Education in the Health Professions

: 2022  |  Volume : 5  |  Issue : 2  |  Page : 46--52

Faculty perceptions on academic entitlement in graduate health professional students

Jill M Ellis1, Theresa A Bacon-Baguley2, Sango Otieno3,  
1 Department of Physician Assistant Studies, Grand Valley State University, Grand Rapids, MI, USA
2 Department of Physician Assistant Studies, College of Health Professions, Grand Valley State University, Grand Rapids, MI, USA
3 Department of Statistics, Grand Valley State University, Grand Rapids, MI, USA

Correspondence Address:
Dr. Jill M Ellis
Department of Physician Assistant Studies, Grand Valley State University, 301 Michigan St. NE, CHS 224, Grand Rapids, MI 49503


Objective: This descriptive study evaluates faculty perceptions of academic entitlement (AE) in graduate health professional students. Materials and Methods: A cross-sectional descriptive survey design was used. Demographic data and faculty perceptions on the prevalence of AE in physician assistant students using two validated surveys were collected. One survey assessed AE as a unidimensional construct, and the second used a two-factor scale to assess entitled expectations (EE) and externalized responsibility (ER). The EE subscale assessed student expectations of faculty, and the ER subscale pertained to student expectations of the educational system. Faculty were recruited via email. Survey data were analyzed using descriptive statistics. Results: One hundred sixty-eight faculty participated in the survey. On the Academic Entitlement Questionnaire and EE subscale score, faculty perceived high AE. They did not agree as strongly with items on the ER subscale. The highest AE perceptions were related to grades, professor roles, course delivery format, exam preparation, exam accommodations, and student responsibility to make up missed work. Faculty reported lower AE levels related to group work, university resources availability, consumerism, and professor knowledge. Conclusions: The sample population was well representative of graduate health faculty based on gender, ethnicity, race, age, years of experience, and tenure in education. Faculty reported high levels of AE in physician assistant students. Understanding faculty perception of students’ AE is essential because it can influence educators’ ability to create an environment for effective learning. Faculty should self-reflect and establish teaching strategies to mitigate AE and promote student learning.

How to cite this article:
Ellis JM, Bacon-Baguley TA, Otieno S. Faculty perceptions on academic entitlement in graduate health professional students.Educ Health Prof 2022;5:46-52

How to cite this URL:
Ellis JM, Bacon-Baguley TA, Otieno S. Faculty perceptions on academic entitlement in graduate health professional students. Educ Health Prof [serial online] 2022 [cited 2022 Oct 7 ];5:46-52
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There is a disagreement about the precise definition of academic entitlement (AE). A commonly accepted definition is a “tendency to possess expectation of academic success without taking personal responsibility for achieving that success.”[1] Students with this expectation assume that faculty will cater to their desire for academic success in unrealistic or unreasonable ways.[1],[2],[3],[4],[5],[6],[7],[8],[9],[10] Academic rewards typically take the form of higher grades or granting of extra credit.[1],[3],[4],[5],[7],[10],[11],[12],[13] Academically entitled students have a reduced sense of personal responsibility, or an external locus of control, to achieve success.[1],[2],[3],[6],[8],[9],[10],[11],[12],[14],[15],[16],[17] Externalized responsibility (ER), a component of AE, allows students to blame academic failures on outside factors, such as teachers, curriculum, universities, or educational systems, rather than internal factors, such as ability.[1],[2],[12],[18] Some authors state that student consumerism, or the idea that education is a commodity students purchase, is another aspect of AE.[5],[8],[9],[17] Others claim this is an underlying etiology for the development of AE but do not include it in the formal definition. Other definitions of AE separate the construct into academically entitled attitudes, as described above, and academically entitled behaviors, such as academic dishonesty or uncivil behavior.[4],[6],[7],[19] Others state that academically entitled behaviors result from AE but are not a required construct component. AE adversely affects multiple stakeholders, including students, faculty, and administration. Therefore, it is critical to understand the prevalence of AE to mitigate its effects.


