This case study provides a summary of the processes incorporated, by both myself and my research colleagues, as we developed a questionnaire for measuring the incidence of engagement in academic dishonesty among medical and health science students in New Zealand and Nigeria. This process can be, and is being, applied to other educational settings. This process aimed to extend measurement from one specific cultural group to groups worldwide. In this case study, I refer to the design and development issues that occurred when applied to the New Zealand and Nigeria medical and health sciences educational contexts. The research collaboration, therefore, occurred between researchers in those two countries, with subsequent sampling from medical and health science institutions situated in each country. Research in New Zealand in the 1990s confirmed initial suspicions that engagement in academic dishonesty was widespread within this educational context. The extent and measure of this phenomenon were not standardized, and hence in 2010, we embarked on trying to develop a more reliable and valid measure. In 2014, our Nigerian colleagues decided to join this developmental process. In this case, I highlight the crucial stages of the ongoing research process and include my reflections on our successes and seemingly unending challenges.