Slides I intended to present on November 11, 2014 at EMS World Expo. Due to severe weather in the upper midwest I was unable to fly to Nashville and present. The slides are provided to any attendees that may be interested in the content of this presentation.
2. Cheat Sheet
Don’t kid yourself
Cheating doesn’t have to happen
Reinforce the right things
Swift consequences
Prevention works
Change the battle
Test stuff that matters
17. Research about Cheating
“Nearly every research report
on cheating … has concluded
that cheating is rampant.“
Cheating on Tests: How to Do It, Detect It, and Prevent It
20. Cheating in School Student Reasons
1. Others are cheating
2. No honor code
3. Required courses
4. Heavy workload
5. No clear rules or consequences
6. Low risk of being caught and or punished
41. Academic Dishonesty
Cheating
Plagiarism
Deception
Fabrication
Impersonation
Bribery
Any attempt to give or
obtain assistance
Copying without proper
acknowledgement
Providing false information
Falsification of date,
information, or citations
Assuming another’s identity
Paying for information
or access
59. Discuss Academic Honesty
Scenario 1 Scenario 2 Scenario 3 Scenario 4
Sharing Falsifying
CE test
questions and
Incorrectly reporting
Wasting narcotics
without a witness
assessments or
attendance
treatments
answers
68. Values Education with I CARE
“The founders of the I CARE program
envision a world where individuals of all
ages understand the importance of ethics
and values as they pertain to a person's
character and through their actions
embody the values of Integrity,
Compassion, Accountability, Respect and
Empathy in their daily lives.”
70. Employee or Student Selection
• Behavior based questions
• Reference checks
• Past work performance
• Effective and secure entrance exam
• Inform of honor code
80. Write Better Questions
What is the average heart rate of a patient with
acute heart failure?
a. 80
b. 90
c. 100
d. 110
e. Who cares!
81. Write Better Questions
In 140 characters or less explain
airway management.
vs.
Demonstrate proper airway
management for this situation.
82. Test High Level Knowledge
Situation Mnemonics
analysis
Time Differentials
intervals
Drug Actions doses
based on
findings
Facts
Critique
performance
84. Importance of Connection
Less cheating…
• More interaction
• More connection
• More respect
• More knowledge
"Oldmech" by Dansan4444 - Own work. Licensed under Creative
Commons Zero, Public Domain Dedication via Wikimedia Commons -
http://commons.wikimedia.org/wiki/File:Oldmech.jpg#mediaviewer/File:
Oldmech.jpg
Cheating in EMS Education: How it Happens, Recognizing, and Preventing
Presented by Greg Friese, MS, NRP
Cheating, such as falsification of attendance records, obtaining exam question banks, and score modification, is common in EMS continuing education:
Agree
Neither agree nor disagree
Disagree
American Board of Radiology recalls on board exam
http://www.cnn.com/2012/01/13/health/prescription-for-cheating/index.html
Braindumps … types of websites that collect questions, exams, and more.
http://www.facultyfocus.com/wp-content/uploads/images/promoting-academic-integrity-in-online-edu1.pdf
Braindump…also a technique to move knowledge from your brain onto paper. A study habit. Write down everything you might know about a topic.
Selling class notes….student taken notes that are for sale to other students
http://www.flashnotes.com/ … “Online marketplace full of study guides, notes, flashcards, and video help created by students for students”
Also http://www.worldmag.com/2014/09/is_selling_class_notes_educational_entrepreneurship_or_academic_fraud
Scenario: Con Ed Article
Scenario: Online CE Completion
(Discouraging Academic Dishonesty in Online Courses)
Clinical Laboratory Sciences Program at Center for Allied Health Programs, Univ of MN
Students worked together on quizzes. Took online quizzes as a group. Used quiz for first person to determine right, wrong answers. Then all used the results.
