Introduction: The landscape of medical education has witnessed significant transformations over the past decades, particularly with the advent of active teaching methodologies. However, despite these advancements, the traditional theoretical assessment methods have remained largely unchanged. This lack of evolution in assessment systems poses a challenge as it is crucial for assessment methods to evolve in tandem with teaching approaches to ensure a comprehensive and effective learning process in medical education. This paper reviews the integration and effectiveness of open-book examinations (OBEs) in medical education, reflecting their growing significance. Methods: An integrative review of the literature was conducted, drawing from a range of relevant publications over the last decade, sourced from databases such as PubMed, Web of Science, Scopus, and ERIC. The inclusion criteria focused on full-text articles in English, with search terms including “medicine,” “assessment,” “open book examination,” “open book exam,” and “open book assessment,” combined using Boolean operators. Thirteen publications were selected and critically appraised using The Critical Appraisal Skills Program checklist. Results: The analysis identified three primary thematic categories: “Teaching Strategy for Pandemic and Challenging Conditions,” “Tool of Learning & Educational Impact”, and “Operational Challenges & Future Directions”. These themes were explored to understand the role and impact of open-book examinations in medical education. Conclusion: The findings indicate that open-book examinations are a crucial component in the evolving landscape of medical education. While certain reservations remain, open-book examinations have shown significant potential in fostering critical thinking, argumentation skills, and lifelong learning among medical students. They reflect the ongoing evolution of knowledge in the medical field and contribute to the development of professionals’ adept at navigating and applying complex information. Further research is recommended to solidify these findings and expand the understanding of open-book examinations in medical education. |
- Boursicot K, Kemp S, Wilkinson T, Findyartini A, Canning C, Cilliers F, et al. Performance assessment: Consensus statement and recommendations from the 2020 Ottawa Conference. Med Teach. 2021;43(1):58–67.
- Pangaro L, Ten Cate O. Frameworks for learner assessment in medicine: AMEE Guide No. 78. Med Teach. 2018;35(6):e1197–210.
- Myyry L, Joutsenvirta T. Open-book, open-web online examinations: Developing examination practices to support university students’ learning and self-efficacy. Active Learning in Higher Education. 2015;16(2):119–32.
- Epstein RM. Assessment in Medical Education. New England Journal of Medicine. 2007;356(4):387–96.
- GMC. Assessment in undergraduate medical education-Tomorrow’s Doctors. UK: General Medical Council-UK; 2018.
- Ben-David MF. AMEE Guide No. 18: Standard setting in student assessment. Med Teach. 2000;22(2):120–30.
- Mahajan R, Saiyad S, Virk A, Joshi A, Singh T. Blended programmatic assessment for competency based curricula. J Postgrad Med. 2021;67(1):18–23.
- Schuwirth LWT, van der Vleuten CPM. How ‘Testing’ Has Become ‘Programmatic Assessment for Learning’. Health Professions Education. 2019;5(3):177–84.
- Vleuten C, Lindemann I, Schmidt L. Programmatic assessment: the process, rationale and evidence for modern evaluation approaches in medical education. Medical Journal of Australia. 2018;209(9):386–8.
- Hauer KE, Boscardin C, Brenner JM, van Schaik SM, Papp KK. Twelve tips for assessing medical knowledge with open-ended questions: Designing constructed response examinations in medical education. Med Teach. 2020;42(8):880–5.
- Durning SJ, Dong T, Ratcliffe T, Schuwirth L, Artino ARJ, Boulet JR, et al. Comparing Open-Book and Closed-Book Examinations: A Systematic Review. Acad Med. 2016;91(4):583.
- Sam AH, Reid MD, Amin A. High‐stakes, remote‐access, open‐book examinations. Med Educ. 2020;54(8):767–8.
- Greene J, Mullally W, Ahmed Y, Khan M, Calvert P, Horgan A, et al. Maintaining a Medical Oncology Service during the Covid-19 Pandemic. Irish medical journal. 2020;11:77.
