Importance of integrity in nursing
Data from the annual Gallup Honesty and Ethics Poll (2025) demonstrated that nursing is ranked as the #1 most trusted and honest profession. Results of this same survey placed Nursing at #1 for 23 years in a row. But why is it so important for nursing to be a trusted profession? The nurse is a member of the largest group of healthcare providers, and the nurse is the only healthcare provider who provides high-level care for patients 24/7/365. The nurse must be able to recognize subtle changes in patient condition prior to an emergent event taking place. All other healthcare disciplines rely on the nurse for a patient’s continuity of care. It is critical that patients and family members are able to trust their nurse.
The International Center for Academic Integrity (2021) stated that academic integrity is “a commitment to six fundamental values: honesty, trust, fairness. respect, responsibility and courage…the fundamental values serve to inform and improve ethical decision-making capacities and behaviour”. Students acquire knowledge and skills while in school, but they also develop an understanding of the “values, attitudes, beliefs and responsibilities of a profession” (Tomlinson & Jackson, 2019, p. 886). Identity formation and professional socialization while in nursing school were shown to be critical to impacting behavior in future employment as a nurse, and instances of academic dishonesty could potentially translate to unethical behavior in patient care (Lynch et al., 2022). The American Nurses Association (ANA) Code of Ethics for Nurses (2015) states that the nurse has the responsibility to preserve wholeness of character and integrity.
Throughout a nursing program, nursing students work toward the ability to apply clinical judgment in patient care, leading, potentially, to success on NCLEX®. Academic dishonesty, a behavior that could occur repeatedly by the same student, can lead to the inability to pass NCLEX® due to disruption of the important work of learning and applying knowledge. If a student’s focus is on academic dishonesty, it is not on learning.
There are several types of academic integrity violations including cheating on tests; plagiarizing the work of others; placing intellectual property, such as tests or other materials, on study/quizzing websites; fabrication or falsification; and collaborating on an assignment that is not meant for collaboration. Students use a variety of methods to cheat on tests in both the in-person and remote environments. Props such as smart glasses are making their way into the mainstream testing environment, as well as more conventional methods of cheating such as writing information on body parts, candy/gum wrappers, water bottles, hats, and clothing.
Counteracting cheating on tests is possible, but it requires rigorous proctoring practices. In the in-person testing environment, proctors must enforce testing policies such as not allowing students to wear hats or have anything on their desk. They should also circulate the room throughout the test so that students may be observed from behind. In the online environment, a monitoring service should be utilized, keeping in mind that these monitoring services are not foolproof. The best solution for online testing is that students should be expected to take tests in a testing center. For both in-person and online testing, a lockdown browser must be installed on the testing computer to prevent students from clicking out of the testing screen.
Other types of academic integrity violations should be taken as seriously as cheating on a test. Faculty should uphold academic integrity program policies that address these violations and students must be held accountable.
Academic integrity violations can be prevented by assuring that students have ample time to complete an assignment or prepare for a test. Faculty should be available to meet with students who have questions about an assignment or anxiety about an upcoming test. Faculty should avoid placing too much weight on a single test or assignment (Meazure Learning, 2023).
It is critical that faculty are supported by leadership when acting upon violations of academic integrity if action on a suspected violation is within policy and documented clearly and objectively. Strong policies must be in place to address any type of academic integrity violation and prevent a “culture of cheating”. Faculty must assure that any action on a suspected violation is within policy (Meazure Learning, 2023).
Nursing faculty and leadership need to keep in mind that it is not fair to those students who do not engage in academic dishonesty if they are in a class with those who do engage in academic dishonesty. The primary focus of nursing education must be educating students who will provide excellent patient care and uphold patient safety within a culture of trust.