AE has undesirable effects in a learning environment. AE is associated with maladaptive learning habits such as an extrinsic learning orientation focused on grades over learning and mastery, decreased ability to self-regulate one’s education, work avoidance, reduced test-taking effort, reduced self-efficacy in the learning process, and reduced academic performance.[4],[11],[16],[17],[19],[20],[21] Some academically entitled students engage in student incivility, generally defined as any action disrupting the learning environment.[1],[2],[3],[6],[12],[13],[17],[22] Students displaying high levels of AE and acts of incivility consume a disproportionate amount of faculty time, leading to increased psychological stress, burnout, and cynicism within faculty.[6],[13],[21],[23] In turn, faculty may become less engaged, less approachable, and less invested in the learning process.[6]

Academically entitled students also adversely affect faculty evaluations, which are essential for hiring and promotion decisions within many universities. Entitled students are inclined to rate faculty poorly when given an evaluation inconsistent with their expectation of academic success.[1],[13],[15],[16] This may pressure faculty to alter classroom policies and grading practices to cater to entitled students and avoid negative evaluations.[3] Over time, this leads to a breakdown in the integrity of the learning environment by prioritizing grades over learning, which can be a catastrophic error in medical education.[9],[13],[18],[19],[24]

AE is also associated with an increased risk of student attrition. Students with high AE tend to have low university satisfaction, poor academic performance, and a perceived lack of control over their academic success.[1],[5],[8] Additionally, students who possess AE are more likely to have adverse effects on their mental health.[4],[11] Moreover, these students become challenging to guide and advise through academic counseling offices.[8] These factors may interact, increasing the likelihood of students dropping out of university programs.

Given the consequences associated with the phenomenon of AE, it is vital to understand its prevalence. Students have indicated that labels of entitlement represent reasonable expectations university students should have concerning their education.[25] Multiple studies explicitly evaluating the prevalence of AE in university students have demonstrated low levels of AE.[4],[8],[12],[16],[17],[20],[21],[25] However, perceptions and anecdotal data from media, faculty members, and college administration indicate that many students on college campuses possess high levels of AE.[3],[4],[12],[13],[21],[23],[24],[25],[26] It is proposed that AE likely occurs in a vocal minority of students consuming disproportionate faculty time, university resources, and media attention.[12],[13],[21]

There is a dearth of literature on faculty perspectives of AE in health professional students. This descriptive study aims to evaluate faculty perspectives on the prevalence of AE in graduate health professional students. This information will help faculty teaching health professional students understand the issue better. It will enable them to engage in strategies to mitigate the consequences of AE in the learning environment.

 Materials and Methods

A quantitative cross-sectional descriptive survey research design was used to assess faculty perceptions of AE. The study was submitted to the University’s Human Subject Review Board and determined exempt (#20-056-H).

The study population was graduate health professional faculty. The sample population was drawn from faculty teaching in accredited physician assistant (PA) programs in the United States. A list of PA programs was obtained from the accrediting organization’s (Accreditation Review Commission on Education for the Physician Assistant) website. PA program websites were reviewed to obtain contact information for program directors for all PA programs with Accreditation-Continued status. Invitations to participate in the research were emailed to the program directors with a request to forward a study recruitment letter to all faculty currently teaching in their program. The recruitment letter contained a study description and a link to a survey in QualtricsXM.

The survey contained an informed consent document, demographic questions, and information about the faculty’s role in PA education. No identifiable information was collected. PA faculty perceptions of AE were obtained by administering two validated surveys. The first survey tool was the 15-item Academic Entitlement Scale developed by Chowning and Campbell.[1] The scale has two factors measured by two subscales: ER, or the level at which students externalize responsibility for their academic success, and entitled expectations (EE), or the level of student expectation for unreasonable or unrealistic accommodations to ensure academic success within the learning environment.[1] This scale was originally developed and validated in 1805 undergraduate students enrolled in an introductory psychology course at a public university.[1] The ER and EE subscales have high-moderate internal consistency (Cronbach’s alpha = 0.81 and 0.62, respectively). The scale has been used in subsequent studies to measure AE in undergraduate students.[2],[6] The second survey tool was the Academic Entitlement Questionnaire developed by Kopp et al.[17] The Academic Entitlement Questionnaire is an eight-item survey that defines AE as a unidimensional construct with five key facets.[17] Three facets related to an external locus of control, similar to the ER subscale in the previous survey tool.[1] The other facets related to the student’s desire to control their learning environment and role as consumers.[17] This tool was originally developed and validated in 2091 undergraduate students enrolled in a midsize university.[17] The Academic Entitlement Questionnaire measurement tool was found to have substantive, structural, and external construct validity as evaluated through confirmatory factor analysis and correlation analysis with external constructs related to AE.[17] This tool has been subsequently used to assess AE in undergraduate students of various disciplines.[22] These scales have also been combined to evaluate the presence of AE in graduate health professional students.[16],[20] Both tools were used in their original validated format in the current survey. Both tools use a seven-point Likert scale, which was subsequently collapsed to agree, neutral, and disagree during the data analysis. Both tools are available in the public domain. Survey data were analyzed using descriptive statistics.