Ask group how they would define cheating
Official definitions
http://dictionary.reference.com/browse/cheat
“representing someone else’s work as your own”
Cheating happens
Cheating on Tests: How to Do It, Detect It, and Prevent It summarizes the body of research this way.
"Nearly every research report on cheating -- whether the data were obtained by a carefully designed study, a survey of self-reported behavior, an RRT (randomized response technique) approach, or questionnaire regarding perceptions of cheating on the part of another -- has concluded that cheating is rampant.“
From http://www.newfoundations.com/PREVPLAGWEB/CheatingTrends1.html
Cheating on Tests: How to Do It, Detect It, and Prevent It summarizes the body of research this way.
"Nearly every research report on cheating -- whether the data were obtained by a carefully designed study, a survey of self-reported behavior, an RRT (randomized response technique) approach, or questionnaire regarding perceptions of cheating on the part of another -- has concluded that cheating is rampant.“
From http://www.newfoundations.com/PREVPLAGWEB/CheatingTrends1.html
http://www.schools.com/visuals/academic-dishonesty.html
From September 2011
More likely to cheat in life
Lie to a customer (patient)
Inflate an insurance claim (back injury)
Deceive their boss (out of service to re-stock)
Cheat on a spouse (arrive late for a shift, not re-stock ambulance, not waste a narcotic, not check gear)
Cheat on taxes (documentation, incident reports)
Cheating happens at all grade levels … elementary, secondary, and college.
May be most rampant at secondary level.
In college there is variation by major – most likely among business majors.
http://www.newfoundations.com/PREVPLAGWEB/CheatingTrends1.html
http://www.glass-castle.com/clients/www-nocheating-org/adcouncil/research/cheatingbackgrounder.html
Info from 1999, cheating background image
The results of the 29th Who's Who Among American High School Students Poll (of 3,123 high-achieving 16- to 18-year olds – that is, students with A or B averages who plan to attend college after graduation) were released in November, 1998.
Among the findings:
80% of the country's best students cheated to get to the top of their class.
More than half the students surveyed said that they don't think cheating is a big deal.
95% of cheaters say they were not caught.
40% cheated on a quiz or a test
67% copied someone else's homework
http://www.glass-castle.com/clients/www-nocheating-org/adcouncil/research/cheatingbackgrounder.html
Reasons:
Others are doing
No honor code
Low risk of being caught and or punished
Higher incidence at less selective institutions
Required courses
Heavy workload – academic and employment
No clear rules or consequences
[Insert picture of tech college or simulation manikin?
Higher incidence at less selective institutions, reason from http://www.glass-castle.com/clients/www-nocheating-org/adcouncil/research/cheatingbackgrounder.html
(Physician Assistant (PA) Students Attitudes and Behaviors Towards Cheating and Academic Integrity)
Using McCabes Survey of academic integrity
Students had been in a program for a few weeks to a year
90 respondents
Cheaters may not have responded
More than half older than 30
87% female
All had GPA > 3.0
(PA Students Attitudes and Behaviors Towards Cheating and Academic Integrity)
Using McCabes Survey of academic integrity
It would be good to have some agreement about what constitutes cheating
Would be a great project to replicate with paramedic students.
Cheating on the job…
http://www.washingtonpost.com/world/national-security/us-air-force-fires-nine-officers-following-nuclear-test-cheating-probe/2014/03/27/9e5eaffa-b5e0-11e3-b899-20667de76985_story.html
U.S. Air Force fires nine officers following nuclear test cheating probe
Promotional exams cheating
http://www.dallasnews.com/news/community-news/garland-mesquite/headlines/20140314-garland-accuses-former-fire-administrators-of-cheating-on-tests.ece
Two former Garland Fire Department administrators accused of cheating on promotional exams from 2009 to 2013 are being sued by the city for more than $1 million.
Former Assistant Chief Todd Peele, 43, and former Capt. Michael Cates, 45, are accused of using smartphones and hidden Bluetooth equipment to gain an unfair advantage over others who were testing for departmental promotions.
