Evidence map›Paper›PMID 42143336›Full record

ArticleBMC medical education2026

Institutional environment, academic attitude, and misconduct among medical students: a structural equation modeling and cluster analysis.

Peng Wang, Fan Li, Ji Li, Jian Yang

Abstract readMulticenter Study
In one paragraph

Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Peng WangSchool of Pharmaceutical Sciences & Yunnan Provincial Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China.
Fan LiYunnan Provincial Center for Drug Policy Research, Kunming, Yunnan, 650500, People's Republic of China.
Ji LiSchool of Pharmaceutical Sciences & Yunnan Provincial Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China.
Jian YangSchool of Pharmaceutical Sciences & Yunnan Provincial Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, Yunnan, 650500, People's Republic of China. yangjian@kmmu.edu.cn.

Funding

the Party Building Research Center of Kunming Medical University KYDJZX25217the Undergraduate Teaching Quality and Teaching Reform Project of Kunming Medical University, 2024 (Course: Clinical Pharmacokinetics) 2024KCSZSFXM022
6 · The paper itself

Abstract

backgroundAcademic misconduct poses a severe threat to scientific integrity and medical ethics. While gender disparities in misconduct are widely documented, the underlying cognitive mechanisms explaining why males are more susceptible, and whether a supportive institutional environment can buffer the risks associated with academic pressure and negative attitudes, remain underexplored in the context of Chinese medical education.

methodsA multi-center cross-sectional study was conducted across medical universities in Southwest China. Standardized assessments evaluating five core constructs, including academic misconduct, academic attitude, institutional environment, ethical climate, and academic pressure, were administered. Structural Equation Modeling (SEM) and K-means cluster analysis were employed to analyze the mechanisms and student profiles.

resultsFrom an initial cohort of 511 participants, 426 valid questionnaires were retained. The study revealed a robust gender disparity, with male students reporting significantly higher engagement in misconduct (β = 0.29, p < 0.001). SEM analysis demonstrated that Academic Attitude-operationally defined as utilitarian tolerance toward dishonesty-served as a critical mediator, accounting for 50.7% of the total gender effect. Contrary to the strict buffering hypothesis, the institutional environment did not significantly moderate the adverse effects of negative attitudes, partially due to severe range restriction in the highly-regulated sample. Furthermore, cluster analysis identified a distinct "High Misconduct-High Strain" phenotype (11.3% of the sample) characterized by high pressure, negative attitude, and prevalent misconduct. Notably, this group was disproportionately male (60.4%) and exhibited a behavioral phenotype consistent with moral disengagement.

conclusionThe gender gap in academic misconduct is primarily driven by utilitarian cognitive framings rather than behavioral inevitabilities. The limited buffering capacity of environmental factors challenges the reliance on external governance alone. To effectively mitigate misconduct, institutions should avoid over-educating the resilient majority and move toward targeted educational strategies. Interventions should prioritize non-universal cognitive restructuring specifically tailored for the identified high-risk subgroup.

Indexed as

Attitude of Health PersonnelProfessional MisconductStudents, MedicalAcademiaChinaCluster AnalysisClustering AlgorithmsCross-Sectional StudiesFemaleHumansLatent Class AnalysisMaleSex FactorsSurveys and QuestionnairesAcademic attitudeAcademic misconductCluster analysisGender disparityInstitutional environmentPrecision education

Identifiers

PMID42143336
PMCPMC13348506

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.