Strides in Development of Medical Education

Document Type : Brief report


Ph.D. in Physiology, Associate Professor, Department of Physiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran


  Background & Objective: Open book exams with free access to resources are effective for the better understanding of concepts and achieving higher levels of Blooms taxonomy This study investigated the correlation of average educational grading with open book exam score and with deep information processing (DIP) The attitudes of medical students in basic sciences stage regarding open book exams were also reported   Methods: In this descriptive study the subjects were 34 medical students in their third semester The students were informed of the date and duration of the quiz issues in question multiplechoice form of questions and the main book source for quiz 2 weeks in advance However students were not aware of it as an open book exam until it was performed After completing the test a survey and DIP were conducted for students anonymously Data were presented in the form of descriptive statistics The ttest and the correlation of educational grading with OBE and with DIP scores were performed using SPSS software   Results: The mean age of students was 2485 ± 012 years Their average educational grading and the the quiz and the DIP scores were 154 ± 022 658 ± 033 and 745 ± 137 respectively There were no significant differences among genders in the above mentioned variables The Pearson coefficient of the average educational grading was not significantly for the quiz score (0272) and the DIP score (0258) Moreover 91% of students stated that understanding is an essential requirement for success in open book exams Only 3% of students stated that open book exams reduce the incentive to attend classes   Conclusion: The average educational grading of medical students in basic sciences stage based on routine quiz scores is not an appropriate index of success in open book exams and gaining a deep understanding of topics The open book exam experience may be effective in increasing their awareness of their weaknesses in understanding concepts reasoning and drawing connection between lessons


  1. Van der Vleuten CP, Schuwirth LW. Assessing professional competence: from methods to programs. Med Educ. 2005; 39(3): 309–17.
  2. Hoskins SG, Stevens LM. Learning our L.I.M.I.T.S.: less is more in teaching science. Adv Physiol Educ. 2009; 33(1):17-20.
  3. Heijne-Penninga M, Kuks JB, Schönrock-Adema J, Snijders TA, Cohen-Schotanus J. Open-book tests to complement assessment-programmes: analysis of open and closed-book testsAdv Health Sci Educ Theory Pract. 2008; 13(3):263-73.
  4. Krasne S, Wimmers PF, Relan A, Drake TA. Differential effects of two types of formative assessment in predicting performance of first-year medical students. Adv Health Sci Educ Theory Pract. 2006; 11(2):155-71.
  5. Vanderburgh PM. Open-book tests and student-authored exam questions as useful tools to increase critical thinking. Adv Physiol Educ. 2005; 29(3):183-4.
  6. Mészáros K, Barnett MJ, McDonald K, Wehring H, Evans DJ, Sasaki-Hill D, et al. Progress examination for assessing students' readiness for advanced pharmacy practice experiences. Am J Pharm Educ. 2009; 73(6):109.
  7. Boniface D. Candidates' use of notes and textbooks during an open book examination. Educ Res. 1985; 27(3): 201–9.
  8. Eilertsen TV, Valdermo O. Open-book assessment: a contribution to improved learning? Studies in Educational Evaluation. 2000; 26(2): 91–103.
  9. Bouman IN, Riechelman HW. Open-book exams: aims, facts and future. Med Teach. 1995; 17(240):b4.
  10. Bruinsma M. Motivation, cognitive processing and achievement in higher education. Learning and Instruction. 2004; 14(6):549–68.
  11. Heijne-Penninga M, Kuks JB, Hofman WH, Cohen-Schotanus J. Influence of open- and closed-book tests on medical students' learning approaches. Med Educ. 2008; 42(10):967-74.
  12. Broyles IL1, Cyr PR, Korsen N. Open book tests: assessment of academic learning in clerkships. Med Teach. 2005; 27(5):456-62.
  13. Bruinsma M. Effectiveness of higher education Factors that determine outcomes of university education. Groningen: Groningen University; 2003: 143-9.
  14. Zhou YX, Zhao ZT, Li L, Wan CS, Peng CH, Yang J, et al. Predictors of first-year GPA of medical students: a longitudinal study of 1285 matriculates in China. BMC Med Educ. 2014; 14:87.
  15. McManus IC, Dewberry C, Nicholson S, Dowell JS. The UKCAT-12 study: educational attainment, aptitude test performance, demographic and socio-economic contextual factors as predictors of first year outcome in a cross-sectional collaborative study of 12 UK medical schools. BMC Med. 2013; 11:244.
  16. Kumar M, Sharma S, Gupta S, Vaish S, Misra R. Effect of stress on academic performance in medical students--a cross sectional study.  Indian  J  Physiol  Pharmacol. 2014;  58(1):81-6.
  17. Ferguson E,  James  D,  Madeley  L.  Factors associated  with  success  in  medical  school: systematic  review  of  the  literature.  BMJ. 2002;  324(7343):952–7.