Addressing Cheating in Online Testing

By Susan Sportsman, PhD, RN ANEF, FAAN

The Coronavirus pandemic has forced most nursing schools to increase their use of online testing, as we reported recently. As I talk to faculty around the country, I continue to hear concerns about the security and validity of online testing. How valid is this concern, and what can we do to mitigate it?

A 2017 study by Kessler International, a global computer forensics company, surveyed 300 college students from both public and private colleges and universities, including online entities (Mattmuller, 2017). The results revealed some interesting findings:

  • 86% said they cheated in some way in school.
  • 54% felt cheating was OK; some even said that it is necessary to stay competitive.
  • 97% of the admitted cheaters say that they have never been identified as cheating.
  • 12% indicated they would never cheat because of ethics.

I do not know how many, if any, of the respondents in this survey were nursing students, so the question might be asked, “Do these statistics represent nursing students?” Unfortunately, nursing research suggests that cheating in nursing programs is surprisingly common (Klocko, 2014; Allen, et al., 2017, Krueger, 2014). These findings—and our own personal experiences—suggest that nursing faculty must be concerned about ensuring academic honesty in online testing. Fortunately, technology is available to help. We’ll review some of the options here.

Learning Management Systems (LMS)

Commonly used learning management systems (LMS), such as Canvas, Blackboard, D2L, etc., provide options that reduce the likelihood that students will cheat on tests. For example, most online tools make it easy to randomize the order of questions and answers to prevent students from quickly sharing answers. The systems can also set a time limit to the test, which advantages students who know the material being tested. Keep in mind that some of your students may need additional time for accessibility reasons; this will impact your use of this technology. Time limits for some distance education students may also be problematic due to limited or “spotty” connectivity. Some literature suggests that providing different windows for the exam period may be a solution to this problem (University of Victoria, 2018).

The NLN Fair Testing Policy states in part that “tests and other evaluative measures are used not only to evaluate students’ achievements, but also to support student learning,” among other uses. Providing a review of the correct answer after completion of a test item or an exam provides such support. Many LMS platforms provide test-takers an opportunity to compare their choice with the correct answer. Unfortunately, some suggest that when feedback is given during a test, particularly when they are able to repeat tests, students may inadvertently be given answers to other test items. Choosing to not allow this review may reduce this potential. However, restricting the ability to see correct answers during the test does not remove the faculty obligation to provide a test review using other methods.

Lockdown Browser

Faculty can require students to use a lockdown browser, which is a custom setting that “locks down” the software that displays the test or quiz. Lockdown browsers prevent students from copying or printing questions or accessing other websites or applications (Hollister, 2020).

Keystroke Verification Software

When keystroke verification software is used in a testing environment, students type a short phrase which is then analyzed by a software program. The program assesses students’ typing speed, rhythm, and other personal characteristics to create a behavioral biometric data profile for each use. This software can be used when the test requires written text (Hollister, 2020).

Off-site Proctered Testing Sites

In the early days of online education, a common testing strategy was to require students to go to either an official or unofficial off-site testing center so that their tests can be proctored. The proctor was required to check students’ IDs, enter passwords if needed and watch them during tests. As online testing became more common, the use of artificial intelligence and machine learning was developed to use advanced technology to create a more secure exam environment.  Inside Digital Learning, a weekly newsletter on technological issues in higher education, found that at least 15 online proctoring companies were offering services to colleges and universities.

Digital online or e-proctoring

A variety of e-proctoring options are available, including:

  • Auto authentication – Before the exam starts, the student takes a photo of their ID and face, answers questions designed to validate their identity, and enters a biometric keystroke, usually the student’s first and last name.
  • Live authentication – As an addition to auto authentication, a live proctor does a facial comparison after the student validates their ID, answers questions, and enters a keystroke signature.
  • Automatic proctoring – After auto authentication, technology monitors the student’s environment for sounds, motions, and systemic changes that might indicate cheating.
  • Record-and-review proctoring – After auto authentication, the student taking the test is videotaped from the start to finish of the examination. A live proctor later reviews the video and provides feedback to the faculty.
  • Live Proctoring – After completing authentication, students are monitored by a live proctor who can identify potential academic dishonesty infractions as they occur (Hollister, 2020).

Live proctoring requires students to schedule the exam; if a human proctor is not involved, the exam can be scheduled any time. Online exam fees range from $7 to $15 per test for automated authentication for an exam proctored in real time by a person. Students may be charged the fee for each test, or raise students’ technology or general fees (Dimeo, 2017).

 Opposition to Online Proctoring

Administrators of online programs, as well as companies offering such technology, describe the advantages of the various approaches to online proctoring. However, not all students or faculty agree with this assessment. Social media is full of complaints about these approaches, including ethical issues associated with privacy (although companies involved in providing the proctoring state that they do not sell student data). Other complaints highlight the problem that poor and rural student lack sufficient access to high-speed connections and compatible laptops to take examinations online (Davis, 2020).

 Does Cheating in Nursing School affect Nursing Practice?

The information about ways to prevent online cheating within all academic disciplines suggests the notion that cheating is ubiquitous. The underlying message is that faculty should do their best to prevent various types of cheating, but it is unlikely to completely eradicate such negative behaviors.  As nursing faculty, we recognize the danger of students cheating during online testing. Receiving passing grades on any type of examination that does not reflect the students’ actual competencies may have significant impact on their success on the NCLEX or other licensing or accreditation examinations.

However, does cheating on tests impact their actual practice?

As an example of the potential problem, in 2014, Linda Krueger reported the results of a survey of 336 nursing students’ engagement in academic dishonesty and their attitudes towards various forms of academic dishonesty, as well as the prevalence of academic dishonesty in which they engaged and witnessed. More than half of the participants reported cheating in the classroom AND in the clinical setting. More troubling, a positive relationship was found between the frequency of cheating in classroom and clinical settings (Krueger, 2014). This study did not differentiate the environment of cheating, but it does validate our general concern about academic honesty in nursing education. While more research regarding the impact of online cheating is necessary, in this time of increased use of online testing, we must be mindful of the possibility of cheating and struggle with the ethical dilemmas that surveillance to prevent such behavior brings.

We will continue to consider these challenges in the CMC blog and would love to hear your experiences in dealing with these dilemmas.


Allen, C., Shaulene, S., Karozan, C.  (2017) Academic dishonestly among undergraduate nursing students.  International Archives of Nursing and Health.  3(3).

Daniels, N. (2020) Should students be monitored when taking online tests? The New York Times. May 12.  Accessed, June 2020.

Dimeo, J. (2017) Online exam proctoring catches cheaters, raises concern.  Inside Higher Ed.  Transforming teaching and learning. May 10. Accessed, June 2020.

Hollister, D. (2020) Deterring cheating in an online course.  Higher Education.  March 17.  Accessed, June 2020.

Klocko,M.N. (2014) Academic Dishonesty in Schools of Nursing:  A literature review.  Journal of Nursing Education. March. 53(3) 121-5.

Krueger, L. (2014) Academic dishonesty among nursing students.  Journal of Nursing Education.  53(2) 77-87.

Mattmuller, K. (2017) Survey shows cheating and academic dishonesty prevalent in colleges and universities.  CISION PRnewswire. February 6.  Accessed, June 2020.

________ (2018) How do I stop online students from cheating?  Learning and Teaching with Technology.  University of Victoria. Accessed, June 2020.

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