Accusations of cheating
http://jacksonville.com/news/crime/2014-03-03/story/jacksonville-fire-rescue-investigates-allegations-cheating-firefighters
Great reference material, likely applicable to allied health professionals
http://www.azbn.gov/documents/news/Statewide%20Educators%20Academic%20Dishonesty.10.05.07.pdf
http://www.fox5vegas.com/story/21198319/las-vegas-probing-cheating-in-fire-academy
Most recent … but this has happened elsewhere.
More
http://www.fireengineering.com/articles/2013/07/las-vegas-nv-firefighter-recruits-suspected-of-cheating-on-academy-exam.html
No specific research on EMS – at least that I could find.
Anecdotally we know it is happening as it is regularly in the news.
Can we generalize findings from other disciplines. I believe we can.
EMT and Paramedic students were once high school students. If cheating exists in nursing, radiology, engineering, business, etc it is present in EMS education.
Is it better, worse, same?
We need some research
http://www.bbc.com/news/uk-england-london-27503323
Access to the exam before the test.
Unable to find updated information on results of the investigation.
Poll: Which factor is mostly likely to lead to cheating...
Course costs
Peer pressure
Limited time
Poor quality of CE
Press F5 or enter presentation mode to view the poll
In an emergency during your presentation, if the poll isn't showing, navigate to this link in your web browser:
http://www.polleverywhere.com/multiple_choice_polls/DM1CJ6vJZOj6B3u
If you like, you can use this slide as a template for your own voting slides. You might use a slide like this if you feel your audience would benefit from the picture showing a text message on a phone.
[Use this slide if I am unable to use Poll Everywhere]
Which factor is mostly likely to lead to cheating?
Course costs
Peer pressure
Limited time
Poor quality of CE
http://www.examiner.com/college-prep-in-long-island/li-sat-cheating-may-lead-to-ny-law
People paid to take a test, false identification
Fraudulent IDs, paid test takes, high stakes exam.
Do you think an NREMT candidate has attempted to have a paid test taker?
I guarantee that someone has tried or at least researched what it would take.
http://nypost.com/2013/07/21/what-a-cheater-emt-offers-400-to-post-reporter-to-take-certification-test-for-him/
EMT posted ad to Craigslist:
“I am looking for a EMT-CC or Paramedic to take the state test for me. Must be a male age 40+ I will take care of the ID.”
Story broke July 2013
Instructor changes answers, falsifies records, provides questions and or answers, looks the other ways, mark students as in attendance even if they are not present
LA Times Investigation
http://www.latimes.com/local/california/la-me-county-fire-family-20141026-story.html#page=1
Family Members Beat The Odds In Winning Prized Firefighting Jobs
“Lists of questions and suggested answers for the formal interviews of applicants have circulated freely through the department's station houses, even though they are supposed to be kept under lock and key.”
The patient cheated death
I am going to show you a shortcut for remembering how to calculate this drug dosage
Use these mnemonics or acronyms to remember
Focus on test prep
Memorization of a sequence of steps
http://www.pinterest.com/pin/67905906855058342/
Or is this a job aide?
If it is a job aide we should be testing ability to use job aide, not the ability to recall the content of the job aide from memory.
“Cheat Sheet”
Also a potential conversation about “Practice Tests”
Don’t confuse cheating, cheat sheets, job aides, exam prep, and career success.
Student and preceptor discuss a skill they might have or could have performed on a patient such as applying CPAP or needle decompression of chest.
After thorough discussion of procedure preceptor signs off student as “completing the skill”
Change the scenario … this is the final skill the student needs.
Will have to keep doing clinical skills until complete.
Other potential scenarios … are you having these discussions with students and preceptors?
