Exam resource availability and student outcomes: an exploratory analysis in Occupational Therapy Students

Written examinations are commonly used to assess learning. Different resources made available during testing (closed-note, open-note, and cheat-sheet) may influence student learning. The effect of resource availability on long-term knowledge application is unknown. Understanding the effects of exam resource availability on long-term knowledge application is needed, as application is essential in applied fields such as Occupational Therapy. To explore differences in short-term knowledge retention (course one overall score, midterm exam, and final exam) and long-term knowledge application (course two summative assessment) among occupational therapy students who had different types of exam resource availability during course one (closed-note, open-note, cheat-sheet). Data were extracted from four consecutive cohorts (n = 73) as they completed two sequential occupational therapy courses. Exam resource availability was the independent variable (k = 3), with course one midterm and final exams and overall course grade, and course two summative assessment grade as dependent variables. Kruskal-Wallis tests compared differences across conditions. Concerning short-term retention, no significant differences were observed between groups for course one midterm exam grade or overall course one grade. Course one final exam grades were significantly higher in the cheat sheet condition compared to closed note (3.9%, p = .009). Concerning long-term application as measured by the course two summative assessment grade, the closed note condition scored significantly higher than open note (6.25%, p = .01). No other comparisons were significantly different. In this sample we observed a small difference in short-term knowledge retention in favor of a cheat sheet condition and moderate difference in long-term application in favor of a closed note condition. While results suggest possible differences in performance across exam conditions, findings should be interpreted cautiously due to the small, convenience-based sample. This exploratory analysis offers preliminary insights and identifies directions for future research on the pedagogical impact of exam design.