Closed-book Tests Research Articles

Steering the medical maze beyond memorization: Harnessing the potential of open-book tests in medical learning

Abstract In the field of medical education, we have employed the closed-book test format as the standard approach for carrying out assessments for many decades. An open-book test in medical education is an assessment method wherein medical students are permitted to refer to learning resources during the examination. Thus, students do not rely primarily on their memory and understanding of the subject rather can access external resources to supplement their problem-solving and decision-making abilities. Even though multiple merits have been attributed to open-book tests, we must give attention to the time duration and the kind of references students can access during such tests. At this juncture, we must reiterate that we are not advocating that open-book tests should be introduced and they should replace the conventional closed-book tests. However, there is immense scope for open-book tests in medical education, and every medical institution must explore the scope and feasibility to introduce open-book tests within their settings.

A COMPARATIVE STUDY OF OPEN BOOK AND CLOSED BOOK EXAMINATION IN A MEDICAL COLLEGE IN NORTH INDIA

Background: It is generally accepted that open book examinations create an enriched environment, offering the student an opportunity to better understand and respond to a particular question. The purpose of the pre Aim Of The Study: sent research was to examine the testing effect with two types of tests commonly found in education: closed-book tests, the traditional method of testing students, and open-book tests, a method gaining popularity. A total of n=109 stude Material & Methods: nts of nal year MBBS participated in the study. A comparative analysis was made for a terminal examination between two papers of general surgery and allied specialties, one paper conducted through conventional method and other one through Open Book Examination. Results were assessed in terms of analysis of feedback form submitted by students and marks obtained. There was st Results: atistically signicant difference in terms of pass percentage between two groups as open book examination clearly surpassed conventional system by having a pass percentage of nearly 70% as compared to closed book examination with ~53%. Marks scored were also better in open book examination. Majority of the students were of the opinion that cheating was less common in open book examination and stress level was lesser, ascertaining open book examination to be a good practical tool for implementation of knowledge. An important consideration was time management which needs to be addressed. Majority of the students were of the opinion to have more open book examinations in future. Open book exami Conclusion: nation is an important tool for practical assessment of knowledge of students & it needs to be explored more for inducting it in our conventional system of examinations.

Assessing open-book examination in medical education: The time is now

As a result of the coronavirus pandemic, the feasibility of holding secure closed-book examinations in medical education is compromised. In this Personal View, we compare the underlying reasoning for using open-book and closed-book exams. We rethink the role of open-book assessment and offer ways in which we believe they can complement closed-book exams. We highlight the gap in research, highlight future directions, and call on medical educators to seize our current golden opportunity to explore the impact of open-book exams – on their own or combined to closed-book tests, as a blended approach – on learners, educators, and licensing bodies.

A Study to Evaluate the Effectiveness of Open Book Tests Over Close Book Tests and Perception of Medical Students in Physiology


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Introduction
 At present, the Medical knowledge is expanding and changing rapidly and there is increasing need to concentrate on education based on competencies. Closed book exam is an established approach to assessment in medical education which is widely accepted method of superficial learning. Adding open book test to the formative assessment can assist in handling this growth of knowledge.
 Objectives
 To evaluate the effectiveness of open book test on student's performance in summative assessment and to know the perception of students on open book test.
 Methodology
 The study was conducted on I MBBS students (n=150), who were divided into 2 groups, Group I: subjected to open book test for 4 weeks and Group II: subjected to closed book tests for 4weeks. There was a cross-over of the two groups and Group I were subjected to the closed book test and Group II students were subjected to open book tests. The mean marks obtained in summative assessment were statistically compared. Perception of the students was taken through feedback questionnaire.
 Results
 The mean marks obtained by the students (n= 141) in the summative assessment after open book test (Mean± SD =26.37±6.235) are statistically significant than those after closed book tests(mean± SD =24.09± 6.3513(p value< 0.005).
 Conclusion
 71% of students recommended open book tests for the formative assessment. Hence, adding open book test to the medical curriculum along with regularly used closed book test are expected to stimulate deep learning.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Comparison of academic performance and stress levels in open book test and closed book test and perceptions of undergraduate dental students

Comparison of academic performance and stress levels in open book test and closed book test and perceptions of undergraduate dental students

Open-Book Versus Closed-Book Tests in University Classes: A Field Experiment.

