Perceptions of Research Integrity Among Medical Researchers in Shanghai Teaching Hospitals: A Cross-Sectional Survey

Research integrity has become a pressing concern in China, which accounts for a large share of global retractions. Yet little is known about how research integrity is understood and enacted within teaching hospitals. In this cross-sectional study, we surveyed 106 medical researchers across four Shanghai hospitals to assess their awareness, attitudes, and practices regarding scientific misconduct, as well as the role of integrity education. Most respondents reported familiarity with definitions of fabrication, falsification, and plagiarism and expressed strong disapproval of these behaviors. Nonetheless, 11%-22% indicated some degree of tolerance toward selective reporting or unjustified authorship, and firsthand reports of witnessed misconduct were uncommon. Participation in formal courses or lectures on research integrity was associated with higher knowledge scores and stronger agreement with ethical principles. These findings reveal a tension between high awareness and partial tolerance, highlighting the importance of exploring how institutional cultures and incentive systems may influence ethical behavior in future research and policy efforts.