Studies have shown that nursing students are similar to other college students in their engagement in classroom academic dishonesty. However, because nursing students provide patient care, their dishonesty in the clinical setting may impact patient safety.

            A convenience sample of 241 diploma and baccalaureate nursing students were surveyed using a 76-item questionnaire to investigate the relationship between clinical academic dishonesty and (a) demographic variables, (b) nursing students' perceptions of unethical behaviors and (c) classroom academic dishonesty.

            Over half of participants reported they had engaged in clinical academic dishonesty.  Students who reported fewer weekly study hours were significantly more likely to report engagement in dishonest clinical activities that could result in felony charges.  The most frequently reported unethical clinical behavior was breaching patient confidentiality, followed by stealing hospital equipment, documenting client observations that were not made, and falsely calling in sick for the clinical experience.

            Students were least likely to agree falsely calling in sick for clinical experiences was unethical, followed by stealing hospital equipment, not questioning a physician order when in doubt, and not providing information to a client about treatment, medications, or recommended health behaviors.  There was a significant inverse relationship between participants' perceptions that a behavior was unethical and reported engagement in the behavior. Pearson R correlations revealed a positive relationship between engagement in clinical and classroom academic dishonesty. 

            Some unethical clinical behaviors seemingly reflect insufficient moral development.  To deter these behaviors, nurse educators must model exemplary behavior, help students correlate honesty to quality patient care, reinforce the legal and professional implications of the behaviors, and hold students accountable. Other unethical clinical behaviors reflect honest mistakes with dishonest follow-up. Nurse educators may deter these behaviors by emanating characteristics of mentors or facilitators, rather than evaluators expecting perfection.