Prevalence and attitudes toward plagiarism among medical students
Lidija Bilić-Zulle
Doctoral disertation
Introduction
• Importance of science:• real knowledge• cultural role• education• well-being and safety
• Biomedical science – influence on human life
• Integrity – the cornerstone of science
Scientific misconduct
Fabrication
Falsification
Plagiarism
Plagiarism
“Unauthorized appropriation of another’s work, ideas, methods, results or words without acknowledging the source and
original author.”
It is a theft and it is against the basic principles of science.
• MeSH subject – 1990
• 442 citation according to PubMed
• 61% of paper – last 10 years
• Google – more than 24 million links
• ORI – Office of Research Integrity
• Scientific conferences on research integrity and plagiarism
Plagiarism
Copyright © 2001 by Pyrczak Publishing. All rights reserved. Reproduced with permission.
Academic misconduct• Plagiarism, cheating,
fraud...
• Dishonest students = dishonest physicians
• Computer technology – “cyberplagiarism”
Copyright © 2001 by Pyrczak Publishing. All rights reserved. Reproduced with permission.
Cyberplagiarism among students
• Downloading a free research paper
• Buying from commercial paper mill (even theses!)
• Copying an article from Web
• Cutting and pasting from several sources
• ...
Detection of plagiarism
• Before computer technology – mainly by chance (or reported)
• Difficult to prove
• Computer technology – plagiarism detection software
Copyright © 2001 by Pyrczak Publishing. All rights reserved. Reproduced with permission.
“The Web giveth and the Web shall taketh...”
• Different techniques
• Text analysis (concordances)
• Web based services: searching the internet for source texts (Turnitin®, EVE) – language restricted
• Close procedure (Glatt Plagiarism Service) and
• WCopyfind – no language restriction; freeware
Attitudes toward plagiarism
• Important to understand
• Culturally influenced
• Lack of knowledge
• Rules, Ethical code
Purpose of the study
Studying prevalence of plagiarism among medical students and student attitudes
toward plagiarism, scientific and professional misconduct will contribute to
the development of the basis for university guidelines on responsible
studying, especially for medical students whose responsibility is all that greater as
their work and knowledge will have direct implications on human life.
Specific aims• To prove the existence and establish the
prevalence of plagiarism among medical students by use of student essays
• To determine how clear warning and punishment influence the rate of plagiarism
• To determine the attitudes of medical students toward different forms of plagiarism, scientific, academic and professional misconduct
• To examine the general attitudes of medical students toward scientific and academic integrity and intellectual property
• To determine the differences in prevalence and attitudes toward plagiarism among students with respect to their sex and academic achievement
Specific aims
Subjects and Methods
Subjects• All second-year medical students of Rijeka
University School of Medicine attending MI course (N=295, 63% woman, median age 21, range 19-27) during three academic years:
• 2001/2002 (N=114, 61% woman)
• 2002/2003 (N= 88, 69% woman)
• 2004/2005 (N=93, 60% woman)
• No difference in number, sex, age or academic achievement between three student samples
Methodes
The study consisted of three parts:• investigation of prevalence of plagiarism
using plagiarism detection software • investigation of attitudes towards six
different scenarios of dishonest academic, scientific and professional behavior
• investigation of general attitudes towards scientific integrity and intellectual property
Prevalence of plagiarismMethods
• Mandatory part of MI practicum, not graded
• Based on one of four provided source articles:
• two in e-format, two in hard copy format
• two with less and two with more complex topic
• Additional sources were not prohibited
Student essays
Additionally warned that essays
would be checked by
plagiarism detection
software and perpetrators
would be punished.
3rd student sample
(y. 2003/2004)
Instructions on plagiarism
2nd student sample (y. 2001/2002)
Explained what
plagiarism was and strictly
warned that it was
forbidden.
1st student sample (y. 2000/2001)
Informed that essay should be their original intellectual creation.
