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This Online Supplement (OS) was inspired by a growing concern about ethical misconduct surrounding scholarship in our field of health professions education research (e.g., Artino Jr et al., 2018). In this OS we begin with authorship decision-making, as it is a publicly-facing and often very challenging aspect of research and scholarship. We see it as the “tip of the iceberg” for ethical research collaboration.

Within the context of academic health sciences there is high value placed on research productivity, resulting in a pervasive pressure to publish. Authorship has become the currency of the academic health professional. At the same time, research in academic medicine increasingly involves large teams of diverse collaborators. These teams often bring together members of multiple disciplines and roles – clinicians, educators, engineers, psychologists, sociologists – each with their own scholarly cultures, expectations and norms. Given this complex context for scholarly practice, being an ethical scholar is challenging; particularly in the practice of authorship.

Significant ethical lapses relating to authorship and publication have spanned from plagiarism to fraudulent research, causing harm to academic institutions, to the health professions, and to society. These major controversies impact the entire academic community, and individuals found guilty of such behavior experience negative consequences such as retraction of papers and forced resignation. But while academic scandals receive the most attention in the media and academic press, major ethical lapses are often predicated and enabled by systematic, minor ethical lapses, as evidenced in authorship. Pervasive, everyday unethical decisions go unacknowledged and unaddressed and contribute to a system that allows and perhaps rewards unethical behavior.

Consider the librarians, statisticians, coordinators, and research assistants who make significant contributions to research but are omitted from authorship lists. This type of ghost authorship is common in situations where there are disparities in experience and power. Equally concerning is the practice of gift authorship, where authorship is granted to those who played no significant role in the work. While these behaviours are clearly identified and problematized in the literature, too often they are ignored in practice. Gift and ghost authorship not only violate the principles of justice; they erode trust between the researcher and the public, and diminish the tenet of truth in health professions research.

Ethical authorship involves values such as truthfulness, trustworthiness, and fairness, enacted in everyday practice. And, like any complex practice, it is learned not only by acquiring facts but also through everyday practice, role modelling, and socialization. We hope this OS helps to prepare scholars in our field to both recognize and negotiate ethically important moments in their own authorship practice as well as train for the ethical enactment of the scholar role.


Artino, A. R., Driessen, E. W., & Maggio, L. A. (2018). Ethical Shades of Gray: Questionable Research Practices in Health Professions Education. bioRxiv, 256982.

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