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Open Book Assessment: Performance and Student Perceptions in a UK Veterinary Programme

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Title: Open Book Assessment: Performance and Student Perceptions in a UK Veterinary Programme
Language: English
Authors: Erica Gummery (ORCID 0000-0001-5385-6847), Sam Marsh, Kate Cobb (ORCID 0000-0002-3390-604X), John Remnant (ORCID 0000-0002-6745-845X)
Source: Assessment & Evaluation in Higher Education. 2026 51(1):161-173.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 13
Publication Date: 2026
Intended Audience: Teachers
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Foreign Countries, Evaluation Methods, Tests, Student Evaluation, College Students, Comparative Testing, Student Experience, Textbooks, Test Format, Academic Achievement, Well Being, Learning Processes, Student Attitudes, Veterinary Medical Education
Geographic Terms: United Kingdom (Nottingham)
DOI: 10.1080/02602938.2025.2523598
ISSN: 0260-2938
1469-297X
Abstract: The COVID-19 pandemic declared in March 2020 led to many academic institutions moving to online teaching and remote assessment, including use of the Open Book (OB) assessment format. The aim of this study was to investigate the impact of an OB format on student performance, and to explore students' perceptions of OB assessment at a UK veterinary school. A mixed methods approach was utilised across three phases of study. Student performance data were compared for Closed Book (CB) and OB conditions. A questionnaire investigated students' perceptions of OB assessments and subsequent focus groups further explored students' experiences. Overall mean marks increased with the change from CB to OB. Students who scored higher in CB assessments tended to have a smaller increase in marks between the formats than those with lower average marks. Students reported less stress associated with the OB format and described a deeper approach to learning. However, a focus on organisation of resources reflects a strategic approach, and concerns regarding examination integrity should not be overlooked. This study highlighted the benefits of the OB format to student learning, wellbeing and performance and the findings can be used to inform educators considering the format within a programme of assessment.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1499297
Database: ERIC
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  Value: <anid>AN0191255577;eva01feb.26;2026Feb03.01:14;v2.2.500</anid> <title id="AN0191255577-1">Open book assessment: performance and student perceptions in a UK veterinary programme </title> <p>The Covid-19 pandemic declared in March 2020 led to many academic institutions moving to online teaching and remote assessment, including use of the Open Book (OB) assessment format. The aim of this study was to investigate the impact of an OB format on student performance, and to explore students' perceptions of OB assessment at a UK veterinary school. A mixed methods approach was utilised across three phases of study. Student performance data were compared for Closed Book (CB) and OB conditions. A questionnaire investigated students' perceptions of OB assessments and subsequent focus groups further explored students' experiences. Overall mean marks increased with the change from CB to OB. Students who scored higher in CB assessments tended to have a smaller increase in marks between the formats than those with lower average marks. Students reported less stress associated with the OB format and described a deeper approach to learning. However, a focus on organisation of resources reflects a strategic approach, and concerns regarding examination integrity should not be overlooked. This study highlighted the benefits of the OB format to student learning, wellbeing and performance and the findings can be used to inform educators considering the format within a programme of assessment.</p> <p>Keywords: Open book assessment; student performance; study approach; veterinary education</p> <hd id="AN0191255577-2">Introduction</hd> <p>There has been an increase in the implementation of competency based veterinary education in recent years (Bok et al. [<reflink idref="bib6" id="ref1">6</reflink>]; Matthew et al. [<reflink idref="bib29" id="ref2">29</reflink>]; Read and Gonya [<reflink idref="bib34" id="ref3">34</reflink>]). Similar trends are seen in healthcare education more broadly (Chuenjitwongsa, Oliver, and Bullock [<reflink idref="bib11" id="ref4">11</reflink>]; Frank et al. [<reflink idref="bib18" id="ref5">18</reflink>]; Gravina [<reflink idref="bib21" id="ref6">21</reflink>]; Holmboe et al. [<reflink idref="bib23" id="ref7">23</reflink>]). The purpose of assessment within the curriculum has therefore shifted from a measure of knowledge to assessment of outcomes achieved, ensuring students are competent to practice as veterinary surgeons upon graduation. The role of traditional examinations, including modified essays and single best answer formats, as assessment of learning is brought into question as a result of the move to competency-based approaches. Consequently, performance-based assessment formats, including Objective Structured Clinical Examination (OSCE), Entrustable Professional Activities (EPA) and Direct Observation of Procedural Skills (DOPS) have increased within veterinary curricula (S. Baillie, Rhind, and Warman [<reflink idref="bib4" id="ref8">4</reflink>]).</p> <p>As competency-based veterinary education requires the integration of knowledge, skills and attitudes (Matthew et al. [<reflink idref="bib29" id="ref9">29</reflink>]), there is still a requirement for traditional examination formats to ensure students have the foundation knowledge and understanding required to make clinical decisions. The delivery of these assessments was drastically changed in 2020 due to the restrictions imposed on Higher Education Institutions by the Covid pandemic. Many universities adopted open book formats, which could be delivered remotely online as a contingency measure.