The present field study compared open-book testing and closed-book testing in two (parallel) introductory university courses in cognitive psychology. The critical manipulation concerned seven lessons. In these lessons, all students received two to three questions concerning the content of the respective lesson. Half the participants (open-book group) were allowed to use their notes and the course materials, which had been distributed at the beginning of each class; the other half was not allowed to use these materials (closed-book group). A surprise test conducted in the eighth week demonstrated better results for the closed-book group. Further 6 weeks later, the final module exam took place. A number of questions in this exam concerned the learning matters instructed during the critical seven lessons. Even with respect to these questions, the closed-book group performed better than the open-book group. We discuss these results with respect to two possible explanations, retrieval practice and motivational differences.

Student Perceptions of Blended Assessment Approach in The Bachelor of Education Degrees in Mathematics And Science Through Open Distance And E–Learning (Odel)

Blended assessment approach (BAA) comprising closed book test (CBT) and open book test (OBT) assessment strategies is being used in the Bachelor of Education Degrees in Mathematics and Science ODeL programme offered by a University M in Zimbabwe. Adherents to BAA identify compensating for weaknesses of one strategy by another, as its major strength. Research studies reveal that if assessment strategies are aligned to assessment objectives the gap between the intended and achieved curricula is reduced. This study was conducted to explore how BAA enhanced congruency between the BED Mathematics and Science ODeL intended and achieved curricula based on the perceptions of in– service teachers in the programme. Interviews, focus group discussions (FDGs) and document analysis were used to gather data. Qualitative data analysis techniques were used, since they were consistent with the objectives of the study. Findings reveal that giving a compulsory OPT after the CBT ensured that learners concentrated both on areas they had challenges, as well as consolidating what they got correct in the CBT. This tended to broaden and deepen frontiers of knowledge of the in–service teachers in their respective subject areas (Mathematics, Physics, Biology and Chemistry). All the in–service teachers in the study concurred that the learner–centred nature of the BAA approach was effective in achieving curriculum objectives. They (in–service teachers) could not hide their support for the BAA by showing their preparedness to immediately implement it in teaching and learning at their schools. Further studies on the use of formative (continuous) assessment strategies like presentations, question setting, group projects and exhibitions by learners are recommended, to improve the blend of assessment strategies in the BAA.

Testing Effect

Abstract. If assessment is the purpose of testing, open-book tests may defeat the purpose. However, a goal of education is to build knowledge, and based on the literature, open-book tests may not be inferior to closed-book tests in promoting long-term retention of information. Participants studied Swahili-English pairs and either re-studied or took an initial quiz, which was cued recall or recognition in an open-book or closed-book format. One week later, the final closed-book recognition test showed higher performance in the quizzed conditions than in the study-twice condition, replicating the testing effect. However, performance was similar across the quizzed conditions, indicating that testing promoted long-term retention regardless of test format (open-book versus closed-book) and test type (cued recall versus recognition). Open-book tests are not inferior to closed-book tests in building knowledge and can be particularly useful in online classes because preventing cheating is difficult when closed-book tests are administered online.

Comparison of open and closed book test for admission in medical school.

This article was migrated. The article was marked as recommended. Introduction: Students' learning methods are highly influenced by the type of evaluation. Consequently, evaluation is a deciding step in the learning process. Multiple Choice Format Tests (MCQs) are almost exclusive in the admission to Health studies. PluriPASS suggests an educational reform of Health studies. This research aims at analyzing docimological features of Open-book Multiple Choice Format tests (OBT) compared to other usual tests used during the first year in Health studies curriculum (CC). Methods: This educational research took place during PluriPASS year in Health studies curriculum at Angers University, during the academic period 2015-2016. The optional course « Disability and Health » (DH) was partly assessed by open-book tests with complex wording, requiring careful thought from students. Results: Out of the 1161 students enrolled in first year curriculum, 190 have chosen the DH. For the students who followed the DH, the CC and OBT distributions are respectively a Skewness score at -0.11 and -0.12 and a Kurtosis score at -0.9 and -0.22. Bland Altman test or Deming method demonstrate a concordance between both method. Conclusion: Distribution characteristics of OBT are satisfactory and allow to consider introducing this method with the objective of promoting reflection and depth learning.

