Accepted Manuscript

Title: Fraud and plagiarisim in school and career

Author: J.L. Agud

PII: S2254-8874(14)00078-2DOI: http://dx.doi.org/doi:10.1016/j.rceng.2014.03.002Reference: RCENG 942

To appear in:

Received date: 9-2-2014Accepted date: 16-3-2014

Please cite this article as: J.L. Agud Fraud and plagiarisim in school and career (2014),http://dx.doi.org/10.1016/j.rceng.2014.03.002

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Special Article

Fraude y plagio en la carrera y en la profesión Fraud and Plagiarism in the University and Workplace J. L. Agud*joseluisagudaparicio@yahoo.es Servicio de Medicina Interna, Hospital Severo Ochoa. Leganés. Madrid, Universidad Alfonso X. Facultad de Medicina Resumen Entre el 0% y el 94% de los estudiantes reconocen haber cometido fraude durante su carrera. Sus formas son diversas, engaños en los exámenes, suplantación en exámenes y trabajos, plagios, citas falsas o inventadas, presentación de resultados ficticios en experimentos, historias clínicas o exploraciones físicas, conducta desleal hacia los compañeros, y muchos otros. Entre las consecuencias del fraude en los estudios se encuentran el aprendizaje de la corrupción, los esfuerzos baldíos de alumnos y profesores, la evaluación incorrecta y la selección injusta para puestos de trabajo. Dado que las trampas en la universidad pueden ser el preludio de la corrupción de los futuros médicos o investigadores, revisamos la prevalencia, factores de riesgo, motivaciones, formas clínicas, detección y prevención de la enfermedad del fraude académico. Palabras clave: engaño; estudiante de medicina; plagio; falta de ética profesional; fraude académico; fraude científico. Abstract Up to 94% of university students acknowledge having perpetrated academic fraud. Its forms are varied and include cheating on examinations, submitting someone else's work as one’s own, plagiarism, false or invented citations, false reporting of experimental, medical history or physical examination results and unfair behavior towards fellow students. The consequences of academic fraud are the learning of corruption,

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useless efforts by students and faculty, incorrect evaluation of performance and unfair selection for jobs. Given that cheating in the university can be a prelude to corruption as doctors or researchers, we have reviewed the prevalence, risk factors, motivations, clinical forms, detection and prevention of the disease that is academic fraud. Keywords: Cheating; Medical student; Plagiarism; Professional misconduct; Academic fraud; Scientific fraud Within the student culture, one can well say that, in the same way that it is the obligation of all prisoners to attempt escape, the obligation of all students is to try to copy Juan Manuel Moreno in “El fraude en la educación” ("Fraud in Education”) Following an incident in which half of the papers handed in by student groups were plagiarized and the information sources hidden, the author reviewed the prevalence of academic fraud, its motives and the forms it takes, with a special emphasis on plagiarism. He analyzed the implications that fraud has on the training of students themselves and on society. He briefly reviews fraud in professional practice and research and its consequences and offers a number of methods to prevent, detect and tackle this “disease”.

The Purpose of Assignments The 2007 definition of university student competences requires “that students have the ability to gather and interpret relevant data [...] to express judgments that include reflection [...] can transmit information, ideas, problems and solutions [...] have developed those learning skills necessary for undertaking subsequent studies with a high degree of autonomy.”1

With group work, students learn to distribute the work and develop skills related to information seeking, synthesis and the presentation of findings, all actively and not as mere recipients. As we will see, the reality is very different.

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Frequency of Cheating Cheating is a part of biology. Harmless snakes mimic venomous ones so that predators leave them alone. “Cheating” bacteria sensitive to antimicrobials take advantage of the work of their beta-lactamase-producing companions to survive.2 Fraud is inherent to humans and is probably inevitable. Thirty-nine percent of Spaniards consider corruption and fraud the second most severe problem in their country.3 The tolerance of fraud worries them, but their culture, unlike others, stoically puts up with corrupt individuals and fraudsters. For example, the Chinese kept their students and candidates locked in individual cells to prevent copying, and if copying occurred, both the examiners and examinees faced the death penalty. However, there are data indicating that despite this, students continued to cheat.4