- Whittemore R. Combining Evidence in Nursing Research: Methods and Implications. Nursing Research. 2005;54(1):56.
- Whittemore R, Knafl K. The integrative review: updated methodology. Journal of Advanced Nursing. 2005;52(5):546–53.
- Yu X, Watson M. Guidance on Conducting a Systematic Literature Review. Journal of Planning Education and Research. 2019;9(1):93–112.
- Halcomb E, Stephens M, Bryce J, Foley E, Ashley C. Nursing competency standards in primary health care: an integrative review. Journal of Clinical Nursing. 2016;25(9–10):1193–205.
- CASP - Critical Appraisal Skills Programme [Internet]. CASP Checklists - Critical Appraisal Skills Programme; 2023 [Cited 2023 Oct 6]. Available from: https://casp-uk.net/casp-tools-checklists/.
- Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews. 2015;4(1):1.
- Elsalem L, Al-Azzam N, Jum’ah AA, Obeidat N. Remote E-exams during Covid-19 pandemic: A cross-sectional study of students’ preferences and academic dishonesty in faculties of medical sciences. Annals of Medicine and Surgery. 2021;62:326–33.
- Eurboonyanun C, Wittayapairoch J, Aphinives P, Petrusa E, Gee DW, Phitayakorn R. Adaptation to Open-Book Online Examination During the COVID-19 Pandemic. J Surg Educ. 2021;78(3):737–9.
- Sarkar S, Mishra P, Nayak A. Online open-book examination of undergraduate medical students - a pilot study of a novel assessment method used during the coronavirus disease 2019 pandemic. J Laryngol Otol. 2021;135(4):288–92.
- Monaghan AM. Medical Teaching and Assessment in the Era of COVID-19. J Med Educ Curric Dev. 2020;7:2382120520965255.
- Rehman J, Ali R, Afzal A, Shakil S, Sultan AS, Idrees R, et al. Assessment during Covid-19: quality assurance of an online open book formative examination for undergraduate medical students. BMC Medical Education. 2022;22(1):792.
- Bobby Z, Meiyappan K. “Test-enhanced” focused self-directed learning after the teaching modules in biochemistry. Biochemistry and Molecular Biology Education. 2018;46(5):472–7.
- Dave M, Patel K, Patel N. A systematic review to compare open and closed book examinations in medicine and dentistry. Faculty Dental Journal [Internet]. 2021 Oct 10 [Cited 2023 Oct 10]. Available from: https://publishing.rcseng.ac.uk/doi/10.1308/rcsfdj.2021.41.
- Ibrahim NK, Al-Sharabi BM, Al-Asiri RA, Alotaibi NA, Al-Husaini WI, Al-Khajah HA, et al. Perceptions of clinical years’ medical students and interns towards assessment methods used in King Abdulaziz University, Jeddah. Pak J Med Sci. 2015;31(4):757–62.
- Brossman BG, Samonte K, Herrschaft B, Lipner RS. A Comparison of Open-Book and Closed-Book Formats for Medical Certification Exams: A Controlled Study. San Antonio, TX: American Educational Research Association; 2017.
- Davies DJ, McLean PF, Kemp PR, Liddle AD, Morrell MJ, Halse O, et al. Assessment of factual recall and higher-order cognitive domains in an open-book medical school examination. Adv Health Sci Educ Theory Pract. 2022;27(1):147–65.
- Erlich D. Because Life Is Open Book: An Open Internet Family Medicine Clerkship Exam. PRiMER. 2017;1:7.
- Prigoff J, Hunter M, Nowygrod R. Medical Student Assessment in the Time of COVID-19. J Surg Educ. 2021;78(2):370–4.
- Zagury-Orly I, Durning SJ. Assessing open-book examination in medical education: The time is now. Med Teach. 2021;43(8):972–3.
- Taha MH, Ahmed Y, El Hassan YAM, Ali NA, Wadi M. Internal Medicine Residents’ perceptions of learning environment in postgraduate training in Sudan. Future of Medical Education Journal. 2019;9(4):3–9.
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