Assessment Practices of Teachers in Selected Primary and Secondary Schools in Jamaica

The purpose of the study was to determine if there were differences in the perceptions of primary and secondary school teachers’ classroom assess-ment practices in region one in Jamaica. Seven research questions guided the study. An analytic survey research design was used to answer the research questions. A stratified random sampling method was used to select 225 teachers. However, a total of 157 (64 primary & 93 secondary) school teachers participated in the study. Data were collected through the use of a web-based questionnaire which had an overall reliability coefficient of 0.749. The findings showed that closed-book test, portfolio, multiple-choice, short answer, restricted essay, and fill-in-the-blanks were popularly used by the teachers. The findings also showed that there were significant differences among the teachers on the following arranging test items according to types and writing specific instructions, informing students about the areas that will be assessed, administration of assessments, grading assessment, explaining how scores were derived, giving students the opportunity to appeal their grades, and using the results of the statistical analyses to improve assessment practices. Based on these findings recommendations were made on how to improve teachers’ assessment practices.

Effect of open-book exercise practice on closed-book tests results

The South-East Asian Journal of Medical Education (SEAJME) is the culmination of the SEARAME's vision to bring together medical educationists in the region to promote collaborative efforts toward uplifting the standards of medical education in the region and beyond through dissemination of knowledge. This journal will be the ideal platform to disseminate research findings and stimulate discussion among experts in the field. Open access policy of the journal will facilitate this ideal.From November 2019, The South-East Asian Journal of Medical Education (SEAJME) is indexed in EuroPub

Effect of Open-Book Exercise Practice on Closed-Book Tests Results

Effect of Open-Book Exercise Practice on Closed-Book Tests Results

Influence of PBL with open-book tests on knowledge retention measured with progress tests

The influence of problem-based learning (PBL) and open-book tests on long-term knowledge retention is unclear and subject of discussion. Hypotheses were that PBL as well as open-book tests positively affect long-term knowledge retention. Four progress test results of fifth and sixth-year medical students (n = 1,648) of three medical schools were analyzed. Two schools had PBL driven curricula, and the third one had a traditional curriculum (TC). One of the PBL schools (PBLob) used a combination of open-book (assessing backup knowledge) and closed-book tests (assessing core knowledge); the other two schools (TC and PBLcb) only used closed-book tests. The items of the progress tests were divided into core and backup knowledge. T tests (with Bonferroni correction) were used to analyze differences between curricula. PBL students performed significantly better than TC students on core knowledge (average effect size (av ES) = 0.37–0.74) and PBL students tested with open-book tests scored somewhat higher than PBL students tested without such tests (av ES = 0.23–0.30). Concerning backup knowledge, no differences were found between the scores of the three curricula. Students of the two PBL curricula showed a substantially better long-term knowledge retention than TC students. PBLob students performed somewhat better on core knowledge than PBLcb students. These outcomes suggest that a problem-based instructional approach in particular can stimulate long-term knowledge retention. Distinguishing knowledge into core and backup knowledge and using open-book tests alongside closed-book tests could enhance long-term core knowledge retention.

A Discussion of the Effect of Open-book and Closed-book Exams on Student Achievement in an Introductory Statistics Course

The use of open-book tests, closed-book tests, and notecards on tests in an introductory statistics course is described in this article. A review of the literature shows that open-book assessments are universally recognized to reduce anxiety. The literature is mixed however on whether deeper learning or better preparation occurs with open-book exams. This article reviews the Math 300 Statistics course testing policy which evolved from closed-book exams to open-book exams to closed-book exams with notecards. Our experience led to increased student enjoyment of the course while continuing to encourage deeper student learning.