Invitations to participate in the study were emailed to 178 PA program directors in January 2021. No verification of PA program participation was obtained; therefore, a program response rate was not calculated. One hundred sixty-eight PA faculty participated in the survey, and all consenting participants were included in the study. Data were not collected on the total number of surveys distributed by PA program directors; therefore, a faculty response rate was not calculated.

Faculty participants ranged from 27 to 77 years, with a mean age of 48.2 years (standard deviation [SD] = 10.7). The majority were female (68.5%), not of Hispanic, Latino, or Spanish origin (96.9%), and White (92.8%) [Table 1]. Faculty had varying years of experience in PA education, from minimal experience to greater than 15 years [Table 2]. The majority of faculty selected the “other” category for their tenure in education (51.0%). Specific responses for this category were not collected but could include various titles such as clinical affiliate, preceptor, lecturer, or instructor. Approximately 42% indicated they were tenured or on a tenure track, and the minority of faculty (6.6%) indicated they were adjunct or part time [Table 2]. The majority of study participants was primarily involved in the didactic phase of education (58.2%), with a smaller percentage engaged in both the clinical and didactic phases (33.3%) [Table 2]. As evident in [Tables 1] and [2], our sample was similar to national data in the 2019 Physician Assistant Education Association’s (PAEA’s) Faculty and Directors Survey.{Table 1} {Table 2}

Participants indicated that PA students had high levels of AE. They agreed with most statements on the Academic Entitlement Questionnaire[17] survey and the EE survey[1] [Table 3][Table 4][Table 5]. The majority of participants agreed with over half of the Academic Entitlement Questionnaire statements[17] (72.86%) and the EE subscale statements[1] (72.62%) [Table 3]. However, PA faculty tended to disagree with the ER subscale[1] statements, with 73.81% of participants disagreeing with over half of the statements [Table 3], [Table 6]. Faculty reported that PA students displayed the highest AE level regarding student expectations about grades, professor roles, course delivery format, exam preparation and accommodations, and student responsibility to make up missed work. Lower AE levels were perceived in the following areas: group work, university resource availability, consumerism, and professor knowledge.{Table 3} {Table 4} {Table 5} {Table 6}

High internal consistency was noted for each survey tool. Therefore, each subscale was collapsed into a single value for descriptive statistical analysis of various subgroups within the study. The raw Cronbach’s coefficient alpha was 0.91 for the Academic Entitlement Questionnaire, 0.83 for the EE subscale, and 0.85 for the ER subscale. Descriptive statistics were calculated for responses from study participants based on position within the PA program, faculty phase of involvement within the program, years of teaching experience, gender, and ethnicity [Table 7]. Race was not evaluated as a separate variable based on multiple responses from study participants, limiting the ability to separate subgroups. Response differences based on age were evaluated using bivariate correlational analysis. For each of the subscales, there exists a weak negative linear association with age, namely, Academic Entitlement Questionnaire[17] (r = −0.2169, n = 157, P = 0.0064), EEs[1] (r = −0.1756, n = 162, P = 0.0255), and ER[1] (r = −0.1805, n = 162, P = 0.0216).{Table 7}


The sample population was well representative of graduate health faculty based on gender, ethnicity, race, and age. A survey of all PA faculty shows the majority are female (68.0%), white (88.1%), not of Hispanic, Latino, or Spanish origin (93.0%), and have an average age in their 40s [Table 1].[27] The current study’s sample population demographic characteristics were also similar to a survey of allied health faculty who were primarily female (80.8%) and non-Hispanic whites (81.6%).[28] Allied health faculty varied in age from 20 to 79 years, with the majority between 30 and 59.[28] Therefore, even though a response rate was not calculated, the sample population had demographic characteristics representing the population of interest.

The sample population was also well representative of graduate health faculty based on years of experience and tenure in education. Comparisons with the PA faculty population were similar for this variable, although exact comparisons could not be made due to differences in response options between surveys [Table 2]. A study of allied professional faculty indicated that the years of experience ranged from zero to over 40, with most faculty having between 0 and 10 years of experience (71.5%). Tenure of allied health faculty also varied and included tenure track (28.3%), non–tenure track (24.4%), clinical track (22.8%), tenured (16.5%), and other (7.9%).[28] These data also support a representative sample population.

