Academic Dishonesty in NP Programs

Nursing has topped Gallup’s honesty and ethics poll for more than two decades running, and the public tends to assume that trust extends to how nurses are trained. The International Center for Academic Integrity defines academic integrity as a commitment to six values: honesty, trust, fairness, respect, responsibility, and courage. In nursing classrooms, that commitment is being tested more than most people realize.

“I prefer the term academic integrity, but what we’re really talking about is preventing cheating,” says Dr. Christina Aplin-Snider, associate professor and FNP concentration coordinator at the University of Michigan-Flint School of Nursing. She’s taught in a fully online graduate nursing program since 2009, one of the first of its kind, and for years cheating wasn’t a visible problem. That’s changed as enrollment has climbed. “When I first started teaching in the early 2000s, I had maybe six students in a class. Now I have maybe over 100,” she says.

The numbers back up what she’s seeing on the ground. A 2024 cross-sectional study of 452 nursing students at two Saudi universities, published in BMC Nursing, found that 93.8 percent admitted to at least one act of academic dishonesty, with plagiarism the most common form at 55.3 percent. Research also increasingly links classroom cheating to what happens later in clinical practice, with direct implications for patient safety.

Keep reading to learn why academic dishonesty is rising in nursing programs, what schools are doing to deter it, and what Dr. Aplin-Snider wants students to understand before they’re the one holding the prescription pad.

Causes of Rising Academic Dishonesty

Dr. Aplin-Snider has watched cheating rates climb over her career, and her explanation is blunt. “The reason it’s growing is the quality of students is decreasing,” she says. “The students we used to see were hardworking, expected to put effort in, and didn’t expect to be spoon-fed things. This generation of students, and I’ve seen it for at least five years, maybe 10, they expect the faculty to do everything. They don’t expect to put forth effort.”

Part of the pressure, she says, comes from enrollment growth itself: “Academia is a business. The more students in the seats, the better off, the more successful the university is.” She points to grade point average (GPA) inflation as a related problem. GPA carries roughly 60 percent of the weight in her program’s admissions scoring, but a 3.5 GPA doesn’t mean what it used to. 

“Are we really looking at a 3.5 student? Are we looking at a 2.9 student who took AP courses?” Admission essays aren’t immune either. “Research tells us that they cheat on that too. At least 50 percent of them get help with that,” she says.

She also points to a specific cohort effect. Students who finished high school during the Covid-19 pandemic show measurable gaps, she says. “As a psychiatric nurse practitioner, I know there’s significant impact on those individuals who are finishing high school during Covid. They emotionall development and social development were stunted.” The pattern isn’t confined to nursing programs, either. Healthcare broadly, she notes, has never recovered the operating rhythm it had before the pandemic.

The Impact of AI on Academic Integrity

Artificial intelligence (AI) has become the newest front in academic integrity, and Dr. Aplin-Snider’s program has adapted rather than tried to ban it outright. Her university’s office of digital education brought in an expert to brief faculty, and the guidance was to not fight it, but to manage it. “You’re not going to be able to prevent the use of it,” Dr. Aplin-Snider says. “You need to incorporate it and put limitations on what students are able to do.”

In her pediatrics courses, she’s redesigned exams around that same logic. Students now take open-book quizzes on pediatric history and physicals, answering in short written responses rather than picking from a list, which forces them to look up the material and write it out in their own words. “That’s the other thing we have to think about in academia,” she says. “Are we just trying to catch students in situations of untruths, or are we trying to teach students? The ultimate outcome in this course, as should be every course, is teaching and learning.”

Nationally, AI use among students is already the norm rather than the exception. The Digital Education Council’s 2024 global survey of 3,839 students across 16 countries found that 86 percent use AI tools in their studies, and a 2025 Inside Higher Ed survey found that 59 percent of senior administrators believe cheating has increased since AI became widespread. Dr. Aplin-Snider is candid that AI has changed her own clinical work too. She uses an AI tool called Freed to draft visit notes during psychiatric appointments. “No longer am I typing all the time when I’m meeting with my patients. I’m actually focused on them,” she says. “It captures a better note than I could ever write.”

Even with AI reshaping how students study, she doesn’t expect exams to disappear from nursing education. “I don’t think we can ever fully move away from exams, because the endpoint for these students is passing a national board examination. There’s a test,” she says. “There are people that are excellent book learners that are lousy clinicians. That’s why we evaluate them clinically. But I think exams will always play a major role in medicine.”

Advice for Nursing and NP Students

Asked what she’d want nursing and NP students to understand about academic integrity, Dr. Aplin-Snider doesn’t hesitate: “It’s probably the very most important component of their studies,” she says. “If they’re not going to be honest with their learning, they’re going to be dishonest in other areas of their life. It’s really a barometer for their ethics, for their integrity.”

Not every student who makes it through a nursing program should be practicing, she adds, and that’s precisely the point of the training itself. “Not everybody was meant to be a nurse practitioner, and it’s our job to figure out who those people are.”