Journal of Health Specialties

: 2017  |  Volume : 5  |  Issue : 4  |  Page : 181--184

The practice and attitude towards plagiarism among postgraduate trainees in Saudi Arabia

Abdullah E Kattan1, Feras Alshomer1, Abdullaziz K Alhujayri1, Faisal Alfaqeeh1, Yasser Alaska2, Khwlaa Alshakrah3,  
1 Department of Surgery, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, KSA
2 Department of Emergency Medicine, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, KSA
3 Department of Medical Student, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, KSA

Correspondence Address:
Feras Alshomer
Department of Surgery, King Khalid University Hospital, 37, P. O. Box: 7805, Riyadh 11472


Introduction: Plagiarism is 'The wrongful appropriation or purloining and publication as one's own, of the ideas, or the expression of the ideas'. It is the most commonly committed research misconduct with the prevalence of 2%. Its effect can be devastating and damaging to science, indicating the need to recognise and curb such an act. Methodology: A cross-sectional survey was distributed to in-training residents from all specialities in one academic hospital using the attitude towards plagiarism questionnaire. Results: A total of 221 physicians in-training participated in this study. 52.2% were males and 47.5% were females. About half of the respondents (48.9%) had attended a medical writing course, 45.2% published manuscripts and 67% had attended courses in medical research ethics. Respondents had a mean positive attitude towards plagiarism score of 29.56 ± 6.81, indicating an inclination towards plagiarism. Moreover, the mean negative attitude towards plagiarism score was 26.26 ± 3.78, indicating the tendency towards diminished tolerance of plagiarism. Furthermore, subjective norms score showed a mean value of 24.84 ± 5.47, representing an inclination towards personal approval of plagiarism practice in society. No strong correlation was found between attending research ethics course and plagiarism. However, we found that having a previous publication or attending medical writing courses was significantly associated with positive leaning towards plagiarism. Conclusions: Despite having had courses in medical writing, research ethics and/or published a scientific manuscript before; we still found a positive lean towards plagiarism. This emphasises the importance of tackling such behaviour by increasing the level of awareness among trainees to avoid such misconduct.

How to cite this article:
Kattan AE, Alshomer F, Alhujayri AK, Alfaqeeh F, Alaska Y, Alshakrah K. The practice and attitude towards plagiarism among postgraduate trainees in Saudi Arabia.J Health Spec 2017;5:181-184

How to cite this URL:
Kattan AE, Alshomer F, Alhujayri AK, Alfaqeeh F, Alaska Y, Alshakrah K. The practice and attitude towards plagiarism among postgraduate trainees in Saudi Arabia. J Health Spec [serial online] 2017 [cited 2017 Dec 17 ];5:181-184
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Plagiarism defined as 'The wrongful appropriation or purloining and publication as one's own, of the ideas, or the expression of the ideas' is a serious behaviour that could endanger the scientific literature and affect the integrity of scientific publications.[1] Plagiarism interrupts the reward system in science and corrupts the research ethics by denying credits to those who deserve it.[2] Studies have estimated that around 2% of authors do not attribute the ideas they used to their original owners, instead present them as their own.[3] This makes plagiarism the most commonly committed unethical act among other academic writing frauds.[4] Thus, the prevalence of plagiarism still remains an area of interest. Baždarić conducted a systematic screening of submitted medical manuscripts in 2009 and observed an 11% rate of plagiarised manuscripts over 2 years.[5] In a medical field, research misconducts such as plagiarism might lead to serious outcomes exhibiting a negative effect on the related science and therefore patient care. Thus, integrity and originality of published medical literature need to be examined carefully for any flaws.[6] Different factors such as, language barrier, lack of moral ethics for intellectual properties and diminished awareness about what plagiarism includes, have shown to be associated with increasing trend of such practices.[6],[7] Being caught and punished, however, was found to be the most important factor affecting cheating according to Buckley et al.[8] In this study, we evaluated residents in-training from different disciplines examining both, the attitude and practice towards plagiarism. By this, we can obtain a baseline view for further enhancement in the education process of future practising physicians.


