The Pharmaceutical Journal
Vol 269 No 7219 p522
12 October 2002

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Honesty in learning: fact or fiction?

By Reena Aggarwal, Ian Bates and J. Graham Davies

Self-regulation is a key feature of professions trusted by the public. However, too many high profile incidents of medical professionals betraying that trust has brought their professionalism under scrutiny. The Royal Pharmaceutical Society's Code of Ethics states that this public trust "requires pharmacists to ensure and maintain high standards of personal and professional conduct". Clearly, the moral, ethical and professional values espoused by the profession must be relayed appropriately to students, since it will be their responsibility to maintain these values during their professional career.

Anecdotally, we know "dishonest behaviour" occurs in higher education, yet incidence of such behaviour was previously unknown in pharmacy undergraduate environments. Our study, published today,¹ identified that 80 per cent of students admitted to at least one incident of academic dishonesty. At face value, this statistic appears shocking. However, it needs to be put into context. What do we mean by academic dishonesty? Is dishonesty common in other disciplines? Are all incidents of dishonesty of equal severity? Will dishonest students become dishonest practitioners?

A definition of "academic dishonesty" is difficult to locate in the research literature. Abouserie,² when asked what she understood by academic dishonesty, replied that, "an intuitive understanding has been regarded as sufficient". Examination cheating is considered most serious by both academics and students. Rules and regulations concerning examinations are transparent, students have experience of examinations from an early age and their behaviour reflects this. However, academic study is no longer assessed using examinations alone. Curricula have evolved to include coursework assignments, group work, use of primary references and peer assessment. A definition of academic dishonesty has to include more than just examination protocol. It has to take into account issues of plagiarism, copying and collusion. Fundamentally, students receiving benefit for work fraudulently claimed to be their own are academically dishonest. Moreover, without consensus and transparency among academics and the student body, policing academic dishonesty is impossible.

Academic dishonesty consistently occurs in higher education environments, where about 50 per cent of students in a range of disciplines admit to dishonest behaviour.³ A recent study involving medical students showed that 56 per cent would consider engaging in behaviour deemed unethical or dishonest by the university.⁴ These activities included borrowing and copying coursework, plagiarism and, most seriously, falsifying data, for example writing "nervous system examination normal" in patient notes when no such examination had been conducted. We concur that such behaviour must be taken seriously by both the university sector and the profession to ensure public confidence in the final qualifications attained by students.

We have evidence that academic staff are in significant agreement about the severity of individual cases of academic dishonesty. Our study shows that attitudinal differences exist between academic staff and students and also between students in the two schools of pharmacy studied. For example, some students do not consider borrowing and copying coursework to be dishonest, yet academic staff view ideas as intellectual property and copying them as a breach of trust. Increasing emphasis on literature review and use of primary references for coursework assignments means students use the internet more often for gathering information. Students are unsure about attribution of both paper and virtual sources and frequently admitted to "website cut and paste". However, do academics teach paraphrasing, inform students about correct attribution of sources and guide students toward appropriate reference sources, or do they just blame the student when such behaviour is identified?

Undergraduate curricula are encouraging self-directed learning and self-management of learning time. Student numbers are increasing, the Government has pledged 50 per cent participation in higher education for 18- to 30-year-olds by the end of the decade and there has been a 65 per cent increase in pharmacy undergraduates over the past 10 years coupled with a four-year degree programme. Conversely, academic staff numbers have not increased and providing timely feedback and guidance in this learning environment is an extra burden. Resourcing small group teaching and maintaining interaction with students is harder. In addition, student expectations are different — "consumerism" is the norm. Academic dishonesty may therefore represent a coping strategy building on a peer network as a substitute for traditional academic guidance.

In February 2002, the General Medical Council announced new guidelines on research standards expected in the NHS, universities and the private sector following exposure of fraudulent research claims. In an era of evidence-based practice, research assessment exercises and increasing focus on research misconduct, integrity regarding publication and dissemination of research results is under surveillance. In our study, half the students surveyed did not consider inventing experimental data to be dishonest and a further 60 per cent admitted to doing something similar. Sceptics may consider this irrelevant, since experimental practicals conducted by student at university rarely proceed as expected. However, the intended purpose of practical enquiry is to inculcate experimental methodology with an ability to interpret experiments yielding seemingly erroneous or unusual results. Do students understand this or do they perceive practicals as lacking vocational relevance and therefore another hurdle to overcome? Do academic staff assess student understanding of data, or do they consider student reports to be purely technical ones that are stimulating neither to produce nor to read?

Academic dishonesty appears to be as common among pharmacy students as in other disciplines, perhaps reflecting the cultural norm in higher education institutions. This practice may cease once students become practitioners but with increasing emphasis on revalidation, habits may resurface. Therefore, neither the profession nor academia can afford to ignore these statistics. Further studies are needed to understand the reasons behind such behaviour. We should be confident that our graduates are highly qualified, have completed the work they claim to and are prepared for the demands of professional practice and lifelong learning. Our preliminary data leave little doubt that academic staff must revise existing definitions of academic dishonesty and, more fundamentally, the teaching and assessment procedures used. Issues of honesty, morality and ethical behaviour are closely linked. It is the responsibility of educators to be transparent about academic and professional values and to relay these to students so that their status, integrity and honesty are without dispute.

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