Use of WCopyfind ver. 2.2 software
Preparing of the essays for text analysis:
• parts removed from manuscripts: student data, title, literature list, figures and tables (existed in 10% of essays)
• Croatian diacritical signs were replaced with international
Body texts of essays and source articles were compared.
Use of WCopyfind ver. 2.2 software
• Comparison rule parameters
Comparison Rule ParameterParameter
Value
Shortest phrase to match 6
Fewest matches to report 1
Shortest text string to consider 100
Most imperfections to allow 2
Minimum percentage (%) of matching words
80
Ignore all punctuation yes
Ignore numbers yes
Ignore letter case yes
Skip non-words and skip words longer than _____ characters
no
• Analyses of the essays:
• total number of words in each essay
• number of matching words
• percentage of copied text in essay (calculated)
• distribution of the chosen source article (with respect to availability – electronic or hard copy – and complexity)
Data collected
• Academic achievement of the students• based on MI exam grade (passed on the
1st attempt):• excellent students
◦ grade 5 (A – excellent) and 4 (B – very good)
• average students◦ grade 3 (C – good) and 2 (D – adequate)
• poor students◦ failed or did not take exam at least for one year
Data collected
Attitudes toward plagiarismMethods
Scenarios
• Six imaginary but possible scenarios of misconduct
• Questionnaire with 6 multiple choice questions (same for all scenarios)
• Epilogue (reversal of situation or aggravating circumstances)
• 7th logical question (different for each scenario)
Anonymous questionnaireYou consider the described behavior: A – appropriate,
B – wrong,
... and you consider it A – justified.B – unjustified.
Should the person who committed the act be punished?
A – no.B – yes, the perpetrator should be:
1 – given an oral warning.2 – taken away the benefit obtained by the act.3 – expelled from school, i.e., excluded from
health/scientific community.
Have you ever done anything similar to the described act?
A – no, because:1 – I did not have the opportunity.2 – I consider such an act unacceptable.3 – I’m afraid of punishment.
B – yes, because:1 – I had a good reason to do it.2 – I don’t think I did anything wrong.
Would you ever do anything similar to the described act?
A – no, never.B – I would in exceptional situation, if there were a real and
urgent need to do it.C – yes, always.
Do you have any knowledge of such or similar acts taking place in reality?
A – I have never heard of any similar act (I have no knowledge of any similar act).
B – I have heard of such (similar) a case.C – I have witnessed or experienced it in my environment or
participated in such an act.
Self-plagiarism• Scenario
At the sixth study year D. copied his student essay already submitted at third year of study and passed exam.
• EpilogueAs scientist, few years latter, D. submitted and publishes his already published paper and applies for higher academic position.
• 7th questionDo you think this is right?
Plagiarism with author’s consent
• ScenarioM. asks her colleague from senior study year for essay to copy it and submitted as own, and friend let her do it.
• EpilogueO. (the third person) noticed fraud and reported it to the instructor.
• 7th questionDo you think what O. did was right?Copyright © 2001 by Pyrczak Publishing. All rights
reserved. Reproduced with permission.
Plagiarism without author’s consent
• ScenarioJ. stole her roommate D.’s essay (graded A) from her computer while using it and submitted it as own without D.’s knowledge.
• EpilogueD. decided to publish essay as a student paper but J. beg her not to did it because plagiarism than probably would be revealed.
• 7th questionIf you were D. would you publish the essay? Copyright © 2001 by Pyrczak Publishing. All rights
reserved. Reproduced with permission.
Plagiarism by the superior• Scenario
Prof P.H. copied his student theses in his book without acknowledging the source or cites his student M.
• EpilogueM. submitted his theses as scientific paper but journal editor notice similarities with P.H.’s book and accused M. for plagiarism, reject manuscript and inform wider scientific community.
• 7th questionIf you were P.H., would you than admit that you plagiarized and that your student M. is author of the text?
Cheating on exam • Scenario
M. did not study, but he still takes the exam for attempt. During the exam he switch the test with his colleague who replies to questions that M. does not know the answer and M. passes the exam.
• EpilogueInstructor noticed the test switch but because he wants to avoid exhausting explanations he just ignores it and act as if nothing happened.