</p> <p>Open book (OB) assessment by its most basic definition is the permitted use of reference materials, such as notes, textbooks, and online materials by students during an examination (Eilertsen and Valdermo [<reflink idref="bib16" id="ref10">16</reflink>]). Although only recently introduced by many veterinary schools, the concept of OB assessments is not new, and has been considered as early as 1935 (Eilertsen and Valdermo [<reflink idref="bib16" id="ref11">16</reflink>]).</p> <p>Proponents of the OB assessment claim the format is more authentic than traditional assessments (S. Baillie, Rhind, and Warman [<reflink idref="bib4" id="ref12">4</reflink>]), better representing the work environment in which numerous sources of information are accessible and used by veterinarians in professional practice. The resources available to clinicians in both medical and veterinary fields are rapidly expanding, and it is important that students can access and apply information specific to the situations they face, to become competent in their future roles as clinicians (Adair and Vohra [<reflink idref="bib1" id="ref13">1</reflink>]; Durning et al. [<reflink idref="bib15" id="ref14">15</reflink>]; Heijne-Penninga et al. [<reflink idref="bib22" id="ref15">22</reflink>]). It is therefore believed that for a clinical assessment to be appropriate, it must challenge the student's ability to understand, evaluate, and apply external resources; and that assessments testing these skills are more reflective of clinical practice (Durning et al. [<reflink idref="bib15" id="ref16">15</reflink>]; Heijne-Penninga et al. [<reflink idref="bib22" id="ref17">22</reflink>]; Theophilides and Dionysiou [<reflink idref="bib38" id="ref18">38</reflink>]). It can be argued that, when compared to the closed book (CB) format, OB assessments offer a more authentic reflection of the clinical setting, in which a clinician will utilize the many external resources available rather than their own memory (C. Baillie and Toohey [<reflink idref="bib5" id="ref19">5</reflink>]; Broyles, Cyr, and Korsen [<reflink idref="bib8" id="ref20">8</reflink>]; Durning et al. [<reflink idref="bib15" id="ref21">15</reflink>]; Frederiksen [<reflink idref="bib19" id="ref22">19</reflink>]; Feller [<reflink idref="bib17" id="ref23">17</reflink>]).</p> <p>Studies investigating the use of the OB format have reported a positive influence on student learning and approach to study, with several studies suggesting the format encourages students to develop deeper approaches to learning (Baillie and Toohey [<reflink idref="bib5" id="ref24">5</reflink>]; Eilertsen and Valdermo [<reflink idref="bib16" id="ref25">16</reflink>]; Theophilides and Dionysiou [<reflink idref="bib38" id="ref26">38</reflink>]). The use of OB assessments can also encourage the use of question items that test students' comprehension and application of knowledge rather than simple recall (Heijne-Penninga et al. [<reflink idref="bib22" id="ref27">22</reflink>]). Permzadian and Cho ([<reflink idref="bib32" id="ref28">32</reflink>]) found no difference in the effect of CB and OB assessment on student learning following their meta-analytic review; however, recommended the implementation of the OB format to potentially reduce test anxiety and improve student perception of assessment.</p> <p>OB assessment has been cited for its role in reducing fear and anxiety associated with assessment (Afshin Gharib et al. [<reflink idref="bib2" id="ref29">2</reflink>]; Theophilides and Dionysiou [<reflink idref="bib38" id="ref30">38</reflink>]) however, the impact of the OB format is neither clear nor consistently demonstrated. Others have found there to be no evidence of a significant difference in test anxiety before or during open and closed book assessments (Lau [<reflink idref="bib26" id="ref31">26</reflink>]) and increased levels of anxiety and lower wellbeing have also been associated with OB assessments (C. Baillie and Toohey [<reflink idref="bib5" id="ref32">5</reflink>]; Spiegel and Nivette [<reflink idref="bib37" id="ref33">37</reflink>]).</p> <p>Critics of the format have raised concerns that OB examinations threaten academic integrity, believing that the format can lead to students gaining marks through collusion, plagiarism, and by copying and pasting answers found online (Campbell, Haikney, and Waddington [<reflink idref="bib9" id="ref34">9</reflink>]). However, following a systematic review of literature comparing OB and CB formats, Durning et al. ([<reflink idref="bib15" id="ref35">15</reflink>]) found there to be no significant difference in examination performance and testing effects between the assessment formats, which may indicate that academic integrity during OB assessments can be maintained. Other less desirable behaviors have been highlighted in the literature, such as students devoting large amounts of time locating information during OB examinations, therefore reducing the time available to formulate their answers (Theophilides and Dionysiou [<reflink idref="bib38" id="ref36">38</reflink>]). It has also been found that students invest less time in preparing for assessments delivered in an OB format (Durning et al. [<reflink idref="bib15" id="ref37">15</reflink>]), which may lead to poor knowledge retention.</p> <p>Nevertheless, the 2020 pandemic resulted in higher education institutions instigating online, remote OB assessments out of necessity rather than through curriculum design, with little understanding of the impact of this change, and some of these assessments may not have been appropriate for the OB format. The aim of this research is to investigate the effect of the OB format on examination performance and the student perception of OB examinations within a UK veterinary school. The following research questions are addressed:</p> <p>Do veterinary students perform differently in OB compared to CB examination conditions?</p> <p>Do veterinary students prepare differently for OB examinations compared to the CB format?</p> <p>How do students perceive their experience of sitting examinations in an OB format?