Say they did something they didn’t do – blood pressure, other skills
Receive signature from non-FTO and try to get credit later, or plead ignorance if confronted
Not reporting an error, mistake – intentional or unintentional errors
Previous scenario …
Ask to be “checked off” or “signed off” for skill discussed rather than skill performed
Broader term for a range of behaviors
http://en.wikipedia.org/wiki/Academic_dishonesty
Plagiarism: The adoption or reproduction of original creations of another author (person, collective, organization, community or other type of author, including anonymous authors) without due acknowledgment.
Fabrication: The falsification of data, information, or citations in any formal academic exercise.
Deception: Providing false information to an instructor concerning a formal academic exercise—e.g., giving a false excuse for missing a deadline or falsely claiming to have submitted work.
Cheating: Any attempt to give or obtain assistance in a formal academic exercise (like an examination) without due acknowledgment.
Bribery: or paid services. Giving certain test answers for money.
Sabotage: Acting to prevent others from completing their work. This includes cutting pages out of library books or willfully disrupting the experiments of others.
Professorial misconduct: Professorial acts that are academically fraudulent equate to academic fraud and/or grade fraud.
Personation: assuming a student's identity with intent to provide an advantage for the student.[1][2][3][4]
http://www.schools.com/news/most-common-cheating-charge-in-college-is-plagiarism-study-finds.html
Study found plagiarism was the most common cheating charge.
Survey of college presidents…55% say plagiarism has increased over the last 10 years.
http://www.washingtonpost.com/entertainment/books/jane-goodall-book-seeds-of-hope-contains-borrowed-passages-without-attribution/2013/03/19/448ad1f6-8bf3-11e2-9f54-f3fdd70acad2_story.html
(Academic Dishonesty PDF from AZ)
Taking, giving or receiving information – sharing test questions
Use of unauthorized materials or resources – browsing internet with Smartphone
Circumventing the processes – using a test taker
Ask audience for examples, based on types of cheating (Group’s Experience)
What have you tried, seen tried, or otherwise definitely know has happened?
http://www.glass-castle.com/clients/www-nocheating-org/adcouncil/research/cheatingbackgrounder.html
Making it tougher to define cheating
Plagiarism of information is easier
Question and answer sharing
Promotional exams
Certification and licensure exams
High Risk Behavior
Remember, radiologists, nurses, airplane pilots, college bound honors students are taking high risks on high stakes testing. EMS students are not significantly different
For the risks to be high students must know there are consequences and they have a chance of being caught
Cheating is tough to catch, prove, and actually lead to discipline.
Need evidence to suspect/accuse, need a policy that has actually been violated, then need to have a process to enforce policy, with consequences that make it worth the effort.
Culture encourages and rewards:
Group problem solving, group action
Creative and novel problem solving
Limited supervision in a highly decentralized work environment
Question Format Lend Themselves to Cheating
Google how to cheat on a test
“how to cheat on a test”
Technology makes it easy to find and share techniques, as well as changing how cheating happens and how it is monitored.
http://www.youtube.com/watch?v=tGhOYbPgETQ
YouTube, How to Cheat on a Test
It might be this easy …
Top 2 as rated by large group of nursing students as to what works …
Instructor announcing penalties for cheating
Asking students not to cheat
91 Ways to Maintain Academic Integrity
http://www.facultyfocus.com/wp-content/uploads/images/promoting-academic-integrity-in-online-edu1.pdf#page=12
(Academic Dishonesty PDF from AZ)
Starts with institutions and instructors
Role model academic honesty
Discuss
Honor code
Values education
Developing relationships
Emphasis on becoming a paramedic rather than passing certification exam
Testing – what is necessary to test and how do you test it?
– not copying 12 leads without attribution, not downloading YouTube videos vs. playing from YouTube, …
“Model Integrity” was noted as a step to instill an “academic honor code and integrity structure” in a K State (Kansas State) learning module for faculty. http://www.elearningfacultymodules.org/index.php/Academic_Integrity_vs._Dishonesty
Early in EMT class, paramedic class, or as CE module on “Ethics” have a scenario based discussion about honesty and cheating
Is this behavior cheating?
