A systematic review comparing open-book and closed-book examinations: Evaluating effects on development of critical thinking skills.

The advantages of using traditional closed-book examinations are closely compared to the advantages of using open-book examinations for the development of critical thinking skills in nursing students. The use of critical thinking skills is vital among nurses to assess patient needs and modify standard approaches to individualize care for better patient outcomes. The following areas are compared and contrasted for both closed-book and open-book examinations: examination preparation, rote memorization versus active learning, intellectual engagement, simulation of working environment, higher order thinking skills, anxiety reduction and student satisfaction. During investigation of closed-book examinations and open-book examinations, the use of collaborative testing was unveiled. Collaborative testing combines areas from both closed-book and open-book examinations. Based on the systematic review of literature, the recommendation is to use a mixed method of examination types throughout the course of the nursing program. Each type of examination helps develop different skill sets in the nursing student.