Cheating among Students Following a very serious incident in an American school of medicine, a survey was conducted of students and teachers to determine what behavior is considered fraudulent and the frequency of this behavior.4 Copying during examinations was the most common (around 20% of students and 18% of teachers were aware of it), but there were also other more or less colorful behaviors: the use of crib notes (19% and 17%, students and teachers, respectively); inventing test results in the patient rounds (18% and 33%); inventing sections in the physical examination that were not performed; impersonating colleagues in examinations; withdrawing books from the library so that their colleagues will not have access to them (4% and 8%); and plagiarizing work from previous years (detected by up to 6% of teachers). This study, like others, is limited by its dependence on an impossible to verify sincerity and by the voluntary nature of the survey responses. “Students, future researchers, copy complete articles from Wikipedia, fearless of the risk of antiplagiarism software, because they know that it is not applied systematically” (the italics are mine).5 A common trait of those who send duplicate publications to research publications is that they are young researchers with recent appointments. The

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pressure to achieve results likely induces individuals to cheating.5 In a recent survey performed during admission to Harvard University (perhaps the most prestigious in the world) in which 1300 students responded (81.2% of those questioned), 42% admitted to having cheated, 1 of every 10 admitted to committing fraud during an examination and 17% admitted to cheating in their homework. The survey was administered to a class of students four years older, and indicated that 7% had cheated during an examination and 7% had cheated on their homework.7 A recent review of the problem of fraud in the university8 showed that in a survey of almost 4000 students in 31 different universities, 62% admitted to having committed fraud. Another interesting but disturbing fact is that 13% to 24% of students admitted to having cheated in activities related to patient care. In Colombia, 94.4% of students admitted to having committed fraud during their academic life.9 In Spain, an anonymous survey that defined academic fraud as any illicit behavior by a university student concerning examinations or written works performed as a requirement for completing a course revealed that of the 250 students surveyed 149 (59.6%) admitted to having cheated at some point in an examination in the university, and 79 (31.6%) admitted to cheating in a written work.10

The Diversity of Fraud Guillermo Roquet makes a fairly accurate taxonomy of fraud with his definitions: inventing content; falsification; fictitious authorship; self-plagiarism or duplication; paid authorship; incorrect citation; missing citation; deliberate plagiarism; unintentional plagiarism; collage plagiarism (the copying of fragments from various sites and presenting them in a unified work as one’s own original creation); inappropriate paraphrasing; plagiarism by assignment (delivering the work of others); false citation; plagiarism by coincidence; invented citations; copying a translation; and, the one that affects us the most as teachers, copying and pasting.11

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Moreno, a professor at UNED,12 differentiates “epic forms” of fraud in which students rich with expertise make this knowledge available for the poor, just like Robin Hood. These involve certain risks for the “donor” and win admiration for their supposed altruistic nature. The “tragic forms” are considered less forgivable. These forms range from plagiarism, which is rarely sanctioned, to the changing of qualifications based on the trafficking of influence, which can result in prison sentences. “Lyrical forms” are those in which the student recognizes and exploits the teacher’s weaknesses in order to pass the course with the minimum of effort. Lastly, we have the “industrial forms” in which ghost agencies, companies, websites and universities offer a seemingly endless variety of ways to embellish the curriculum vitae of those willing to pay for them. 12 Federico Ignacio Talens-Alesson described the operations of an agency (www.AcademicKnowledge.co.uk) that offers already written papers. The company claims to have 3700 researchers and has different fees according to the type of study and the extent and urgency of the deadline. The author points out, rightly in my opinion, that the alleged benefits of continuous assessment adopted by Bologna, imitating the English-speaking world, do not take this reality into account.13

Risk Factors and Motives of Fraud Ordoñez in Colombia conducted interviews on the academic, personal and interpersonal motives and received the following responses.9 Academic: Too much work is requested (42%); the need to achieve good grades, regardless of the quality of the learning (26%); only memory is requested or the assessment lacks sense (12%); disinterest in some of the mandatory materials (20%); and a passive approach by the teacher towards fraud (28%). Among the personal motives, the author mentions laziness and irresponsibility (44%) and insecurity concerning the knowledge or study method (37%). Eighteen percent of the respondents considered that revealing fraud was not their problem. With regard to interpersonal issues, 60% of the students considered that solidarity, reciprocity and companionship encouraged fraud.

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Other studies have mentioned the following risk factors for fraud: having poor grades; a personality that is less self-sufficient, more neurotic, extroverted and overly ambitious; having done the work before; peer pressure; burnout; and the so-called “hidden curriculum” (activities that are part of the training, such as internships, in which there is obvious pressure on the student that leads the student to fabricate data).8 Moreno describes the concept of hidden curriculum thusly: “And perhaps nothing is done or little is done because fraud enters into the logic of the ‘system’, and to a large extent this is extra learning that the students have to perform, either as protagonists or spectators, because it will be enormously useful for their later life; learning about fraud and corruption is, unfortunately, the number one content of the hidden curriculum of civic education, which the educational system provides our students.”8 The author also mentions the value attributed to fraud as a defense mechanism against the arbitrariness perceived in educational assessments. In the student culture, all examinations are, by definition, unjust. The need to collect titles in the current meritocracy is also a powerful stimulant of fraud. This author sees a close relationship between fraud, the devaluation of the social perception of educational assessment instruments and the devaluation of specialized pedagogical knowledge.

