The National Board of Examiners in Optometry (NBEO) is investigating whether students and one faculty member at the New England College of Optometry (NECO) “engaged in an organized attempt to memorize confidential, copyrighted exam content in order to reproduce it for use by other students taking future administrations of the exam,” the NBEO posted on its website.

The NBEO refers to this as “piracy” of exam items.

NBEO’s Board of Directors determined that the widespread exposure of pirated items compromised the validity of the examination as a whole at NECO. As a result, the Board cancelled the test scores of the entire NECO class of 2011 for the Part 1 exam, which had been administered in March.

NBEO has also visited at least one other school of optometry as part of the ongoing investigation, says Jack E. Terry, O.D., Ph.D., executive director of NBEO.

Dr. Terry declined to name NECO, the NECO faculty member or the other school in question because the board is still conducting its investigation.

Nevertheless, a statement on NECO’s website confirms that it is the primary school under investigation. “We are working with the NBEO and will continue to do so until their work has been completed,” wrote NECO president Clifford Scott, O.D., M.P.H., in the statement.

During the course of the investigation, “NBEO investigators discovered that a substantial number of items from prior years’ Part I exams also had been pirated and that those pirated items were available and exposed to exam candidates at that same institution on a widespread basis via intranet posting and email circulation,” NBEO posted on its website. “Some of the pirated items came from students at other institutions, and the NBEO has extended its investigation to those institutions.”

Were the students deliberately trying to cheat, or had they memorized test items with the intention of putting together some kind of study guide for the exam? When did they cross the line? The answer: “When copyrighted material that belongs to the National Board is memorized and pirated in a deliberate effort with the intent to more focus on the items and much less just on the content,” Dr. Terry says.

The exam repeats about 10% to 20% of the same questions from year to year, Dr. Terry says. These questions—called anchor questions—are used to measure whether the test is comparable from one year to the next.

He adds that it’s unnecessary for students to create a “homemade” study guide because the National Board already offers so many different study aids, from content outlines to sample questions.

“For the credibility of the exam, the National Board really has no choice but to investigate it thoroughly,” Dr. Terry says. “The state boards use our assessments in making critical licensure decisions, and they take their role very seriously. Therefore … we take it very seriously. That’s why the Board is expending so much time and resources in the investigation. And we’ll continue looking into it until we’re satisfied we’ve come to a conclusion.”

In the meantime, students at NECO will be able to re-take Part 1 of the exam this month. “The NBEO Board of Directors understands and regrets the undeserved anxiety suffered by those candidates who took their Part I exams in honest, ethical fashion and who have endured the postponement of score release due to the requisite investigation,” NBEO says.

However, any candidate who is found to have participated in item piracy or other improper conduct will be barred from taking NBEO exams for an as-yet-undefined period of time as a penalty for the violation, and will not be eligible to re-take the Part I exam until such bar expires.

“I cannot emphasize strongly enough that the New England College of Optometry is committed to the highest standards of academic and professional ethics,” wrote Dr. Scott of NECO. “Our Ethics Policy is also an integral part of our student handbook, which students are expected to follow in all their academic pursuits.”

“What were they thinking? How could optometry students violate basic ethical principles, a stated ethics policy, and their signed student code of ethics agreement?” asks Michael G. Harris, O.D., J.D., M.S., an instructor of professional ethics at the University of California Berkeley School of Optometry. “Certainly, the students involved in the cheating scandal knew right from wrong. They knew that cheating was wrong. Yet they cheated anyway.”

Dr. Harris wonders whether students who violate a code of ethics should be permitted to continue with their optometric education. “Should they be allowed to become licensed practitioners and members of our profession?” he asks. “Would you be proud to have such individuals as members of our profession? What kind of a message would this send to our patients and our colleagues? Is this the image we want for optometry?”

Indeed, this scandal is not helping the public’s image of the profession. The investigation garnered national attention in a July 15 editorial in the Boston Globe. “The New England College of Optometry has a serious case of myopia,” the article said.

The notoriety came at an unfortunate time. In July, optometrists in Massachusetts had a scope of practice bill moving forward in the legislature that, if passed, would have allowed Massachusetts O.D.s to finally treat glaucoma. Massachusetts is the last remaining state in which optometrists are not permitted to manage or treat glaucoma. 

The glaucoma bill was more than a decade in the making, says Richie Lawless, director of communications and public relations for the Massachusetts Society of Optometrists (MSO). In late July, the state Senate passed the bill and it reached a committee in the House of Representatives—the last step before reaching the House floor for a vote. But the legislature adjourned July 31, before the House could vote on the bill.

“It got further than it ever got before this cycle,” Mr. Lawless says. The MSO plans to file the bill again when the legislature resumes in January. “We were optimistic this time and we’ll be more optimistic next time,” he says.

Looking to the future of the National Boards, what will be done to prevent another cheating scandal?

The exam format will change to prevent the memorization of items, Dr. Terry says. The exam will eventually become computer-based, so that the test can be totally randomized. This means that students at the same sitting will effectively take different exams.

Meanwhile, at NECO, “No matter the outcome of the NBEO’s inquiry, both the course [of Professional Ethics] and the [student] handbook will be reinvigorated to ensure that students fully appreciate their responsibilities in this area,” Dr. Scott wrote.