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A high level of professional integrity is expected from healthcare professionals, and literature suggests a relationship between unethical behavior of healthcare professionals and poor academic integrity behavior at medical school. While academic integrity is well researched in western countries, it is not so in the Middle East, which is characterized by different cultural values that may influence students' academic integrity conduct. We conducted a cross-sectional study among health-professions students at a university in the Middle East to assess perceptual differences on various cheating behaviors, as well as to explore the reasons underlying the cheating behavior. A validated survey instrument disseminated among first and second-year undergraduate students resulted in 211 complete responses and this data was analyzed using descriptive and inferential statistics. Pearson's Chi-square/ Fischer's exact test was applied to test the association of various factors with academic misconduct. The major determinants of academic misconduct were investigated using Binary Logistic regression model. The conducted analysis and the results showed that preceding cheating behavior was the only factor significantly associated with cheating in the university (p < 0.001). No association was found between cheating behavior and age, college/major, awareness regarding academic integrity, or perception of faculty response. The reasons provided by students for cheating behavior were mainly academic workload and pressure to get a good grade. Various suggestions are made to enhance academic integrity among health-professions students including organizing workshops and events by the university to increase awareness and create an academic integrity culture, providing peer guidance as well as emotional and social support. Supplementary information: The online version contains supplementary material available at 10.1007/s10805-022-09452-6.
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