Expectancy of an open-book test decreases performance on a delayed closed-book test

Two experiments examined the influence of practice with, and the expectancy of, open-book tests (students viewed studied material while taking the test) versus closed-book tests (students completed the test without viewing the studied material) on delayed retention and transfer. Using GRE materials specifically designed for open-book testing, participants studied passages and then took initial open- or closed-book tests. Open-book testing led to better initial performance than closed-book testing, but on a delayed criterial (closed-book) test both types of testing produced similar retention after a two-day delay in Experiment 1. In Experiment 2 participants were informed in advance about the type of delayed criterial test to expect (open- or closed-book). Expecting an open-book test (relative to a closed-book test) decreased participants’ time spent studying and their delayed test performance on closed-book comprehension and transfer tests, demonstrating that test expectancy can influence long-term learning. Expectancy of open-book tests may impair long-term retention and transfer compared to closed-book tests, despite superior initial performance on open-book tests and students’ preference for open-book tests.

Directing students to profound open-book test preparation: The relationship between deep learning and open-book test time

Background: Considering the growing amount of medical knowledge and the focus of medical education on acquiring competences, using open-book tests seems inevitable. A possible disadvantage of these tests is that students underestimate test preparation.Aims: We examined whether students who used a deep learning approach needed less open-book test time, and how students performed on open-book questions asked in a closed-book setting.Method: Second- (N = 491) and third-year students (N = 325) prepared half of the subject matter to be tested closed-book and half to be tested open-book. In agreement with the Board of Examiners, some questions in the closed-book test concerned open-book subject matter, and vice versa. Data were gathered about test time, deep learning and preparation time. Repeated measurement analysis, t-tests and partial correlations were used to analyse the data.Results: We found a negative relationship between deep learning and open-book test time for second-year students. Students scored the lowest on closed-book questions about open-book subject matter.Conclusions: Reduction of the available test time might force students to prepare longer and deeper for open-book tests. Further research is needed to identify variables that influence open-book test time and to determine how restrictive this time should be.

Influences of deep learning, need for cognition and preparation time on open- and closed-book test performance

The ability to master discipline-specific knowledge is one of the competencies medical students must acquire. In this context, 'mastering' means being able to recall and apply knowledge. A way to assess this competency is to use both open- and closed-book tests. Student performance on both tests can be influenced by the way the student processes information. Deep information processing is expected to influence performance positively. The personal preferences of students in relation to how they process information in general (i.e. their level of need for cognition) may also be of importance. In this study, we examined the inter-relatedness of deep learning, need for cognition and preparation time, and scores on open- and closed-book tests. This study was conducted at the University Medical Centre Groningen. Participants were Year 2 students (n = 423). They were asked to complete a questionnaire on deep information processing, a scale for need for cognition on a questionnaire on intellectualism and, additionally, to write down the time they spent on test preparation. We related these measures to the students' scores on two tests, both consisting of open- and closed-book components and used structural equation modelling to analyse the data. Both questionnaires were completed by 239 students (57%). The results showed that need for cognition positively influenced both open- and closed-book test scores (beta-coefficients 0.05 and 0.11, respectively). Furthermore, study outcomes measured by open-book tests predicted closed-book test results better than the other way around (beta-coefficients 0.72 and 0.11, respectively). Students with a high need for cognition performed better on open- as well as closed-book tests. Deep learning did not influence their performance. Adding open-book tests to the regularly used closed-book tests seems to improve the recall of knowledge that has to be known by heart. Need for cognition may provide a valuable addition to existing theories on learning.