</p> <hd id="AN0191255577-3">Methods</hd> <p></p> <hd id="AN0191255577-4">Context</hd> <p>This study was conducted at the University of Nottingham, School of Veterinary Medicine and Science. Under government advice face-to-face teaching was suspended from March 23<sups>rd</sups> 2020, requiring delivery of remote, OB assessment. Previously, all assessments were conducted online under invigilated, in-person, CB examination conditions. The assessments had already been written and reviewed, and due to the short amount of time between the move to remote assessments and the examination periods, the questions were not altered to reflect the OB format. Students were informed of the change and advised to prepare for the assessments in the same manner as for a CB assessment.</p> <p>In 2020, all University of Nottingham students were granted an additional 60 min to allow for IT issues. Proctoring software was not available for use, and the examinations were un-invigilated. Students could access any resources they chose during the assessments, including material provided by the school, online resources, and their own notes. Students were informed that while they were permitted to refer to resources, collusion or collaboration with anyone else was prohibited and would be viewed by the school as academic misconduct.</p> <p>In 2021, students undertaking high-stakes assessments in years 4 (<emph>n</emph> = 149) and 5 (<emph>n</emph> = 148) of the course returned to campus to complete their assessments, which remained OB but were invigilated to prevent collusion or collaboration between students. For students in years 1 (<emph>n</emph> = 165), 2 (<emph>n</emph> = 150), and 3 (<emph>n</emph> = 163) assessments remained in the remote, OB format. Students in all years were permitted access to online resources and their own notes, examination papers were prepared to reflect the open book format and the additional time allocated for IT issues was reduced to 30 min.</p> <p>The study comprised of three phases: comparison of student performance data from 2019, 2020 and 2021; a questionnaire distributed to students in all years in 2020 and 2021; and student focus groups.</p> <p>Ethical approval was granted from the SVMS ethical review panel, approval number 3264 201021. Participation in the questionnaire and focus groups was voluntary and required informed consent; participants were informed of data handling process and of their right to withdraw. All data were anonymised.</p> <hd id="AN0191255577-5">Comparing student performance</hd> <p>Student performance data in written examinations undertaken in 2019 (pre-pandemic; CB), 2020 (early pandemic; OB, no adaptation) and 2021 (late pandemic; OB, with adaptations) were collated. Data were stored in Microsoft Excel, with analysis and visualisation carried out in R using the Tidyverse collection of packages (Kassambara [<reflink idref="bib24" id="ref38">24</reflink>]; R Core Team [<reflink idref="bib33" id="ref39">33</reflink>]; Wickham et al. [<reflink idref="bib40" id="ref40">40</reflink>]). Each student undertook a Multiple-Choice Question (MCQ) paper, and a Short Answer Question (SAQ) paper within each module. The number of modules varied across years (three modules in years 1, 3 and 5, five modules in year 2 and eight in year 4). Each individual mark for each paper was treated as the unit of data, marks are shown as a proportion between 0 and 1 (where 0 is a score of zero, and 1 is a score of 100%). The distribution of student performance between different academic years and formats were visualised using violin plots. The distribution of the combined marks of all students in all modules for each of the academic years in question were compared. Differences between academic years were tested using the Kruskal-Wallis Test, if the global test revealed significant differences, pairwise comparisons were conducted using the Wilcoxon Test with <emph>p</emph> < 0.05 considered significant in both cases.</p> <p>Where the same students undertook examinations in subsequent academic years the overall marks achieved by each student in each academic year were compared. The difference between performance in CB (2019), OB, no adaptation (2020), and OB, with adaptation (2021) formats were calculated for each student that had scores at each time point. A Bland-Altman plot was used to visualise the differences in performance between each year, by mean performance (Lehnert [<reflink idref="bib27" id="ref41">27</reflink>]).</p> <hd id="AN0191255577-6">Student preparation and perceptions</hd> <p>A mixed-methods approach was used to investigate student perceptions of open book examinations, namely online questionnaires and focus groups. In June 2020, after the first assessments had been completed, a survey was distributed to all students. A further survey was sent to students the following academic year, after the 2021 assessment period. Focus groups were conducted with students in 2021 following the assessment period.</p> <p>The questionnaire comprised of categorical and Likert-style items relating to students' preparation, approach to OB assessments, and their experiences of the format. Participants were asked the extent to which they agreed with each statement (1= strongly disagree to 5= strongly agree). Free-text boxes invited further comments throughout the questionnaire. The questionnaire was piloted with a small number of veterinary students in May 2020, subsequently distributed to all students <emph>via</emph> email and remained open for 8 weeks. The questionnaire was redistributed to all students the following academic year in 2021, at which point students were invited to attend either an in-person or online focus group.</p> <p>The questionnaire data were used to inform the design of the focus group phase which enabled a deeper insight into their experience of sitting examinations in open book conditions. A semi-structured script was developed to further explore responses to the questionnaire and piloted with three postgraduate students. Questions explored the student experience of OB assessments, and the impact of the OB format on their learning and mental wellbeing.