while doing homework assignments and the mean scores obtained from the ADTS and its ‘‘tendency toward dishonesty in homework projects’’ subscale was found to be statistically significant (p < 0.05; Table 3). This difference was between groups that used the Internet ‘‘often’’ and ‘‘rarely.’’ In the group that often used the Internet, the mean scores for the ‘‘tendency toward dishonesty in research reporting’’ and ‘‘academic dishonesty tendencies in referencing’’ subscales were found to be lower than those of the other groups. Perhaps if ‘‘guidelines on the accurate and efficient use of the Internet’’ were prepared and submitted to both students and educators by the educational institutions, or if the first-year curriculum included a course on how to properly and effectively use the Internet under ethical principles, the students’ awareness of academic dishonesty would be higher. The Internet not only makes it possible to acquire a huge amount of information quickly but also leads to information pollution. One needs to be careful about using the Internet to access correct information and to eliminate unreliable information. Otherwise, one might consider incorrect and unsafe information to be correct and safe. If one uses all of the obtained information without questioning it, one may become a victim of ignorance. This prediction has been emphasized in some studies.41,42 Students who use the Internet frequently during their education gain experience in obtaining accurate and reliable information over the years. Uc¸ak et al.42 indicated that the more frequently one uses the Internet, the more accurately and effectively he or she makes use of it, and as a result, he or she will develop behaviors that comply with ethical principles. On the other hand, those who rarely use the Internet will not be able to develop efficient and accurate use skills, which might cause them to display tendencies of academic dishonesty. In our study, students who rarely used the Internet while doing homework achieved high ADTS scores, which suggests that they fell into this trap. Analysis of the frequency of students’ library use while doing homework indicated that the ADTS scores of those who never used the library were higher than those of other groups, and the difference was statistically significant (p < 0.05, Table 3). This result indicates that the students who frequently used the library did not display academic dishonesty-related behaviors. Instead, they tended to use information with ethical principles. Burke43 indicated the importance of library use in the prevention of students’ tendency toward academic dishonesty and stated that libraries and librarians should undertake a new mission to combat academic dishonesty. Caravello44 reported that library use raised awareness of academic dishonesty among students. Sciammarella45 pointed out that library use enabled students to appropriately use the resources in their academic studies and discouraged them from partaking in academic dishonesty.
Conclusion and recommendations Unfortunately, students’ tendencies toward academic dishonesty have been steadily increasing in recent years.28,29 It is well known that health science students have an especially difficult educational process. In this study, participating students were observed committing academic dishonesty during this process. The fact that students tend to commit academic dishonesty raises concerns that this behavior might persist. To prevent students from committing academic dishonesty, the following is recommended: (1) Create programs that are aimed toward strengthening ethical values such as honesty in students; (2) Educational institutions should take comprehensive measures against academic fraud, declare their academic integrity policies, clearly define acceptable and unacceptable behaviors, and inform students about all measures in writing; (3) Educators should clearly tell students to not only use the Internet but also use the library while completing assignments and projects; (4) Universities should install computer software programs to confirm that homework assignments and projects are completed in compliance with the ethics of science, and educators should accept homework assignments and projects through these software programs; and finally, and (5) Educational institutions should implement
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policies that encourage academic integrity, and impose effective sanctions in case academic dishonesty is detected. Acknowledgements We would like to extend our sincere thanks to the Department of Biostatistics and Medical Informatics, Ege University, for their invaluable contribution to the analysis of the data. We also thank the students who participated in the study for their sincere responses. The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, please see: http://www.textch eck.com/certificate/iT5W26 Conflict of interest The authors declare no conflicts of interest. Funding This research received no specific grant from any funding agency in the public, commercial, or not-forprofit sectors. References 1. Guthrie CL. Plagiarism and cheating: a mixed methods study of student academic dishonesty. Unpublished Master of Social Sciences, The University of Waikato, 2009, http://hdl.handle.net/10289/4282 (accessed 11 June 2013). 2. Jurdi R, Hage HS and Chow HPH. Academic dishonesty in the Canadian classroom: behaviours of a sample of university students. Can J High Educ 2011; 41(3): 1–35. 3. Storch EA and Storch JB. Fraternities, sororities and academic dishonesty. Coll Student J 2002; 36(2): 247–251. 4. Kolanko KM, Clark C, Heinrich KT, et al. Academic dishonesty, bullying, incivility, and violence: difficult challenges facing nurse educators. Nurs Educ Perspect 2006; 27(1): 34–43. 5. Arhin AO and Jones KA. A multidiscipline exploration of college students’ perceptions of academic dishonesty: are nursing students different from other college students? Nurse Educ Today 2009; 29(7): 710–714. 6. Woith W, Jenkins SD and Kerber C. Perceptions of academic integrity among nursing students. Nurs Forum 2012; 47(4): 253–259. 7. The Center of Academic Integrity. The fundamental values of academic integrity, http://www.academicintegrity. org/icai/assets/FVProject.pdf (1999, accessed 20 June 2013). 8. Altschuler GC. Battling the cheats. The New York Times (Education Life Supplement), 2001, http://www.nytimes. com/2001/01/07/education/college-prep-battling-the-cheats.html?pagewanted¼all&src¼pm (accessed 26 May 2013). 9. McCabe D. It takes a village: academic dishonesty and educational opportunity. Liberal Educ 2005; 91(3): 26–31. 10. Josephson Institute of Ethics. Josephson Institute’s 2010 Report Card on the Ethics of American Youth, http://charactercounts.org/pdf/reportcard/2010/ReportCard2010_data-tables.pdf (2011, accessed 27 May 2013). 11. Josephson Institute of Ethics. 2012 Report Card on the Ethics of American Youth, http://charactercounts.org/pdf/ reportcard/2012/ReportCard-2012-DataTables.pdf (2012, accessed 21 May 2014). 12. Patrzek J, Sattler S, van Veen F, et al. Investigating the effect of academic procrastination on the frequency and variety of academic misconduct: a panel study. Stud High Educ 2014, http://dx.doi.org/10.1080/03075079.2013. 854765 13. Akdag˘ M and Gu¨nes¸ H. Kopya c¸ekme davranıs¸ ları ve kopya c¸ekmeye ilis¸ kin tutumlar [Cheating behaviors and attitudes toward cheating]. Kuram ve Uygul Eg˘it Yo¨net 2002; 8: 330–343 (in Turkish). 14. Mert EL. Temel is¸ levi bilim insanı yetis¸ tirmek olan bazı bo¨lu¨mlerde kopya [Cheating at some department whose basic function is to train academician]. Turk Stud: Int Period Lang Lit Hist Turk Turk 2012; 7(3): 1813–1829 (in Turkish).
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