Critical action procedures testing: a novel method for test-enhanced learning

Human error is a leading cause of adverse events in anaesthesia. Residents' knowledge of how to respond to rare, yet potentially life-threatening events has been shown to deteriorate over time and thus cost-effective educational interventions are indicated. Previous research has shown that test-enhanced learning has the potential to strengthen both clinical knowledge and performance. We hypothesised that critical action procedures (CAPs) tests, similar to those employed by high-performance aircraft pilots, would help improve resident knowledge about how to respond to rare and potentially catastrophic events encountered during the perioperative period. Knowledge assessments were administered to 29 first-year anaesthesiology residents over the course of 9 months. Five-minute closed-book tests were administered with fill-in-the-blank questions regarding the American Society of Anesthesiologists' difficult airway guideline, advanced cardiac life support protocols, an institutional airway fire protocol and drug dosing for malignant hyperthermia. Inter-group comparisons were evaluated using the Kruskal-Wallis test. The difference between the pre-test and final test scores for each subsection was determined with the Mann-Whitney U-test for independent samples. Composite subtest scores, when compared with baseline pre-test scores and subsequent scores, and when adjusted for attrition, significantly improved over the course of 9 months (20.5% versus 80%; P < or = 0.001). Likert-based survey data indicated a positive report for attainment of knowledge. In this longitudinal observational study of first-year anaesthesiology residents, CAPs testing helped improve knowledge about critical events. Although the study was limited by its small number of subjects, a significant attrition rate and the lack of a control group, it demonstrates a cost-effective educational intervention that improved resident knowledge. This intervention may enable residents to transfer learned skills from theoretical testing situations to real-life scenarios. We propose the use and further study of CAPs testing as a cost-effective modality to augment both simulated and actual experiential learning.

Influence of open- and closed-book tests on medical students' learning approaches

Two learning approaches are consistently distinguished in the literature: deep and surface learning. The deep learning approach is considered preferable. Open-book tests are expected to stimulate deep learning and to offer a possible way of handling the substantial growth in medical knowledge. In this study we test the hypothesis that open-book tests stimulate deep learning more than closed-book tests. Medical students in Years 2 (n = 423) and 3 (n = 306) participated in this study. They evaluated their preparation for open- and closed-book tests using the test for Deep Information Processing (DIP). This questionnaire consists of 24 items divided into three subscales: Critical Reading; Broaden One's Context, and Structuring. A paired t-test was used to analyse the data. Both cohorts scored significantly higher when preparing for closed-book tests for the overall DIP score and on the Broaden One's Context and Structuring scales. Year 3 students also scored significantly higher on the Critical Reading scale when preparing for closed-book tests. Gender differences were found: women used deeper learning approaches than men. Our hypothesis was not supported. In fact, the opposite was found: closed-book tests stimulated a deep learning approach more than open-book tests. Three possible explanations are: deep learning is particularly necessary for remembering and recalling knowledge; students feel more confident when preparing for closed-book tests, and students are more motivated to study for closed-book tests. The debate on the concept of deep learning in higher education should probably be renewed.

Open-book Tests to Complement Assessment-programmes: Analysis of Open and Closed-book Tests

Today's health sciences educational programmes have to deal with a growing and changing amount of knowledge. It is becoming increasingly important for students to be able to use and manage knowledge. We suggest incorporating open-book tests in assessment programmes to meet these changes. This view on the use of open-book tests is discussed and the influence on test quality is examined. To cope with the growing amount of medical knowledge, we have divided the body of knowledge into core knowledge, which students must know without need for references, and backup knowledge, which students need to understand and use properly with the help of references if so desired. As a result, all tests consist of a subtest for reproduction and understanding of core knowledge (a closed-book test) and a subtest for the ability to understand and manage backup knowledge (an open-book test). Statistical data from 14 such double-subtest exams for first and second-year students were analyzed for two cohorts (N = 435 and N = 449) with multilevel analysis, in accordance with generalizability theory. The reliability of the open and closed-book sections of the separate tests varied between 0.712 and 0.850. The open-book items reduce reliability somewhat. The estimated disattenuated correlation was 0.960 and 0.937 for cohorts 1 and 2 respectively. It is concluded that the use of open-book items with closed-book items slightly decreases test reliability but the overall index is acceptable. In addition, open and closed-book sections are strongly positively related. Therefore, open-book tests could be helpful in complementing today's assessment programmes.