</p> <p>Focus groups conducted in-person were recorded with a handheld voice recorder and then manually transcribed. The focus groups conducted online were recorded and transcribed on Microsoft Stream © then manually checked and edited as necessary.</p> <p>Analysis of qualitative data from the questionnaires and focus groups was carried out using a reflexive thematic approach, as described by Braun and Clarke (Braun and Clarke [<reflink idref="bib7" id="ref42">7</reflink>]). Coding was carried out in NVivo 12 using an inductive approach, a secondary researcher independently reviewed the codes and a process of comparison and review lead to the production of the final codebook. A theme was defined by how well it captured an important element in the data rather than by the number of responses relating to it.</p> <hd id="AN0191255577-7">Results</hd> <p></p> <hd id="AN0191255577-8">Student performance</hd> <p>Candidate performance in all examinations was significantly different between academic years (Figure 1 and Table 1). Overall mean marks increased by 0.084 with the change from closed to open book between 2019 and 2020. Similar increases were seen when calculating the MCQ examination performance and SAQ examination performance in isolation (increases of 0.073 and 0.065 respectively). Following the adaptations in 2021, performance reduced overall but remained higher than 2019 (0.059 higher than 2019), and similarly for each of the MCQ and SAQ categories (0.060 and 0.056 higher than 2019 respectively).</p> <p>PHOTO (COLOR): Figure 1. Violin plot showing the distribution of overall marks across all examinations for the 2019 (closed book), 2020 (open book, no adaptations), and 2021 (open book with adaptations) academic years. **** indicates p < 0.0001.</p> <p>Table 1. Mean mark and standard deviation for each academic year. Average marks for multiple choice question (MCQ) and short answer question (SAQ) paper formats are shown in addition to the combined overall mean average.</p> <p> <ephtml> <table><thead><tr><td>Year</td><td>Mean overall mark (sd, n)</td><td>MCQ mean mark (sd, n)</td><td>SAQ mean mark (sd, n)</td></tr></thead><tbody valign="top"><tr><td>2018–19</td><td char=".">0.68 (0.077, 686)</td><td char=".">0.69 (0.12, 2282)</td><td char=".">0.69 (0.11, 2282)</td></tr><tr><td>2019–20</td><td char=".">0.76 (0.056, 746)</td><td char=".">0.77 (0.10, 2550)</td><td char=".">0.75 (0.10, 2550)</td></tr><tr><td>2020–21</td><td char=".">0.74 (0.061, 758)</td><td char=".">0.76 (0.11, 1927)</td><td char=".">0.75 (0.089, 1927)</td></tr></tbody></table> </ephtml> </p> <p>When visualising the difference in overall performance between the same students sitting the 2019 (CB) and 2020 (OB, no adaptations) there was a trend for smaller differences in performance at higher average levels of achievement, i.e. those students who scored higher marks tended to have a smaller increase in examination marks between the closed and open book academic years, than those with lower average levels of performance (Figure 2). A similar trend is seen comparing 2019 (CB) and 2021 (OB with adaptation) (Figure 3).</p> <p>Graph: Figure 2. Bland-Altman Plot showing the difference in performance in 2019 (closed book) and 2020 (open book, no adaptations) against the mean performance for each student. The central dashed line shows the mean change in performance, and the outer dashed lines the 95% confidence interval around this mean.</p> <p>Graph: Figure 3. Bland-Altman Plot showing the difference in performance in 2019 (closed book) and 2021 (open book, with adaptations) against the mean performance for each student. The central dashed line shows the mean change in performance, and the outer dashed lines the 95% confidence interval around this mean.</p> <hd id="AN0191255577-9">Student perceptions</hd> <p></p> <hd id="AN0191255577-10">Quantitative survey data</hd> <p>The first administration of the survey (S1) returned 296 responses (38% response rate). The second administration (S2) returned 117 responses (12% response rate).</p> <p>The majority of students (72% in S1 and 82% in S2) agreed that preparing for OB was less stressful than preparing for CB assessments. Similarly, students agreed that they felt more confident going into OB examinations (72% in S1 and 84% in S2). When asked if they prepared for OB and CB assessments in the same way, 54% of respondents agreed in S1 and 42% agreed in S2, suggesting a change in approach between years.</p> <p>Most students agreed that sitting OB compared to CB assessments was less stressful (67% in S1 and 54% in S2). However, fewer students agreed that the OB format was easier (39% in S1 and 20% in S2). Overall students felt the OB format was a fair reflection of their ability (77% and 94% agreement in S1 and S2 respectively) and agreed that OB examinations improved their learning and understanding of the subject material (68% in S1 and 84% in S2).</p> <p>When asked about academic misconduct, the majority of students understood what constituted plagiarism (82% in S1 and 84% in S2) and collusion (99% in S1 and 98% in S2) during OB assessments. A minority of students (3.4% in S1 and 5.1% in S2) confirmed that they had copied answers verbatim from external sources, and 1.4% of respondents in S1 admitted to discussing questions with another person during the assessment.</p> <hd id="AN0191255577-11">Qualitative survey and focus group data</hd> <p>Six focus groups took place between 10<sups>th</sups> May and 24<sups>th</sups> November 2021. Thematic analysis of the qualitative data identified four main themes: approach to assessment, student well-being, assessment for learning, and preparation for clinical practice. The following section describes these themes using example quotes. Triangulation with quantitative data is included where relevant.</p> <hd id="AN0191255577-12">Approach to assessment</hd> <p>This theme arose as students discussed how the change in format from CB to OB book examinations impacted their approach to study in the lead up to assessments. These discussions were not limited to the revision methods utilised, but included broader discussions around motivations, confidence in their own abilities and how the Covid-19 pandemic had impacted their learning.