What are the impacts of this behavior?
What should the consequences be for that behavior?
Create really specific scenarios …
Poll: Does your program/organization have an academic dishonesty policy?
Yes
No
Don’t know
Press F5 or enter presentation mode to view the poll
In an emergency during your presentation, if the poll isn't showing, navigate to this link in your web browser:
http://www.polleverywhere.com/multiple_choice_polls/qEhO34my8dACVau
If you like, you can use this slide as a template for your own voting slides. You might use a slide like this if you feel your audience would benefit from the picture showing a text message on a phone.
[Use this slide if I am unable to use Poll Everywhere]
Does your program/organization have an academic dishonesty policy?
Yes
No
Don’t know
Might not even exist …. Can’t enforce if it doesn’t exist
Foothill College Paramedic Program
Incidence of cheating is lower in medical schools with an honor code (PA Students Attitudes and Behaviors Towards Cheating and Academic Integrity)
Honor code also helps students know what to do should they observe cheating (PA Students Attitudes and Behaviors Towards Cheating and Academic Integrity)
Imperial Community College District Allied Health
Honor code also helps students know what to do should they observe cheating (PA Students Attitudes and Behaviors Towards Cheating and Academic Integrity)
Imperial Community College District Allied Health
From http://www.ktc.edu/Portals/0/Documents/EMT/EMT%20Handbook%202014.pdf
A letter to students….
What students can expect from Professor Taylor and what Professor Taylor expects from students.
http://www.oakton.edu/user/4/pboisver/NewFaculty/LetterTaylor.htm
Needs to be failure to perform not for harm caused by failure to perform
Common notion that cheating is a victimless crime … no one is harmed.
Oddly there is also no benefit derived from enabling others to cheat.
Planet Money, Episode 531: The Tough, The Sweet And The Nosy, http://www.npr.org/blogs/money/2014/04/11/301493984/episode-531-the-tough-the-sweet-and-the-nosy
Get tough
Go after biggest cheats
Publicize widely to change perception that enforcement is widespread and likely to catch cheaters
Needs to be in your policy
http://www.icarevalues.org/
Vision Statement:
“The founders of the I CARE program envision a world where individuals of all ages understand the importance of ethics and values as they pertain to a person's character and through their actions embody the values of Integrity, Compassion, Accountability, Respect and Empathy in their daily lives.”
Re cheating “Integrity” and “Accountability” seem especially relevant
Courage…key value, differentiator. To live or act with integrity. Even when those around you are not. Or the courage to report wrong doing…narcotics diversion always happens with co-workers that know or suspect but don’t report (for many reasons, courage included).
http://www.academicintegrity.org/icai/assets/Revised_FV_2014.pdf
Honesty
Trust
Fairness
Respect
Responsibility
Courage
Admissions process can be used to screen for cheating experience and attitudes towards cheating … especially at paramedic level.
Behavior based questions
What did you do when a partner cut corners on rig check
Describe a time you witnessed or suspected cheating, how did you handle it.
Also time to inform of honor code (let cheaters self select out of program)
Might be pretty rare in actual paramedic courses
More common in other academic and general study courses
Habits developed in those courses will carry over to paramedic instruction
Prevention (some from http://www.schools.com/news/most-common-cheating-charge-in-college-is-plagiarism-study-finds.html)
http://www.plagiarism.org/plag_article_educational_tips_on_plagiarism_prevention.html
Define what it is. Many don’t understand what it is.
Give examples of intentional and unintentional plagiarism practices (search vs.. research, peer pressure, confusion about expectations.
Define proper citation practices
Provide clear/precise guidelines
Verify content with something like TurnItIn.com
University of Illinois Chicago Infographic
http://healthinformatics.uic.edu/resources/infographics/the-reality-and-solution-of-college-plagiarism-infographic/
University of Maryland University College
https://www.umuc.edu/students/academic-integrity/vail-tutorial.cfm
Nice part about online education is we don’t need to be experts on everything. We can let others teach…for example students could be assigned this course.
