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Cheating by Physician Assistant Students on Patient Encounter Logs

Purpose: Medical educators commonly rely on patient encounter logs to evaluate the adequacy of students’ clinical encounters. Anecdotally, most training programs that utilize logging systems encounter problems with student falsification of entries. However, despite a large body of work on medical student cheating, falsification of log entries during clinical rotations has not been researched. This project aims to survey a national cross‐section of recent physician assistant (PA) graduates regarding cheating on patient encounter logs in order to estimate the magnitude of the problem and potentially identify factors associated with cheating. The project was supported by a PAEA research grant. Methods: After obtaining local IRB approval, an anonymous paper survey was distributed in mid‐March 2007 to a random sample of 1,800 recent PA graduates, using mailing labels obtained through the American Academy of Physician Assistants. The survey was also available in Web‐based format. Results: The response rate was 31%. The majority of respondents reported completing encounter logs during clinical rotations (94%), and of those who completed logs, 63% reported that patient encounter logs were tied to grades or some other measure of student progress. More than half (57%) self‐reported some degree of cheating behavior themselves, and 90% of respondents reported cheating behavior in their classmates. Conclusions: Cheating on patient logs during clinical training of PA students is a significant problem, but one that schools may not be aware of, since 46% of graduates reported that their program did not check the accuracy of logs. PA educators need to take proactive measures to address this issue.