What is it?

Here are a few common types of cheating that we experience in the world of higher education:

  • Using notes or accessing online resources during an exam
  • Copying another students exam answers
  • Plagiarism
  • Buying a term paper

In real life, people have to do their own jobs. So copying another students exam answers, blatant plagiarism, or something like buying a term paper are evidence of a student who will probably not be competent in practice. However, using the Internet to research solutions to clinical problems after one is in practice is neither cheating nor evidence of incompetence. In fact, it is the opposite of both. It is not cheating in real life to use all the tools at your disposal to help your patients, and it’s not incompetence to develop the search and evaluation skills necessary in a world with an overwhelming amount of data points. So, I would argue that in the modern era, accessing online resources during an exam should no longer be considered cheating. Yet, in the world of licensed healthcare professions, there is still a zero tolerance policy for doing in school what one would always be doing when in practice.

Why is it bad?

The main reason to prohibit cheating isbecause people who are willing to break the rules with impunity gain an academic advantage over those who play by the rules. You might think that anyone who cheats is going to regret it later in life when they don’t have access to the information they need d to excel at their jobs.

However, the reality is that not all cheating is equal. For example, if I copy the answers to a fellow student’s exam, I not only demonstrate my lack of ability to recall facts and concepts. I also am not applying my clinical problem-solving skills (although I am honing my criminal problem-solving skills, which I am probably going to need in the future if I continue this behavior). On the other hand, when in the course of analyzing a case, what if I look up some possible diagnoses on a website? When working on an authentic case study, it is unlikely that a student is going to come across the exact same case study on the Internet with the one and only correct diagnosis presented as the solution. Instead, they are going to find similar cases and bits and pieces of other information that will require their analysis, synthesis, and evaluation before they are able to complete the task of creating a unique treatment plan for their patient.

They may not have memorized every fact and concept yet, but they are repeatedly practicing the equally important critical thinking and problem-solving skills that will be used on a daily basis in real life. There’s actually evidence from programs that train healthcare practitioners using what is called a problem based learning method that students in these programs don’t necessarily do as well on standardized exams (although their pass rates are still equivalent). However, students who graduate from such programs demonstrate far superior clinical problem-solving skills. Problem-based learning is an educational process that allows for exactly what I have been describing above. No restrictions on access to information and primary emphasis on critical thinking and problem-solving skills.

Is such a student really at a disadvantage in the long term? Or, are they actually at an advantage? They may not be able to demonstrate the same level of rote regurgitation of facts and concepts on a standardized exam, but there is no reason that their analytical and problem-solving skills would suffer as a result. In fact, arguably, by being able to focus on the analytical and problem-solving skills and rely on computer resources to retrieve facts and concepts as needed, they would be quite well prepared for their careers. Whereas the student who has been forced to spend the bulk of their time memorizing facts and concepts may be weak in analysis and not particularly skillful at searching and evaluating relevant information for their clinical cases.

To be clear,  I do firmly believe that in order to be expert in a specific area of practice, one must have committed a large amount of facts to memory. Relying on Google to access facts in order to practice is analogous to relying on a translation application when traveling in a foreign country. Think of the quality of the discussion that you can have under such circumstances and extrapolate that to becoming an expert practitioner. The evidence shows that students who study medicine using a problem based learning method do permanently memorize the essential facts by the time they begin to see patients independently. It is just that the method of permanently memorizing the facts is less focused on drilling and repetition and more on application in authentic contexts.  in a nutshell, if you don’t have a command of the facts of your domain of practice, you’re not an expert in that domain.

I’m not suggesting that we look the other way when people cheat. I just think it’s time we reconsider how people use what they learn in real life and adjust our learning and assessment expectations accordingly.