</p> <p>Free-text comments reflected a positive change in learning behaviour for some students in response to the OB format, in that they reported spending less time memorising facts, focusing more on core concepts. One student reported</p> <p> <emph>'(I) focused more on note sorting and overall knowledge and understanding rather than focusing on memorising definitions and random information, (which) meant I knew the concepts of everything much more clearly</emph>'.</p> <p>However, others reported spending more time organising their notes than they did learning material. This effect is less desirable given the importance of core knowledge to clinical competency. An increasing change in approach was seen in the quantitative results, this suggests that once they had the experience of the open book format, students adapted their approach further.</p> <p>The OB format appeared to affect students' motivation to study. Some students reported that the OB format decreased their motivation due to feeling under less pressure to revise. However, others utilised their preparation time to do additional reading and to research subjects that they were interested in, suggesting that the OB format might be beneficial to students who are intrinsically motivated by the topic area being assessed.</p> <p>Students reported feeling more confident about the outcome of OB examinations, but comments reflected the uncertainty some felt about their approach. Further, students described the impact that Covid-19 restrictions had on their preparation, regardless of the OB format</p> <p> <emph>'I think my answers would be quite different had this not been in the midst of the coronavirus crisis. The reason I spent less time preparing was not because the exams were open book, but because I was struggling to focus in a new environment, there were a lot of changes to day-to-day life and I generally found concentrating difficult.'</emph> </p> <p>The OB context clearly resulted in a change in study approach in preparation for assessment. However, it is not clear as to how much of this is attributed to the pandemic, with students working in new environments, some with caring responsibilities and many being concerned about family members. Neither is it clear if the overall educational impact of these changes is beneficial for learning and development of clinical competency.</p> <hd id="AN0191255577-13">Student wellbeing</hd> <p>This theme reflects how students felt the OB format affected their wellbeing. They discussed examination stress, the difficulty of the assessments, and how this impacted their performance, and perceptions of their physical and mental wellbeing.</p> <p>Students reported a decrease in stress associated with the OB format and this enabled them to concentrate on their revision and to be productive in preparation for their assessments. Some also felt that they could perform better during the examination as they were less stressed. This concurs with the findings of the quantitative questionnaire data. There was some evidence to suggest that the reduction in stress reported was not necessarily due to perceptions of the OB examinations being easier</p> <p> <emph>'(I found the open-book exams) less stressful and (they) did not cause me the anxiety that usual exams do without it being in any way easier. I could not have done it without the same level of work put in as in non-open book examinations'</emph> </p> <p>Students perceived there to be an improvement in their mental and physical health because of a reduction in stress levels. As they were worrying less about assessments and living a healthier lifestyle.</p> <p> <emph>'I'm feeling like it's still stressful now, but I'm managing it better and I actually I get up at a reasonable hour. I go to bed at a reasonable hour. I have three meals a day that are like, nutritious.'</emph> </p> <p>However, a minority of students in the first year of the open book format described increased levels of stress associated with being unsure of how to prepare for the new assessment method and were underconfident in their open book examination technique. Some identified an increased pressure to look up information rather than trust their knowledge, which they found stressful.</p> <hd id="AN0191255577-14">Assessment for learning</hd> <p>Discussions contributing to this theme highlight how the OB examinations affected their approach to learning and understanding of the course content. Students discussed the impact of OB examinations on their knowledge retention and engagement with teaching.</p> <p>Students felt less pressure to memorise information during their studies, so they were able to focus on developing a deeper understanding of the material, feeling they could better focus on learning how to be a good clinician than memorising facts for an examination. They also felt that knowing they had to study for OB assessments led to better engagement during teaching, as they felt less pressure to write down every fact.</p> <p> <emph>'I feel I take so many more opportunities in a lecture to make sure I understand what's being said. I think like the whole of our year, there's so many more people asking questions, querying things'</emph> </p> <p>Some students described the examination as a formative opportunity to receive feedback on their understanding, although there were no comments to indicate how students responded if they identified any gaps in their knowledge</p> <p>'<emph>Having an open book exam enabled me to answer first without referring to external sources followed by checking my understanding/confirming or correcting my answer using external sources.'</emph></p> <p>Some students felt that they had retained more information as a result of preparing for OB examinations because they felt that their approach had been less superficial.</p> <hd id="AN0191255577-15">Preparation for clinical practice</hd> <p>This theme arose as students discussed how OB examinations could prepare them for working in clinical practice, through improving information literacy, simulating clinical scenarios, and practicing application of knowledge.