Consequences of Fraud in Teaching and Research Learning corruption: “The school is the first ‘practice field’ for fraud and corruption and where we learn to legitimize such behavior.”12 In my opinion, this is the most undesirable consequence of the implementation and consent of cheating among students. As physicians, they might draft reports in which important complications are omitted, where the word “pus” does not appear despite its presence in the operating room or that have anonymous comments in the medical history, “so that my name does not come up in this controversial case.” Wasted efforts: Copying word for word does not help students at all. Their time could probably be better spent studying. For teachers, reading,

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detecting and discussing fraud with their students represents an investment of time and effort. Incorrect assessment: Continuous assessment seeks to better understand students. With assignment fraud, we might understand the student’s financial situation better (if they pay for the papers) or their inventiveness in finding remote and hidden sources, but it is hard for us to assess their comprehension of a topic. In group work, the detection of fraudulent behavior can also blemish the records of the entire group. Unfairness in the future selection of personnel: Given that the academic transcript counts in the final assessment of the selective resident medical intern tests, the varying tolerance to fraud by medical schools introduces inequality. In research, the consequences of fraud are immense.14-17 In addition to the notorious cases of falsified results in the cloning of human embryonic cells18 and the false relationship between the MMR vaccine and autism,19 there are many other skeletons in the closet for research fraud. The true authors of the discoveries are forgotten or relegated to poverty. Valuable space is taken up in publications to provide room for plagiarism, perhaps rejecting original research of much greater interest. In a pilot study of a plagiarism detection system, 3 important journals were obliged to retract 6%, 10% and 23% of the studies accepted for publication, respectively.20 Readers waste time reading copies, and resources are invested in reproducing results that were possibly fabricated. The social alarm, the false hopes raised among patients and the blocking of scientific progress are other undesirable consequences. Fraud in the exercise of the profession covers all aspects, from the falsification of titles, the invention of diagnoses, the implementation of unwarranted procedures (a single American cardiologist spent 12 and a half years in federal prison for performing 750 unnecessary catheterizations21) to the practically unlimited ways to inflate the invoice. The enumeration of the multiple aspects of fraud is beyond the scope of this chapter, but there are books22,23 and organizations such as the National

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Health Care Anti-Fraud Association (NHCAA)21 that are unmasking these forms of fraud.

Proposed Solutions Although the “recycling” of material itself has its proponents, in the sense that it is good to spread ideas provided they are scientifically valid, current and not copied from another author without attribution,24 duplication is considered harmful and should be combated. In research, there is extensive literature on how to combat fraud, ranging from the use of applications that detect matches in the text, applications that important journals are increasingly employing,20 to peculiar proposals to make blacklists and a type of card with points for researchers.14 Ober provides 5 simple rules, which are summarized in Table 1 Table 1.25

Kusnoor and Falik have issued the following proposals to fight fraud8: Define what is inappropriate behavior. Care for the wellbeing of students to avoid burnout. (Anderson also requests that students be integrated into the social fabric of the institution).4 Enforce honor codes, but define the consequences for violating them; for example, defined expulsion or sanctions. An English student who copied during a final examination but who was ultimately exonerated triggered a bitter debate in the British Medical Journal, echoing the negative consequences for the profession that tolerates this action.26 It is important to establish a culture of integrity with leadership, planning and incorporation of changes. Anderson proposed that teachers and students participate in discussions about ethical values in the profession.4 Report incidents and standardize the response to them. Emphasize learning and de-emphasize assessment.4

Plagiarism in Student Assignments Table 2 Table 2 lists a number of issues to discuss with students to combat plagiarism. Humberto Macías Navarro analyzed fraud in a website and recommended the following27: Preven t ion Review all presented material (but, as he sarcastically says, take into account that “If they are