A cross-sectional survey was distributed randomly and anonymously to 221 residents in-training from different specialities in one academic hospital from 1st of August until 15th of October 2016 using the attitude towards plagiarism (ATP) questionnaire. This ATP questionnaire is a validated tool containing 29 questions divided into three main sections; positive attitude towards plagiarism, negative attitude towards plagiarism and subjective norms towards plagiarism assessing medical faculty's trends towards plagiarism.[4] A five-point Likert scale was used in the questionnaire for each of the questions on which a score from 1 to 5 was given (1 for 'Strongly disagree' and 5 for 'Strongly agree'). Twelve statements reflecting procedures that participants will do to self-measure positive attitude, with a score range of 12 - 60. Score ranges between 12 and 28 indicate low tolerance towards plagiarism. Seven statements to measure disapproval of plagiarism in the negative attitude section, with a score range of 7 - 35. High scores were associated with no tolerance to plagiarism with a range between 27 and 35. Finally, 10 statements reflect recognition and acceptance of plagiarism practice in subjective norms with score range of 10 - 50. Score range of 10 - 23 indicates low subjective norms with personal disapproval of such practice in society [Table 1].[4],[7]{Table 1}

After the IRB reviewed and approved our proposal to conduct the study, an electronic version of the questionnaire was distributed through (an online, validated electronic service managing electronic surveys). Surveys were submitted unmodified and in English as it is the main language in local practice. The surveys were sent weekly for 4 weeks utilising the postgraduate residency email database. Exclusion of duplicates was assured through assessment of electronic IP address. Statistical analysis was performed using SPSS software version (Statistical Product and Service Solutions, SSPS Inc., Chicago, IL, USA). Student's t-test was used to assess associations of the participants' ATP scores and the variables set in the questionnaire. One ANOVA test was performed between different scores and level of training and speciality. Results are expressed as means and standard deviation. A value of P < 0.05 was considered statistically significant.


A total of 221 residents in-training participated in this study. Among the screened sample, 52.2% were males and 47.5% were females. Participants from the 1st year of training represented the majority of respondents with 51.6% followed by 2nd, 3rd, 4th, 6th and 5th year of training (16.3%, 14%, 13.1%, 3.2% and 1.8%, respectively). Majority of the respondents attended Emergency Medicine residency training (22.2%), followed by Internal Medicine (13.6%) and Family Medicine (11.8%) training. Plastic surgery residents represented (4.5%) of the screened physicians in-training. Nearly half (48.9%) of the respondents had attended a medical writing course and about 45.2% of them had published a medical research manuscript. A considerable number of respondents (67%) had attended courses in medical research ethics.

Analysis of different categories of the ATP ® survey was performed. Respondents to the positive attitude towards plagiarism section had a mean score value of 29.56 ± 6.81. Analysis of respondents' view of the negative attitude towards plagiarism section showed a mean score value of 26.26 ± 3.78. Finally, assessment of respondents to subjective norms towards plagiarism section showed a mean score value of 24.84 ± 5.47. Further interpretation of the ATP ® survey sections showed no significant difference between the level of training with positive and negative attitude scores. A significant difference in subjective norms towards plagiarism section was found, however, between 3rd and 4th year residents with mean scores of 26.52 ± 7.29 and 22.24 ± 4.67, respectively (P = 0.037).

Attending medical writing course showed a significant difference between those who attended the course and those who did not in their positive attitude towards plagiarism score values with (P = 0.021), whereas no significant association was found between the other ATP ® survey sections. In addition, respondents who had previous publications were also significantly associated with positive attitude towards plagiarism score values (P = 0.001) but no significant correlation was found with other ATP ® survey components. Interestingly, no significant associations were found between the different ATP ® questionnaire sections and attending research ethics courses.


ATP ® questionnaire is a validated tool developed as a standard means to explore the attitude of different populations towards such an ethical dilemma. The questionnaire was established on the basis of Ajzen's theory, in which planned behaviour accurately predicts a person's expected conducts through attitude and intentions towards the examined issue. The questionnaire contains three parts; one assessing the approval of plagiarism (positive attitude), then the disapproval (negative attitude) and finally, the social and normative components that could alter one's belief towards the issue (subjective norms). The validation process of the questionnaire using principal component analysis showed >0.70 reliability levels.[4]

Our respondents had a mean positive attitude towards plagiarism score of 29.56 ± 6.81, indicating a moderate attitude and inclination towards plagiarism being away from low score levels. Moreover, the mean negative attitude towards plagiarism score was 26.26 ± 3.78, indicating the tendency towards diminished tolerance of plagiarism. Furthermore, subjective norms score assessment showed a mean value of 24.84 ± 5.47, representing a moderate level with an inclination towards personal approval of plagiarism practice in society. Several studies have examined such issue utilising the same evaluation tool.

