Students' perceptions of whistle blowing: implications for self-regulation. A questionnaire and focus group survey

The aims of this study are to gauge and use the views of medical students to elaborate on the concept of whistle blowing and to give an indication of its role in self-regulation.

An anonymous questionnaire survey was conducted among medical students from a Scottish medical school. Students were asked (i) whether they should, and (ii) whether they would report to faculty academic misconduct by other students. Comparisons were made between all five year groups. Subsequently students in focus groups were asked to give their reasons for whistle-blowing or not doing so.

Of the students, 40% felt they should whistle-blow, with 13% saying they would actually do so. The numbers of students who felt they should or would whistle blow were smaller in the later year groups. Focus groups identified positive and negative reasons for whistle blowing or not, and reasons connected to the process itself. Reasons given for not whistle blowing included camaraderie, retaliation by peers, self-preservation and a belief that it is not a student's responsibility to report the misconduct of others.

The results have two important implications. First, medical schools have to decide whether students have a duty to whistle blow and/or whether there is a need to devise clear procedures. Any procedures should take into account the reasons given for not whistle blowing, but should concentrate on positive motivating factors. Secondly the medical profession needs to consider the role of whistle blowing, as the results suggest that whistle blowing should not be the only method of detection of misconduct in an undergraduate setting.