• 7th questionDo you think that the instructor did the right thing?
Issuing a false medical report • Scenario
Dr. B.N. issued the medical report but did not examine a patient – his good friend A.B. who was to undergo a surgery, to spare him another visit to hospital.
• EpilogueFamily physician copies the medical report into A.B.’s medical file explaining how important the medical findings are for the course of surgery.
• 7th questionIf you were A.B. would you tell your family physician that you were not examined?
General attitudes toward academic and scientific
integrity and intellectual property
Methods
Anonymous questionnaire• six logical questions (yes/no)• completed after passed MI exam
- Have you as a student been introduced to the principles of academic and research integrity?
- Do you consider intellectual property equal to other forms of property?
- Should the School have clearly articulated rules against plagiarism included in the official documents?
- Do you think that a researcher has to be completely honest in his/her work, irrespective of circumstances?
- In your opinion, is it acceptable to ignore research results that are not very important or in accordance with most other (expected) results?
- Is the following statement true: who cheats once, will cheat again, at least when presented with the opportunity?
Results
Proportion of plagiarized text
• Median plagiarism rate 7% (5th-95th percentile = 0-84%)
Distribution of students with respect of plagiarized text
0 10 20 30 40 50 60 70 80 90 100
200
150
100
50
0
Proportion of plagiarised text [%]
Nu
mb
er
of
stu
den
ts
Proportion of plagiarised text
• No difference between female and male students (8% vs. 6%)
• No difference between hard copy and electronic format of source (14% vs. 6%)
• No difference between simpler and more complex topic of source (7% vs. 10%)
Proportion of plagiarized text• Warning against plagiarism (student sample)
Difference between 2004/2005 student sample and the others (17% vs. 21% vs. 2%, P<0.001)
100
80
60
40
20
0
Student sample
Perc
en
tag
e o
f p
lag
iari
zed
text
[%
]
2001/20022002/20032004/2005
Proportion of plagiarized text• Academic achivement (overall)
No difference beetwen poor, average and excelent students (6% vs. 12% vs. 6%)
100
80
60
40
20
0
Academic achivement
Perc
en
tag
e o
f p
lag
iari
zed
text
[%
]
poor average excellent
Proportion of plagiarized text• Academic achivement (only 2001/2002 and 2002/2003
sample)Difference between excellent students and the others (25 % vs. 22% vs. 12 %, P=0.015)
100
80
60
40
20
0
Academic achivement
Perc
en
tag
e o
f p
lag
iari
zed
text
[%
]
poor average excellent
Availability of source article
Student sample
P<0.001
Complexty of topic of source article
Student sample
P<0.001
Length of essay (number of words)• Difference between all three student samples
(455 vs. 553 vs. 399, P<0.001)
2000
1600
1200
800
400
0
Student sample
Nu
mb
er
of
word
s
2001/20022002/20032004/5005
Attitudes toward various scenarios
Copyright © 2001 by Pyrczak Publishing. All rights reserved. Reproduced with permission.
on plagiarism,academic andproffesionalmisconduct
Appropriateness
Scenario Appropriate Wrong
Self-plagiarism 65 30
Plagiarism with author’s consent
18 77
Plagiarism without author’s consent
5 90
Plagiarism by the superior 16 67
Cheating on exam 25 65
Issuing a false medical report 7 83Percentage (%) of students presented.
Do not add up to 100% because of missing values.
Justifiability
Scenario Justified Unjustified
Self-plagiarism 75 16
Plagiarism with author’s consent
55 32
Plagiarism without author’s consent
28 64
Plagiarism by the superior 21 59
Cheating on exam 57 30
Issuing a false medical report 17 69Percentage (%) of students presented.
Do not add up to 100% because of missing values.
Punishement
Scenario NoJust
verbal
Take the
benefit away
Expell
Self-plagiarism 79 9 7 0
Plagiarism with author’s consent
43 26 23 0
Plagiarism without author’s consent
15 41 37 2
Plagiarism by the superior 25 21 32 4
Cheating on exam 51 14 25 0
Issuing a false medical report 24 56 7 2Percentage (%) of students presented.