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given more work than is humanly possible to review, don’t be surprised if the prose of an essay is filled out with Ave Marias.”). Get to know the students. Know the information sources. Manage information technology (“technophobia is not an option for teachers”). Personalize the work content. Perform the research before they do. Give very specific and clear instructions on the structure of the work. Request a synthesis of understanding more than extensive information. Schedule assignments with sufficient time. Demand honesty and transparency. Anticipate cases of fraud and its consequences. Detec t ion Review all material with discussions and ask for details about the work (“it is uncommon for a mother not to know the details of her baby”). Review the stated sources. Assess the required continuity and structure. Warning signs include incongruity, missing citations and references, changes in writing style, irrelevant information and comments and a disproportionate preparation time for the extent of the work. Advocate talking with students. Search for similar studies on the Internet (Humberto Macías Navarro already mentions the legendary “Rincón del vago” [The Slacker’s Corner]) and assess other aspects apart from the work presented. Roquet insists that students have to learn to credit authors and quote correctly. To avoid copying and pasting, the author proposes that students be asked specific questions, develop summary tables and give their personal point of view, as well as other strategies that require individual work.11 In my recent experience with students reported in this article, I have insisted more on the anomaly of hiding the source more than the fact of copying the information. Detec t ion techno logy As with Job, “the Web giveth and the Web taketh away.”28 The simplest detection method is to enter (within quotes) a phrase or fragment of the student’s writing. Plag ia r i sm de tec t ion webs i tes There are numerous sites, but many of them are not free. Some measure the percentage of similarity between documents (for example, Collusion by

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Nimisis, http://es.nimisis.com/software/collusion.php); others detect whether an article has been copied (Copyscape, http://www.copyscape.com). There are websites that offer solutions to the problem of copying (www.plagiarism.com) and databases that store information on plagiarism (plagiarism.org). However, this technology can also be used to cheat. Anderson described how copycat authors pass their text through a plagiarism detector and insert changes until the system stops indicating a match.14 Universities should make an effort to implement use these applications and instruct teachers in their use. I do not believe that the solution lies in requesting students, in the age of electronic medical records, to hand in handwritten assignments. With regard to assessment and given that the academic transcript is vital, group work should have the signatures of the various parties and should be scored separately and collectively, to mitigate the damage by the shameless on the other parties’ transcripts.

Conclusion Fraud is a ubiquitous phenomenon in everyday life. It is taught and learned. We have dissected it in a very specific setting (medical education), with the hope of contributing to better standards of behavior for future doctors.

Conflicts of Interest The author declares that he has no conflicts of interest. Acknowledgements The author would like to thank C. de Dios Perrino and J.M. Agud for reviewing the manuscript and for their valuable suggestions. References <BIBL> <BIB> 1 AT Ministry of Education, Culture and Sports. Royal Decree 1393/2007, 29 of October, which establishing the establece the organization of university education, official

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JT Offical State Bolletin D 2007 P 44037 </BIB> <BIB> 2 S Yurtsev F E.A. S Chao F H.X. S Datta F M.S. S Artemova F T. S Gore F J. AT Bacterial cheating drives the population dynamics of cooperative antibiotic resistance plasmids JT Mol Syst Biol V 9 D 2013 P 683 </BIB> <BIB> 3 January 2014 barometer. Preview of results. Study no. 3011. 2014 [Accessed Feb 8, 2014]. Available at: http://ep00.epimg.net/descargables/2014/01/08/4db01d9dade70023d90267c0260b6b7c.pdf.). </BIB> <BIB> 4 S Anderson F R.E. S Obenshain F S.S. AT Cheating by students: Findings, reflections, and remedies JT Acad Med V 69 D 1994 P 323-L 332 </BIB> <BIB> 5 S Derby F B. AT Duplication and plagiarism increasing among students JT Nature V 452 D 2008 P 29 </BIB> <BIB> 6

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Top universities by reputation 2013. TSL Education Ltd., 2013 [Accessed Jan 12, 2014]. Available at: http://www.timeshighereducation.co.uk/world-university-rankings/2013/reputation-ranking </BIB> <BIB> 7 S Conway F M.R. S Mendez F C. AT Freshman survey part III: Classes, clubs, and concussions JT The Harvard Crimson 2013 September 5 D 2013 </BIB> <BIB> 8 S Kusnoor F A.V. S Falik F R. AT Cheating in medical school: The unacknowledged ailment JT South Med J V 106 D 2013 P 479-L 483 </BIB> <BIB> 9 S Ordoñez F C.O. S Mejía F J.F. S Castellanos F S. AT Percepciones estudiantiles sobre el fraude académico: hallazgos y reflexiones pedagógicas JT Rev Estud Soc V 23 D 2006 P 37-L 44 </BIB> <BIB> 10 García Pérez E, Manchado B. Un modelo econométrico del fraude académico en una universidad española. Universidad Complutense de Madrid; 1998 [Accessed Feb 4, 2014]. Available at: http://eprints.ucm.es/6672/. </BIB> <BIB> 11 Roquet G. Fraude y plagio académico [Acceso 12 Ene 2014]. Available at:

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http://www.slideshare.net/guillermoroquet/fraude-y-plagio-acadmico-2011-roquet.2011 </BIB> <BIB> 12 S Moreno F J.M. AT Con trampa y con cartón. El fraude en la educación, o cómo la corrupción también se aprende JT Cuadernos de Pedagogía V 283 D 1999 P 71-L 77 </BIB> <BIB> 13 Talens-Alesson FI. El proceso de Bolonia (I): evaluación continuada y fraude estudiantil [Acceso 12 En 2014]. Available at: http://bolonia-fraude-estudiantil.blogspot.co.uk/2014/01/el-proceso-de-bolonia-i-evaluacion.html </BIB> <BIB> 14 S Garner F H. S Pulverer F B. S MaruSic F A. S Petrovecki F M. S Loadsman F J. S Zhang F Y.<ET-AL> AT Science publishing: How to stop plagiarism JT Nature V 481 D 2012 P 21-L 23 </BIB> <BIB> 15 S Reyes F B.H. AT El plagio en las publicaciones científicas JT Rev Med Chil V 137 D 2009 P 7-L 9 </BIB> <BIB> 16 S Zaenker F K.S.

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AT Editorial [The emperor of all academic and cultural maladies in scientific writing: plagiarism and auto-plagiarism] JT Inflamm Allergy Drug Targets. V 11 D 2012 P 1-L 2 </BIB> <BIB> 17 S Errami F M. S Hicks F J.M. S Fisher F W. S Trusty F D. S Wren F J.D. S Long F T.C.<ET-AL> AT Deja vu--a study of duplicate citations in Medline JT Bioinformatics V 24 D 2008 P 243-L 249 </BIB> <BIB> 18 S Kennedy F D. AT Editorial retraction JT Science V 311 D 2006 P 335 </BIB> <BIB> 19 S Rao F T.S. S Andrade F C. AT The MMR vaccine and autism: Sensation, refutation, retraction, and fraud JT Indian J Psychiatry V 53 D 2011 P 95-L 96 </BIB> <BIB> 20 AT Plagiarism, pinioned JT Nature V 466 D 2010 P 159-L 160

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</BIB> <BIB> 21 National Health Care Anti-Fraud Association (NHCAA) [Acceso 7 Feb 2014]. Available at: http://www.nhcaa.org/resources/health-care-anti-fraud-resources/the-challenge-of-health-care-fraud.aspx </BIB> <BIB> 22 S Wanjek F C. BT Bad medicine. Misconceptions and misuses revealed, from distance healing to vitamin O PL Hoboken, New Yersey PN John Wiley and Sons, Inc D 2003 </BIB> <BIB> 23 S Goldacre F B. BT Bad science PL London PN Fourth Estate D 2008 </BIB> <BIB> 24 S Miller F N.R. AT Checking for plagiarism, duplicate publication, and text recycling JT Lancet V 377 D 2011 P 1403 </BIB> <BIB> 25 S Ober F H. S Simon F S.I. S Elson F D. AT Five simple rules to avoid plagiarism JT Ann Biomed Eng V 41 D 2013 P 1-L 2 </BIB> <BIB>

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26 S Smith F R. AT Cheating at medical school JT Br Med J V 321 D 2000 P 398 </BIB> <BIB> 27 Consejos para evitar plagios y fraudes escolares (y otras plagas similares) [Accessed Jan 12, 2014]. Available at: http://www.tij.uia.mx/~humberto/fraude_escolar.html </BIB> <BIB> 28 S Barrie F J.M. S Presti F D.E. AT Digital plagiarism--the Web giveth and the Web shall taketh JT J Med Internet Res V 2 D 2000 P E6 </BIB> <BIB> 29 S Fischer F B.A. S Zigmond F M.J. AT Educational approaches for discouraging plagiarism JT Urol Oncol V 29 D 2011 P 100-L 103 </BIB> </BIBL> Table 1 Rules to Avoid Plagiarism 1. Do not copy. 2. Use your own words. 3. When in doubt, quote. 4. Do not recycle figures, tables or text from

one of your previous publications without citation.

5. Ask permission. Modified from Ober et al.25 Table 2 Consequences of Plagiarism 1. Plagiarism is theft.

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2. It harms the interests of those who wrote the original, denying them the credit they deserve.

3. It limits learning. 4. It can lead to suspension or expulsion. 5. It can limit future professional

possibilities and lead to the loss of certification.

Abbreviated from Fisher y Zigmond.29