The instructors do know, and have collectively taken a stripe off the class for messing around. It doesn't seem to have made a dent in the offenders particularly. Luckily, they will probably fail the national exams and not certify, or even better, they'll fail this course and not even make it to the national exams. What irks me most is these are the college kids who intend to go on to nursing and medical school. I'd like to know where they plan to practice so I can avoid those areas/hospitals.