Questionable research practices are well-documented in biomedicine.

“But we have limited information about such behavior in our field of health professions education,” says Lauren Maggio, PhD, associate director for technology and distributed learning of the graduate programs in health professions education at the Uniformed Services University of the Health Sciences, Bethesda, MD.

Maggio and colleagues surveyed 590 health professions education researchers in 2017.1 “As educators and leaders in graduate programs, we wanted to determine which research characteristics and practice factors might explain the frequency of irresponsible research practices,” says Maggio. Some key findings include:

• Older researchers tended to report misconduct less. This may be in part because they have been involved in research for much longer, with more opportunities to act unethically. “And yet, our results suggest they do not [act unethically],” says Maggio.

• The strongest individual predictor of misconduct is publication pressure.

The greater the publication pressure, the greater the reported misconduct.

“Unfortunately, we were unsurprised by this. This is a finding that has been replicated in several other fields,” says Maggio.

• Researchers with more publications had higher misconduct scores.

• Researchers in Asia tended to have higher misconduct scores compared to researchers in North America.

• Those who defined their role as researcher showed higher misconduct scores than those of clinicians.

“We think our findings, which speak to the way in which research is conducted, have implications for all health practitioners, including hospital ethicists,” says Maggio.

The take-home message, Maggio says, is that misconduct and unethical research practices could seriously damage the quality of scientific work.

“We should be aware of the researcher characteristics and practice factors that explain the frequency of such irresponsible practices,” she adds.

Despite the known prevalence of questionable research practices, it is not actively discussed, says Maggio. This can exacerbate the problem.

Ethicists could help, suggests Maggio, “by raising awareness of and facilitating discussions on questionable research practices.”


1. Maggio L, Dong T, Driessen E, et al. Factors associated with scientific misconduct and questionable research practices in health professions education. Perspect Med Educ 2019; Mar 26. doi: 10.1007/s40037-019-0501-x [Epub ahead of print].


• Lauren Maggio, PhD, Associate Director for Technology and Distributed Learning of the Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD. Email: