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Comparing Open-Book and Closed-Book Examinations: A Systematic Review
Steven J Durning1, Ting Dong, Temple Ratcliffe
1S.J. Durning is professor of medicine and pathology, Uniformed Services University of the Health Sciences, Bethesda, Maryland. T. Dong is assistant professor of medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. T. Ratcliffe is assistant professor of medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. L. Schuwirth is professor of medical education, Flinders University, Bedford Park, South Australia, Australia, and professor for innovative assessment, Maastricht University, Maastricht, the Netherlands. A.R. Artino Jr is professor of medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. J.R. Boulet is vice president of research and evaluation, Foundation for Advancement of International Medical Education and Research, Philadelphia, Pennsylvania. K. Eva is professor of medicine, University of British Columbia, Vancouver, British Columbia, Canada.
This systematic review found insufficient evidence to exclusively use open-book examinations (OBEs) or closed-book examinations (CBEs). A combined approach may better assess competencies beyond knowledge recall.
Area of Science:
- Educational assessment
- Medical education research
Background:
- The rapid expansion of accessible knowledge challenges traditional examination formats.
- Open-book examinations (OBEs) and closed-book examinations (CBEs) are common assessment methods with varying implications.
Purpose of the Study:
- To compare the relative utility of OBEs and CBEs in the context of readily available information.
- To evaluate the impact of different examination formats on various outcome categories.
Main Methods:
- A systematic review of peer-reviewed articles from major databases (MEDLINE, ERIC, Embase, PsycINFO) up to June 2013.
- Inclusion criteria were applied, and 37 studies were reviewed and coded for six outcome categories: preparation, anxiety, performance, psychometrics/logistics, testing effects, and public perception.
Main Results:
- Studies on examination performance favored CBEs, especially when preparation for CBE exceeded that for OBEs.
- Pre-examination findings were equivocal, though students may prepare more for CBEs.
- During-examination, examinees took longer to complete OBEs, with little difference in post-examination effects or public perception.
Conclusions:
- Current evidence does not support the exclusive use of either CBE or OBE.
- A combined approach to examinations may be beneficial for assessing competencies beyond rote knowledge maintenance.
- This integrated strategy could be valuable for licensing bodies.
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