</p> <p>Students suggested the OB format improved information literacy including the organisation of notes and the use of trusted resources for their assessments</p> <p>'<emph>It is important to understand what sources can be trusted and which can't which using it in exams was useful to appreciate</emph>'.</p> <p>However, how students organise notes in these examinations may not be reflective of the skills required for practice. Some described how the format better represented their ability to utilise and apply knowledge, as is required in clinical problem-solving, and they felt that the OB format is a more realistic reflection of life as a clinician in practice, using underlying base knowledge, but referring to resources to check information when necessary.</p> <p> <emph>'I feel way more prepared to go into placement or practice now than I would have done, I think if we had closed book exams'</emph> </p> <p>Findings from the qualitative and quantitative phases demonstrate that these students experienced increased levels of confidence in preparation for examinations and clinical placements following OB assessments. Whether this increased confidence translates to increased competence, however, is not known. Some students doubted their ability to perform similarly in a CB context and anecdotal feedback from teaching clinicians suggests knowledge gaps which may indicate that students' confidence may be misplaced, due to a naive understanding of what core knowledge is required to underpin clinical competency.</p> <hd id="AN0191255577-16">Discussion</hd> <p>This study aimed to investigate the impact of the OB examination format on performance and to gain an insight into the student experience of sitting OB examinations in a UK veterinary school. The move to open book conditions resulted in an increase in student performance. While previous studies have not identified a difference in student performance between OB and CB formats (Durning et al. [<reflink idref="bib15" id="ref43">15</reflink>]; Spiegel and Nivette [<reflink idref="bib37" id="ref44">37</reflink>]), these results were not unexpected in 2020 as the question style was not adapted to the open book format. However, the effect on performance was still present the following year with OB adaptations, albeit to a lesser degree. This increase in performance is not uniform among all students, the difference in performance was generally greater for lower achieving students. This finding potentially has more significance and may inform how assessments can be delivered to cater for a range of students with different backgrounds and learning differences. The impact of having a declared disability and support plan was not within the scope of this research, however, medical students with learning differences such as dyslexia, have been shown to perform less well in certain examination formats and early in their course compared to their peers (Shaw, Malik, and Anderson [<reflink idref="bib36" id="ref45">36</reflink>]). Whilst it is known that neurodiverse students benefit from a range of alternative assessment formats (Clouder et al. [<reflink idref="bib12" id="ref46">12</reflink>]), further work is needed to understand the impact and potential benefits of OB examination conditions on the performance of students with learning differences. Examination format has previously been shown to affect the awarding gap for different socio-demographic groups of students (Canal and Child [<reflink idref="bib10" id="ref47">10</reflink>]) therefore, consideration of OB assessments may be helpful in reducing an attainment gap in some higher education contexts, where students are struggling to reach their potential.</p> <p>The students in this study appeared to adapt their approach to assessment for the OB format, similar to previous findings in teacher education students (Theophilides and Dionysiou [<reflink idref="bib38" id="ref48">38</reflink>]). Students described a deeper approach to their study, resulting in a more holistic understanding of content and increased confidence in their ability. Given the lack of difference previously seen in learning between OB and CB assessment (Permzadian and Cho [<reflink idref="bib32" id="ref49">32</reflink>]), it should be acknowledged that this change in approach may reflect strategic approaches to study, previously identified in veterinary students, and an intrinsic motivation to succeed on the course (Cobb et al. [<reflink idref="bib13" id="ref50">13</reflink>]; Zamor et al. [<reflink idref="bib41" id="ref51">41</reflink>]), rather than the educational impact of the OB format per se. However, if this behaviour is strategic and purely driven by a desire to achieve, it is still considered a positive change.</p> <p>Reflecting on examination preparation, students described spending less time on learning and more time on organisation of resources for effective retrieval within the examination. Again, demonstrating a strategic approach and whilst organisation of credible resources is an important skill for lifelong learning, there is a concern that this comes at the expense of learning fundamental knowledge, which is essential to clinical competency. Furthermore, a preference for information organisation, over knowledge and understanding of content, may result in knowledge gaps and contribute to subsequent imposter syndrome experienced by clinicians and students within the veterinary profession (Appleby, Evola, and Royal [<reflink idref="bib3" id="ref52">3</reflink>]; Kogan et al. [<reflink idref="bib25" id="ref53">25</reflink>]) and described by participants in the current study.</p> <p>Findings from the questionnaire and focus groups demonstrate that there was a variation in the way different students perceived the OB format. Some described less pressure, not having to memorise information, which allowed a deeper approach to learning throughout the year, with more freedom to read around their subject resulting in greater understanding. They also perceived the format to be authentic preparation for working in clinical practice. This finding should be interpreted with consideration of the limited clinical experience of many of the participants. Whilst they may expect to have time to refer to resources within their clinical decision making, this may not be the case in a varied and time-pressured clinical workplace (Magnier et al. [<reflink idref="bib28" id="ref54">28</reflink>]).