In Pakistan, ATP ® survey assessment showed an overall positive leaning towards plagiarism in about 85.3% of the faculty members (n = 95) and 55% of the screened students (n = 421).[9] Similarly, a Romanian study examining 150 medical students also showed an overall positive inclination towards such practice.[10] On the other side, in Croatia, a study that included 144 students from the faculty of pharmacy and medical biochemistry was set to examine the ATP and it showed that 90% of the participants had a generally negative ATP by agreeing that such act would negatively affect the investigator's spirit. However, two-thirds of them felt that plagiarism was not a serious issue and will not affect science.[7]

The effect of attending medical research ethics or medical writing courses and having previous publications was examined in different studies for its relation to plagiarism. Rathore et al., showed that medical students who received medical writing training had an overall negative behaviour towards plagiarism, whereas those who received research training did not show a difference. In addition, an overall positive ATP among faculty members was seen, even though, most of them had received previous training in both medical writing and research ethics.[9]

Since the aforementioned studies used the ATP ® and interpreted their scores, each in a different manner, we could not directly compare our absolute results against theirs; however, we listed their interpretations for the readers [Table 2]. In our participants, similar points were screened for its effects on the obtained ATP ® survey components. No significant correlation was found if the participant had attended a medical research ethics course. Interestingly however, having a previous publication or if the respondent attended medical writing courses, it was significantly associated with an overall moderately positive leaning towards plagiarism. Such finding indicates a serious issue that needs to be to addressed and tackled.{Table 2}

Plagiarism is a serious form of misconduct affecting the integrity of medical literature. The true prevalence, however, is of relevance. A study conducted in 2009, screened manuscripts submitted to the Croatian Medical Journal for plagiarism and it reported an 11% rate of plagiarised manuscripts over 2 years using an electronic software for plagiarism analysis as their tool.[12] Different reasons were shown to be associated with higher ATP which includes lack of awareness in research ethics and writing,[13],[14] knowledge of avoiding plagiarism,[15] poor language or language barrier [11] and finally distinctive cultural influence.[16]

Plagiarism can take different forms in which intentional and unintentional forms were described. Intentional types were shown to include mosaic plagiarism, idea plagiarism, text plagiarism and finally, self-plagiarism.[17]

Recently, with the advancement in technology and information systems, the Internet has become a major source of plagiarism with easy access to different lectures and manuscripts. In exploring plagiarism using information technology (IT), undergraduate students generally reported leaning towards intellectual property violation, contrary to when IT is not used. With the use of IT means, students reported that it is more acceptable for them to cheat than others. When no such technology is involved, these results take the opposite direction. This has led to emerging efforts to introduce ethics of using IT systems in the students' curriculum that can help reduce this issue.[18] The use of such utility in the same time is a major tool to eradicate plagiarism.[6] Many web-based and commercial software are currently available with fees or without fees for checking and cross-screening different manuscripts for related contents to help detect plagiarised content [17] such as; Turnitin,[19] iThenticate,[20] Plagiarism detect,[17] CrossCheck,[21] Plagiarism Checker X,[17] Plagiarisma [17] and eTBLAST.[22] The utility and availability of such service among different institutes could help decrease this problem.[23]

Awareness and teaching ethical principles were found to be effective in controlling plagiarism.[24] Others have investigated the utility of behavioural manipulation through instructional courses, which showed the potential ability to avoid such acts.[25] Universities and teaching institutions' adoption of clear and at the same time strict policies against such acts of plagiarism are also required to diminish this incidence.[1] Strict implementation and understanding of such policies by academic tutors is necessary to affect students' behaviour and acknowledging plagiarism as an unethical act.[26]

This study was conducted in a single centre which is among the limitations of this article, however, larger scale assessment could further help estimate the true prevalence of such an issue. Keeping this in mind, we have shown a serious matter in which further efforts are needed such as: awareness campaigns, leaflets, rules and regulation, including potential penalties directly related towards plagiarism.


This is the first study that aims to assess the tendency of local plagiarism practice in Saudi Arabia. Our assessment showed a generalised tendency to plagiarise even if a respondent had received courses in medical writing, research ethics and/or published a manuscript. These findings signify the need for proper education at earlier levels about the definition, practice and effects of plagiarism and how it can have devastating impacts on the literature and ways to avoid it. Lack of plagiarism detection tools plays a significant role. Many institutes and journals have implemented these platforms to cross-check assignments or submissions in order to help detect and eradicate such an act.

Financial support and sponsorship

The study was supported by the College of Medicine Research Center, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia. This study was approved by the Ethics Committee at the Medical College of King Saud University.

Conflicts of interest

There are no conflicts of interest.


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