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I would have removed this student from the exam, but I would have shown him that in a job that carries responsibility for human lives there is no cheating, but good sense and experience guarantee a safe and secure service. To consider whether he is ready to put his health in the hands of someone who has cheated on the exam and to answer me whether he would feel safe and secure and trust in the person who did it. I would give him a chance to re-apply, but under conditions to learn and in accordance with regulations
I work in healthcare and look at this issue from that angle, but I do not think cheating on the exam and later ignorance can leave serious consequences. Imagine building a dam where an ignorant engineer would overlook something very important that would cause serious damage and dysfunctionality, financial damage, and very likely consequences for people
First try to understand the reason and analyse the circumstances prompting him to do so. Find solutions to kill the influence of circumsatances. Best way to deal such students is changing their mind set, motivation and enhancing Self-Confidence.
I would make them understand the consequence of cheating, will make them understand cheating is only a temporary win and wont lead to a successful career in life.
I would personally control this one and will not let them cheat, by taking away cell or cribs
Whenever I see a pattern of cheating occur, I work on building a bank of questions for the next exam. From this, I construct at least two (up to four or five as needed) versions of the exam. I alert the students in advance that there will be different forms of the test and if they try to cheat that they will fail horribly. It does tend to work. Either they continue to cheat and fail completely or they learn to do their own work from then on.
It is a bit more labor intensive on my part, but ultimately solves the problem.