</p> <p>The effect of the OB format on student anxiety isn't clear. Similar to previous findings in teacher education and psychology students (Gharib, Phillips, and Mathew [<reflink idref="bib2" id="ref55">2</reflink>]; Theophilides and Dionysiou [<reflink idref="bib38" id="ref56">38</reflink>]), there seemed to be less student anxiety associated with the OB format. However, a minority of participants reported increased stress levels associated with preparing for an unknown format, increased stress has previously been associated with the OB format in engineering students (Lau [<reflink idref="bib26" id="ref57">26</reflink>]) and this may be reflective of the broader educational context, the degree of constructive alignment and individual student preference.</p> <p>One concerning finding was the identification of academic misconduct as a result of the examination conditions. These data were anonymous, and participants clearly felt able to answer truthfully. However, the implications for examination integrity and reliance on OB as the only format within a competency assessment strategy should not be overlooked. Seemingly, for some students, the desire to succeed and progress to the next stage of the course overrides the requirement for a professional and honest approach to their study. Notably there seemed to be a higher declared rate of plagiarism compared to collusion, with less understanding of what might constitute plagiarism in an OB context. It should be acknowledged that students were not asked about conduct during CB examinations; previous studies have shown that cheating persists at low levels within higher education and requires a multifaceted approach to address the problem (Tight [<reflink idref="bib39" id="ref58">39</reflink>]). Whilst this behaviour may not be exclusive to OB examinations, the format does provide additional opportunities for academic misconduct and so training of both students and assessors to provide clarity around what constitutes cheating in this context is essential.</p> <p>Much emphasis has been given to the purpose of assessment within higher education, with greater emphasis being placed on assessment for learning to enable feedback and progression (Gibbs [<reflink idref="bib20" id="ref59">20</reflink>]; McLachlan [<reflink idref="bib30" id="ref60">30</reflink>]). Having identified ways in which students test their own knowledge and research information during the open book format, we propose it has the potential to enhance assessment for learning and assessment as learning (Schellekens et al. [<reflink idref="bib35" id="ref61">35</reflink>]). These findings build on previous studies, where students have been shown to spend more time researching and developing a deeper understanding of their subject during an OB examination (Theophilides and Dionysiou [<reflink idref="bib38" id="ref62">38</reflink>]). If the examination conditions are conducive to constructive research, deepening understanding and identifying knowledge gaps, there is potentially a place for the OB format in veterinary curricula post pandemic. Future work to explore the perception of educators and any relationship with subsequent clinical performance would add to the growing evidence in support of the OB format in healthcare education.</p> <p>Whilst this study has identified some potential advantages of the OB format within veterinary education, the effect of the pandemic on experience and performance cannot be overlooked and may be responsible for some of the observations made relating to the student approach and experience. The participants of this study were veterinary students from one university within the UK, as such the findings and conclusions drawn may not be transferable to other contexts. However, these findings are discussed in light of and add to the growing evidence surrounding the OB format in a range of higher education settings. The qualitative phase of this mixed methods study is not generalizable to other higher education settings but intended to provide a deeper insight into the experience of these students which may be helpful for other educators considering this format. The findings relating to students' perceptions are subject to the limitations of survey-based research, for example, the timing of data collection may have influenced students' responses, and they may have been more skeptical about the format prior to the assessment period and release of their results. Finally, recent advances in generative AI should be considered in delivering any OB examination with internet access and further guidance is available on setting restrictions in OB examinations considering current technology available (Dawson, Nicola-Richmond, and Partridge [<reflink idref="bib14" id="ref63">14</reflink>]). Clarity around what will be considered plagiarism in an OB context is essential to examination integrity, however, the use of AI in higher education is increasingly being adapted to both teaching and assessment practices (Michel-Villarreal et al. [<reflink idref="bib31" id="ref64">31</reflink>]) and technological advances should be considered in assessment strategy.</p> <hd id="AN0191255577-17">Conclusions</hd> <p>These veterinary students demonstrated higher levels of performance under OB conditions, with the greatest impact amongst lower achieving students. Students generally reported less stress and described a deeper approach to their learning. However, a strategic study approach was identified, with a reliance on information organisation at the expense of knowledge and understanding, and the impact of this on development of clinical competency is not clear. Concerns over examination integrity can't be overlooked and should deter educators from overreliance on the OB format within a curriculum, particularly for high stakes assessments. However, there are benefits of the OB format to student learning, wellbeing and performance and we recommend consideration of the OB format, particularly to enhance the formative function of assessment.