Examining the attitude of nursing students of Gilan University of Medical Sciences towards academic dishonesty, neutralizing behaviors, nursing ethics codes and commitment to ethical care in 2010-2018.

statement of the problem

Today, ethics is the focus and center of many developments in the current world. Humanity goes through different periods to have a rational and moral approach in meeting its material and spiritual needs. For this reason, ethics can be considered the focus and center of developments in the future world. This approach mostly affects the disciplines that are leading in providing services to humans. Nursing profession is one of the sciences that has many exemplary ethical aspects in the past, present and future. Nursing ethics is a branch of medical ethics that has been influenced by the developments in this field. The developments of the current world include features that have made the need for an ethical approach in medical professions an undeniable necessity ([i]).

The nature of health services that deals with the valuable issue of preserving life and improving its quality and eliminating or reducing disease and disability in general and the field of nursing in particular is compatible with this trend and idea in service management. In other words, it can be said that the foundation stone and the original principle in providing nursing care worthy of today's society and the future world is the training of nurses who have professional ethics ([ii])

Despite all the emphasis that has been placed on the need to prioritize ethics over any other phenomenon, what is currently observed in practice is doubt about the professional qualifications of nursing and other fields related to health ([iii]). Despite the growing and dynamic nursing system, there is a need for nurses with professional qualifications who can provide good and ethical care. This requires that nurses, in addition to having appropriate functional skills, have a high ability in moral reasoning and effective communication with the patient ([iv]).

Nursing is providing care to needy clients, which requires the existence of an element of ethics as an integral part in all aspects of providing these services. Moral care is a universal need, because it is an important part in providing nursing care. Commitment to ethical care [1] is defined as the core of nursing values ??and shows the degree of concern for the patient and the level of respect for the patient's personality during nursing care. The importance of commitment to moral care is such that it sometimes surpasses the technical aspects of nursing work. This point is not just an impression and feeling that is caused by human nature and his tendency towards good character, but it is a logical issue, because paying attention to ethics in self-care will require continuous learning and doing good deeds ([viii]).

In order to achieve this goal, we need to increase the ability of nurses in ethical matters, this ability is essential for nurses. For many years, ethical codes (confidentiality, respect for patient rights, honesty, etc.) have been developed in the world, and this shows the importance of ethics as one of the main elements of nursing ([ix]) Valuing ethical care in the nursing profession has brought nurses to the highest level of standards and their attitude and philosophy leads them to ethical commitment and accurate performance to support patients, but what exists as a fundamental challenge on the way to achieving commitment to ethical care is the existence of a phenomenon called scientific dishonesty[2]. is And according to the definition, it is any form of dishonesty that occurs in connection with official academic activities. Scientific dishonesty in the form of copying, forgery, destruction, etc. It has become a long-term challenge in higher education centers and for teachers, and its existence has been proven in many studies ([x]). Scientific dishonesty has become a growing phenomenon from the pre-student period to the student period, especially in nursing schools. Scientific dishonesty has become an acute issue for contemporary scientific centers, as it has been the subject of more than 100 researches in the past 30 years. ([xi])..

According to McLafferty[3], every profession has a sacred purpose and honesty is an essential part of that profession for survival and progress. As a result, the issue of scientific dishonesty is a vital issue for professions because it reflects the growing concern about ethical problems in the world of work. Among all professions in the world, nursing is one of the most honest professions. In a census conducted in the United States in 2003, nursing had the highest ethical standards and work honesty among 23 professions. At such a high level of ethical expectations, it seems that scientific dishonesty does not exist in nursing programs, while nursing students commit acts of scientific dishonesty without knowing it as dishonesty ([xii]).

Scientific dishonesty in scientific and clinical environments in related professions With health like nursing, it is very worrying because these professions affect the lives of other people ([xiii]). What worries nursing educators is that nursing students suffer from scientific dishonesty both in the classroom and in clinical environments (6) and this is because the moral behaviors of individuals in the workplace are correlated with their moral behaviors as students (7). Since the basis of communication between nurse and patient is based on honesty and correctness, the issue of scientific dishonesty is a big challenge because nurses are in direct contact with patients (6). Scientific dishonesty in the classroom has potentially serious effects on patients because if students commit scientific dishonesty in the classroom, they will not learn the skills and knowledge needed to perform safe care in clinical environments. From a scientific point of view, if nursing enters the field without sufficient knowledge, critical errors can occur, despite the fact that the nursing profession has a high level of honesty, a significant percentage of nursing students exhibit scientific dishonesty behaviors.

    Bowers [4] (1964) showed in his research that 26% of students commit academic dishonesty during the exam session. McCabe and Trevino [5] (2002) conducted this research on students again in 1993 and observed that this time 52% of students committed academic dishonesty. Due to the similarity of the samples, it can be argued that the level of academic dishonesty among students has increased (7). On the other hand, it is the foundation of an effective evaluation structure and system on mutual respect and honesty. Students and instructors must treat each other with respect and honesty, which forms the basis for teaching, learning, and evaluation. The incidence of scientific dishonesty such as copying, lying, etc. It can destroy the trust of instructors towards students ([xiv]). The scientific dishonesty of nursing students can seriously reduce the professional standards of nursing work, damage the cohesion of the scientific community of nurses and weaken the quality of the health system. Educators should be aware of various forms of scientific dishonesty of nursing students. (4). Patterson and others [6] (2003) showed that the opinions of professors and students about the phenomenon of copying as a part of scientific dishonesty are different. While the professors consider this phenomenon to be the result of the student's moral failure, the students see it as a characteristic of academic centers. Also, students consider copying as an action according to the situation and not due to dishonesty (5). Most students are aware of the effects of scientific dishonesty in the clinical environment on patients, but they are not aware of the effects of scientific dishonesty in the classroom and its transfer to clinical environments ([xv]). Some educational centers use ethical codes [7] of nursing (care for patients, confidentiality, honesty in behavior, maintaining nursing values, etc.) to combat the phenomenon of scientific dishonesty among students (8) Codes of ethics are ethical values ??in scientific and clinical environments that are part of the training program of nurses and are a prominent sign of the nursing profession ([xvi]) Gold[8] and colleagues in their research 4 main concerns of nurses in the field of ethical care of patients are lack of confidentiality of nurses, lack of fairness in care From the patients, they have expressed the failure to maintain moral values ??in care, the inability of nurses to recognize the ethical problems of care and the correct way to face them correctly ([xvii]).