Study results indicate that faculty generally agree with statements indicating AE in graduate health students. Anecdotal evidence supports this finding. Media reports claiming university students have higher AE levels than previous generations abound.[3],[4],[7],[9],[12],[13],[17],[23],[24],[26] There has been minimal research, however, to support these claims. It was essential to more accurately characterize faculty perceptions of AE in students because this can influence the faculty–student relationship.

Faculty perceived the highest student AE in areas related to classroom management: grades, professor roles, course delivery format, exam preparation and accommodations, and student responsibility to make up missed coursework. This concept is vital for faculty to recognize, as steps can be taken to reduce AE and minimize its effects on graduate health students. It is helpful to remember that both faculty and students share a common goal in the learning process. Both groups strive to maintain high academic standards leading to highly qualified medical professionals. However, faculty and students may differ in their approach to achieving this goal, leading to difficulties in the learning environment. Unmet student expectations in the learning process may manifest as perceived AE by faculty.

Classroom management techniques can help align expectations. A clear delineation of course purposes, learning objectives, grading policies, and learner roles and responsibilities is critical.[1],[11],[14],[23] Explicit explanations of course purposes and how they fit into the program goals encourage a learning orientation in students instead of a grade orientation.[14] Student frustration arises when expectations are unclear or change throughout the learning process.[26] Expectations can reduce students’ perceived need to engage in negotiation throughout the course.[13]

Course management can also allow students to engage in course planning. Effective pedagogical strategies and incorporation of student suggestions may lead to a broader array of high-yield learning activities. Student involvement in course planning also allows faculty to understand and adapt to changing student needs while achieving overarching educational goals.[19],[24] However, faculty still need to critically appraise student suggestions as course changes can have positive and negative aspects.

Assignments should be structured to allow learners to become empowered in their learning. Students should clearly understand that personal effort will directly affect course performance.[11] Formative assessments throughout the curriculum can allow students to self-regulate, directly reducing AE levels.[2],[11] Faculty should provide adequate guidance for assignment completion while allowing for a growth focus enabling learners to stretch their understanding of each topic.[11],[26]

Grading practices must be transparent and designed to encourage self-reflection and growth. Lax grading practices prompt disengagement and detract from mastery learning, whereas overly harsh grading practices frustrate students.[26] Rubrics can help align student and faculty grading expectations.[13],[23] Additionally, students may find it helpful when faculty provide examples of outstanding work to guide assignment completion.[13],[23] Classroom policy regarding student grade discussions can be designed to minimize grade negotiation after assignments are graded. Lippman et al.[13] suggest that students assume some risk in grade negotiations. Classroom policy can require students to submit their requests for grade negotiation in writing and understand that regrades may result in a higher or lower grade based on further evaluation.[13]

Graduate health professions programs can expand efforts to reduce AE beyond individual classrooms by emphasizing overarching program goals and students’ professional development. Programs can embed milestone assessments throughout the curriculum to measure students’ ability to integrate learning across courses and over time.[3] These assessments foster self-regulated and independent learning skills. Additionally, faculty should model unentitled and professional behaviors such as participation in professional organizations and scholarly activities.[3],[19],[23]

Institutional efforts can also augment faculty efforts. The administration must support faculty and student needs while avoiding division between the two groups.[3] Universities should invest in faculty training and education to develop classrooms that encourage well-adapted learning practices and effectively address students’ AE behaviors when they arise.[3],[14],[29] Universities should also adopt a holistic approach to hiring and promotion decisions that do not focus predominantly on student evaluations.[13] This practice would allow faculty to make classroom decisions to foster the learning environment rather than cater to academically entitled students.

This study’s strengths include a sample adequate in size and representation. It is the first to quantify faculty perceptions of AE in graduate health professional students. Limitations include the inability to calculate program or faculty response rates. Additionally, demographic characteristics varied slightly from demographic information collected from the entire PA faculty population and allied health faculty, making some comparisons between the study sample and the population of interest difficult. However, the sample population is demonstrated to sufficiently represent the study population to provide helpful information. Participation bias could have influenced results because participation was voluntary, and participating faculty may have different opinions than faculty who elected not to participate.


Although this study found that faculty perceive PA students as exhibiting AE, it also opens the door to a dialogue of understanding and communication between faculty and students regarding expectations in higher education. Further research in this area could include other health professional students and qualitative study designs to understand the different perspectives between students and faculty. Additionally, research to evaluate the effectiveness of interventions to reduce the differences between student and faculty perspectives on AE would be helpful.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


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