</p> <hd id="AN0191255577-18">Ethical approval</hd> <p>Ethical approval was granted from the SVMS ethical review panel, approval number 3264 201021. Participation in the questionnaire and focus groups was voluntary and required informed consent; participants were informed of data handling process and of their right to withdraw. All data were anonymised.</p> <hd id="AN0191255577-19">Authors' contributions</hd> <p>There are no competing interests. All authors contributed to the conceptualisation of the research project, EG, SM and JR completed the data collection, KC, EG and JR contributed to the writing of the manuscript.</p> <hd id="AN0191255577-20">Disclosure statement</hd> <p>No potential conflict of interest was reported by the author(s).</p> <ref id="AN0191255577-21"> <title> References </title> <blist> <bibl id="bib1" idref="ref13" type="bt">1</bibl> <bibtext> Adair, J. G., and N. Vohra. 2003. " The Explosion of Knowledge, References, and Citations: Psychology's Unique Response to a Crisis." American Psychologist 58 (1): 15 – 23. https://doi.org/10.1037/0003-066X.58.1.15.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref29" type="bt">2</bibl> <bibtext> Afshin Gharib, William Phillips, & Noelle Mathew. (2012). Cheat Sheet or Open-Book? 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  Data: <searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+Methods%22">Evaluation Methods</searchLink><br /><searchLink fieldCode="DE" term="%22Tests%22">Tests</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Evaluation%22">Student Evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+Testing%22">Comparative Testing</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Experience%22">Student Experience</searchLink><br /><searchLink fieldCode="DE" term="%22Textbooks%22">Textbooks</searchLink><br /><searchLink fieldCode="DE" term="%22Test+Format%22">Test Format</searchLink><br /><searchLink fieldCode="DE" term="%22Academic+Achievement%22">Academic Achievement</searchLink><br /><searchLink fieldCode="DE" term="%22Well+Being%22">Well Being</searchLink><br /><searchLink fieldCode="DE" term="%22Learning+Processes%22">Learning Processes</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Veterinary+Medical+Education%22">Veterinary Medical Education</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22United+Kingdom+%28Nottingham%29%22">United Kingdom (Nottingham)</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/02602938.2025.2523598
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0260-2938<br />1469-297X
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: The COVID-19 pandemic declared in March 2020 led to many academic institutions moving to online teaching and remote assessment, including use of the Open Book (OB) assessment format. The aim of this study was to investigate the impact of an OB format on student performance, and to explore students' perceptions of OB assessment at a UK veterinary school. A mixed methods approach was utilised across three phases of study. Student performance data were compared for Closed Book (CB) and OB conditions. A questionnaire investigated students' perceptions of OB assessments and subsequent focus groups further explored students' experiences. Overall mean marks increased with the change from CB to OB. Students who scored higher in CB assessments tended to have a smaller increase in marks between the formats than those with lower average marks. Students reported less stress associated with the OB format and described a deeper approach to learning. However, a focus on organisation of resources reflects a strategic approach, and concerns regarding examination integrity should not be overlooked. This study highlighted the benefits of the OB format to student learning, wellbeing and performance and the findings can be used to inform educators considering the format within a programme of assessment.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2026
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1499297
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1499297
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/02602938.2025.2523598
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 13
        StartPage: 161
    Subjects:
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Evaluation Methods
        Type: general
      – SubjectFull: Tests
        Type: general
      – SubjectFull: Student Evaluation
        Type: general
      – SubjectFull: College Students
        Type: general
      – SubjectFull: Comparative Testing
        Type: general
      – SubjectFull: Student Experience
        Type: general
      – SubjectFull: Textbooks
        Type: general
      – SubjectFull: Test Format
        Type: general
      – SubjectFull: Academic Achievement
        Type: general
      – SubjectFull: Well Being
        Type: general
      – SubjectFull: Learning Processes
        Type: general
      – SubjectFull: Student Attitudes
        Type: general
      – SubjectFull: Veterinary Medical Education
        Type: general
      – SubjectFull: United Kingdom (Nottingham)
        Type: general
    Titles:
      – TitleFull: Open Book Assessment: Performance and Student Perceptions in a UK Veterinary Programme
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Erica Gummery
      – PersonEntity:
          Name:
            NameFull: Sam Marsh
      – PersonEntity:
          Name:
            NameFull: Kate Cobb
      – PersonEntity:
          Name:
            NameFull: John Remnant
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      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-print
              Value: 0260-2938
            – Type: issn-electronic
              Value: 1469-297X
          Numbering:
            – Type: volume
              Value: 51
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: Assessment & Evaluation in Higher Education
              Type: main
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