Do not add up to 100% because of missing values.
Students who have NOT done anything similar to described scenario
ScenarioDid not
have opportunity
Consider it unacceptab
le
Because of punishmen
t
Self-plagiarism 55 7 3
Plagiarism with author’s consent
48 28 6
Plagiarism without author’s consent
32 49 8
Plagiarism by the superior 49 28 2
Cheating on exam 45 20 9
Issuing a false medical report 59 27 1Percentage (%) of students presented.Do not add up to 100% because of missing values.
Scenario Because of good reason
It is not wrong
Self-plagiarism 8 21
Plagiarism with author’s consent
9 1
Plagiarism without author’s consent
3 2
Plagiarism by the superior 2 1
Cheating on exam 9 6
Issuing a false medical report 1 1Percentage (%) of students presented.Do not add up to 100% because of missing values.
Students who have already done something similar to described scenario
Would you ever do anything similar to the scenario?
Scenario NeverExceptionally (in need)
Always
Self-plagiarism 6 60 29
Plagiarism with author’s consent
24 66 3
Plagiarism without author’s consent
37 57 1
Plagiarism by the superior 40 39 4
Cheating on exam 20 56 13
Issuing a false medical report 39 48 3Percentage (%) of students presented.Do not add up to 100% because of missing values.
Knowledge of such or similar event in reality
Scenario Never heard of
Just heard
of
Witnessed or
experienced
Self-plagiarism 13 35 46
Plagiarism with author’s consent
17 45 32
Plagiarism without author’s consent
20 44 31
Plagiarism by the superior 46 33 4
Cheating on exam 19 33 38
Issuing a false medical report 29 44 17Percentage (%) of students presented.Do not add up to 100% because of missing values.
Inconsistency in attitudes and 7th question confusion
?
??
?
??
?
?
? ????
??
?
Self-plagiarismWhen done by student... When done by instructor...
Punishment
Plagiarism with author’s consentWhen done by student... Is whistleblower right...
Punishment
Plagiarism without author’s consentWhen done by student... Would you publish the
essay...
Punishment
Plagiarism by the superiorIs it appropriate... Would you admit...
Punishment
Cheating on examWhen done by student... When instructor ignores
it...
Punishment
Issuing a false medical reportWould you tell your doctor...
Punishment
Is it appropriate...
General attitudes towardresearch and academic integrity and intelectual property
©
Q: Were you as a student introduced to the principles of research and academic integrity?
Q: Do you consider intellectual property equal to other forms or property?
Q: Should a school have clearly articulated rules against plagiarism included in the official documents?
Q: Do you think that a scientist has to be completely honest in her or his work irrespective of the circumstances?
Q: Is it permissible in research to ignore individual results that are not very important and do not correspond to the expected results?
Q: Is the following true: Once a cheater, always a cheater, or at least when there is an opportunity?
Results on general attitudes
• Answers – socialy diserable
• No difference beetwen men and women in distribution of answers to any question
• No difference beetwen student sample in distribution of answers to any question
Conclusions• Plagiarism is present among medical students
• The proportion of plagiarized text – not influenced by the availability of the source or by the complexity of the essay topic
• Significant reduction – only by awareness of objective check methods and punishment
• Just teaching and clear warning not enough
Conclusions• Student attitudes are worrisome – need for
teaching and promotion of the principles of academic integrity among students.
• Inconsistency in student attitudes – indicates the lack of knowledge and recognition of an act as wrong.
• General attitudes – socially desirable answers, in contradiction with their behavior
Conclusions• Academic achievement – influenced the
plagiarism in student essays only if they were not warned about the subsequent computer-check of their work and punishment
• Faculty awareness of the inappropriate attitudes of students toward academic misconduct – education and promotion of the highest standards of academic integrity
Plagiarism as well as other forms of misconduct should be recognized and
must not be tolerated.
Thank you all...
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