IJAR.2026.142
Type of Article: Original Research
Volume 14; Issue 2 (June 2026)
Page No.: 9524-9531
DOI: https://dx.doi.org/10.16965/ijar.2026.142
Perceptions of Phase-1 MBBS Students on Open Book (Resource) Formative Assessment in Enhancing Higher Order Thinking Skills
Swathi Poornima Chandaka *1, Shivasakthy Manivasakan 2.
*1 Professor and Head, Department of Anatomy, Dr Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, MHPE scholar, Institute of Health Professions Education, Sri Balaji Vidyapeeth, Puducherry, India. ORCiD: 0009-0004-8649-4060
2 Director, Institute of Health Professions Education, Professor, Department of Prosthodontics, Indira Institute of Dental Sciences, Sri Balaji Vidyapeeth, Puducherry, India. ORCiD: 0000-0002-2925-0682
Corresponding Author: Prof. (Dr) Swathi Poornima Chandaka, Department of Anatomy, Dr Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, MHPE scholar, Institute of Health Professions Education, Sri Balaji Vidyapeeth, Puducherry, India. E-Mail: swathi79poornima@gmail.com
Abstract
Background: Contemporary medical education emphasizes critical reasoning and knowledge application rather than rote memorization. Open-book formative assessments (OBFA) provide an authentic approach that fosters analysis, synthesis, and problem-solving. However, evidence on their role in enhancing higher-order thinking skills (HOTS) among Phase-1 MBBS students in India remains limited. This study explored student perceptions of OBFA in fostering HOTS and identified its perceived benefits and challenges.
Methods: A cross-sectional mixed-methods study using an explanatory sequential design was conducted among 137 Phase-1 MBBS students in Andhra Pradesh. Participants undertook both closed-book and open-book formative assessments in anatomy. Quantitative data from a validated questionnaire (Cronbach’s α = 0.707) and qualitative data from ten focus-group discussions (7–8 students each) were analyzed using descriptive statistics, correlation, and Braun and Clarke’s thematic framework.
Results: Mean scores improved significantly from closed-book (12.95 ± 3.54) to open-book assessments (18.41 ± 2.07; p < 0.001). Students perceived OBFA as enhancing critical thinking (3.91), application of anatomical knowledge (3.99), and analytical integration (4.09). It reduced anxiety (3.82) and promoted self-directed learning (3.99). Perception of OBFA strongly correlated with analytical integration (r = 0.71, p < 0.001). Themes reflected a shift from memorization to conceptual learning, improved problem-solving, and reduced stress, though time constraints and resource management posed challenges.
Conclusions: OBFA fosters higher-order cognitive engagement, conceptual understanding, and independent learning among early-phase medical students. With appropriate orientation and faculty training, its integration with traditional methods can strengthen CBME-aligned assessment practices.
Keywords: Open-Book Examination, Formative Assessment, Higher-Order Thinking Skills, Self-Directed Learning, Competency-Based Medical Education.
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