Are you reinforcing what you think you are reinforcing
Cutting corners
Reinforcement of behaviors
Consequences match severity
Drills
Functional exercises
Full scale exercises
Reward Learning over Completion
Team or Squad Learning
Group testing
Open resources (book, apps, job aids)
Time limits
Knowledge
Skill
Ability
Consider testing before training
Testing – what is necessary to test and how do you test it?
Do you need a test?
Completion might be enough
Educations (and students) should begin with the end in mind. If I know the questions are likely to be trivial knowledge retention I am unlikely to push myself to learn beyond the trivial.
These are also very easy questions to recall and share with others.
What is a better question?
In 140 characters or less explain airway management
Wide open, general, generic questions with no real expectation that they will be answered with any depth.
Guess what Greg is thinking, answer in as few words as possible, and then share that answer
Applying
Analyzing
Evaluating
A solution identified in http://www.elearningfacultymodules.org/index.php/Academic_Integrity_vs._Dishonesty
Especially well-suited to EMS as we have lots of building blocks between zero and megacode to assess students.
Use of frequent, low stakes/risk assessments puts less burden on students rather than a single, high stakes/risk assessment
Portfolios and Team Leaders. Success is a measure of accomplishment, rather than a percentage of correctly done contacts.
Use of multiple assessment techniques…. http://www.facultyfocus.com/wp-content/uploads/images/promoting-academic-integrity-in-online-edu1.pdf
Relationships matter.
There may be a correlation between interaction and cheating. More interaction less cheating.
There may be a correlation between institutional connection and cheating. More students are connected to institution less cheating.
There may be a correlation between instruction relationship and cheating. More students respect and know the instruction less cheating.
http://failedmessiah.typepad.com/failed_messiahcom/2013/11/haredi-rabbi-caught-cheating-on-emt-test-state-voids-results-of-25-test-takers-changes-test-123.html
EMT accused of photographing exam booklet.
http://nypost.com/2013/11/10/emt-tests-voided-due-to-cheating/
Dispute of this report
http://jpupdates.com/2013/11/10/sources-ny-post-grossly-inaccurate-emt-cheating-report/
(Academic Dishonesty PDF from AZ)
Clear test taking instructions – dos and don’ts for test taking
Room set-up, placement of students around the room
Provide any required supplies
Monitor
Video tape
Remove bags, books, coats etc
Disable all smart phones (and consequences for using)
Turn off wireless hotspot in classroom
Confiscate electronics
Change passwords and login verification frequently
These are 2 great products that made something we already had better.
I know one for sure is the handiwork of an EMS professional.
Bring the cultural aspects of ingenuity, mash-ups, making it work, group learning, innovation into the EMS training.
Need to add
[Update as needed]
[Update closer to presentation]
Me and what I do
My primary role is director of education for CLS
Have been involved and engaged in online education development, production, and use since 2004.
Variety of online education involvement:
Continuing education courses
Podcasts host
Blog author
Web videos
Microblogging
Cheating is a pervasive problem in society, ensnaring …. Match these three men with how they cheated.
Athletes and performance enhancing drugs – Ryan Braun (http://www.millerparkdrunk.com/baseball/brauns-big-day/) reigning NL MVP, TDF winner Flyond Landis and Alberto Contador, and many others
Politicians – Jack Abramhoff and Tom De Lay and many others (http://www.huffingtonpost.com/2010/06/23/jack-abramoff-pizza-shop_n_622635.html)
No profession is immune, mentioned MDs already. Cheating also found among Airline Pilots - http://news.google.com/newspapers?nid=1499&dat=19880805&id=s2saAAAAIBAJ&sjid=1ioEAAAAIBAJ&pg=1806,3582090
Relationships – spouses, we all probably know a couple that has cheating in their relationship – Arnie S (http://www.topnews.in/people/arnold-schwarzenegger)