Health fields fight cheating on tests

On the heels of cheating scandals that threatened the licensing process in three health professions, test administrators are striking back with novel legal strategies, Internet police work and a willingness to bar suspected cheaters from the professions.

The group that gives the standardized exam that is used to license physical therapists has filed federal lawsuits against four graduates who they charge logged onto an Internet chat room last summer and traded more than 100 questions that had been leaked from the standardized national exam.

The Federation of State Boards of Physical Therapy is claiming that the four, two from California and two from Florida, violated copyright laws.

The National Association of Boards of Pharmacy said it was preparing similar lawsuits against 15 foreign-trained pharmacists it caught trading 200 exam questions last summer on two Web sites -- one Indian, the other Korean. The association also has asked the FBI to investigate.

The National Board of Podiatric Medical Examiners and its testing agent, The Chauncey Group International, refused last summer to validate the scores of hundreds of students from four of the nation's seven podiatry colleges because of worries about cheating.

Chauncey attorney Keith Harris said some students traded exam material by e-mail while others had access to a study guide containing questions "remarkably similar" to those on the licensing test.

The scandals raise the question of how often students use inside information, usually from previous test takers, to pass exams and get licenses in technical fields.

"I see no reason it would affect one profession and not another," said Leon Gross, associate executive director of the National Board of Examiners in Optometry.

Gregory Cizek, professor of educational measurement and evaluation at the University of North Carolina at Chapel Hill, said cheating might be more prevalent on licensing exams than at other stages of the educational process. The stakes, Cizek said, are higher.

Now, testing organizations hope to discourage cheating by showing students how high the stakes can be. Gross said lawsuits against students, now rare, might become more common in the developing "arms race" between those who cheat and those who try to thwart them.

Copyright law typically is used to protects financial interests, such as a record industry that sues those who download music free from the Internet. Testing organizations said they had found a more compelling use -- protecting the public welfare.

"Downloading records is one thing. But you know, getting a shortcut to get a license to treat human beings is another one," said the attorney for the physical therapy federation, J. Kent Culley of the Pittsburgh law firm Tucker Arensberg.

Taking the problem public

William Hatherill, the physical therapy federation's chief executive officer, said an anonymous tip last summer led him to an Internet chat room where he found aspiring therapists trading questions evidently memorized and put into circulation by those who had taken the exam before. He said Matthew Estevez of Winter Park, Fla., gave his name and address, and offered to wash the cars of those who could provide exam material.

The federation sued Estevez on June 13 and three others last month. Estevez's attorney, Nancy Price, said her client participated in an online study group but did not trade proprietary information.

Carmen Catizone, executive director of the pharmacy association, said he suspended the educational equivalency exam for foreign-trained pharmacists for seven months after finding test material on the Korean and Indian Web sites. The test was given again, under heightened security, two months ago.

The group uses the exam to determine whether foreign pharmacists who want to work in the United States have educations equivalent to pharmacists trained here. After passing the equivalency test, candidates must take the licensing exam required of those who graduate from U.S. pharmacy programs.

In a sting, the association's security officers posed as foreign students and persuaded some of those trading questions to provide their names. Catizone said the association invalidated the scores of the 15 it caught, wouldn't permit them to take the exam again and wanted them barred from U.S. residency.

Like the physical therapy group, the pharmacy association believes that questions were leaked by those who had taken the exam. About 30 percent fail the first time, Catizone said.

Testing organizations must delete compromised questions from their "item banks."

Students fight back

The podiatry board and The Chauncey Group offered one installment of the profession's licensing exam during a three-day period last summer, and students made appointments to take the exam one of those days.

Harris, the Chauncey attorney, said a group of students at the Miami podiatry school held a meeting before testing began and agreed to circulate exam questions through a common e-mail account; the address was written on the blackboard. He said the plan enabled students who took the test earlier in the three-day period -- perhaps the better students -- to help those testing later.

The board and Chauncey later learned about a similar e-mail arrangement at the New York podiatry school and about the study guides circulating in Cleveland, Miami and Philadelphia, Harris said. It isn't known who created the guide or how it traveled, virtually intact, from school to school, he added.

Harris said the board and Chauncey, not knowing how extensively the exam had been compromised, refused to validate any score from the four schools.

Thirty-three students from the Cleveland school went to federal court, and a judge's order forced the board and Chauncey to validate their scores.

The Cleveland judge's ruling prompted the board and testing agency to validate the scores of students from the Philadelphia school, according to Harris. While the study guide was found on campus, Harris said, investigators had no evidence of wrongdoing by individuals.

Cases in Miami and New York remain unresolved, and the students' scores have not been validated. Harris said the board filed a countersuit against the New York students, alleging copyright infringements.

The physical therapy, pharmacy and podiatry groups gave computerized exams, believed to be more secure than the traditional paper-and-pencil format because students can't steal a test booklet. But it's impossible to stop students from remembering what they saw on the test or keep them from discussing the exam later.

In an article last winter in the journal "CLEAR Exam Review," the optometry board's Gross called systematic memorization of test material an "invisible, silent adversary," and he warned that an entire exam might be pirated by a large, organized university class.

The physical therapy and pharmacy cases show the Internet can do just as much damage to a test, if not more, than the kind of organized effort Gross described.

Chat rooms can assemble groups of unlimited size at any time, without planning, for dissemination of test material around the globe. The material can float in cyberspace for years, and the test is further compromised each time it's given.

In the article, Gross predicted efforts to cheat and to stop cheaters would become more intense.

He said hackers might penetrate computer systems and steal tests. Or, perhaps, a camera inserted into a piece of jewelry or a cell phone with video capabilities, hidden in a restroom, might be the next weapon test takers use.

"As the cheating arms race evolves," he wrote, "the test center of the future may require candidates to pass through a metal detector."