Sir, the pandemic has resulted in cessation of face-to-face teaching in the UK and numerous countries globally with many universities adopting online classroom learning and remote assessments. There is limited evidence on learner perspectives for the delivery of this examination format and so we conducted a service evaluation exploring learner experiences of open-book examinations in dentistry during the pandemic.

The retrospective survey involved an anonymous 14-item questionnaire which contained both quantitative and qualitative data items. This was distributed to all undergraduate dentistry and BSc oral health sciences learners across all years: 210 learners participated in the survey with 52.4% strongly agreeing a preference for open-book examinations in comparison to conventional closed-book examinations. Of the learners, 42.9% either agreed or strongly agreed that less preparation was required for open-book examinations, however, 80.5% reported learning new information; 85.2% disagreed or strongly disagreed that open-book examinations were stressful, however, 13.3% reported they disagreed or strongly disagreed with having a suitable working space during the open-book examination. Nearly half (49.5%) of learners indicated they would prefer an open-book examination in the future, 12.4% indicated a preference for closed-book examinations and 38.1% a combination of both examination formats.

Several learners mentioned that reduced stress resulted in increased happiness and improved mental wellbeing which allowed them to perform to the best of their ability. Some learners mentioned closed-book examinations gave them anxiety which was relieved through undertaking open-book examinations. However, some learners did state that the lack of stress meant learners did not feel there were any rewards when they got their results. One learner reported they 'enjoyed [their] revision a lot more, focusing on note making to help [them] understand content…'

During preparation for their open-book examinations, learners reported they did not memorise content to the best of their ability as they knew they had access to resources and as a result, felt they did not learn the content as thoroughly as if they had sat closed-book examinations; 'Because you know you can use your notes, you're less likely to fully revise and memorise the content because there isn't that stress of not knowing it...' Learners reported that some were not motivated to study for their examinations and expressed concern on their preparedness in subsequent years of their degree; 'open-book exams can make you feel less prepared for the following year and the rest of your degree'.

To conclude, open-book exam questions need to be tailored in such a way that they promote application of knowledge rather than resource searching skills. There needs to be both learner and educator preparation and training (including support structures for home working and wellbeing support) and intended learning objective mapping to ensure new assessment methods fulfil GDC requirements of Preparing for practice.1 We are happy to share our study with educators should they wish to get in contact. The full study has been submitted for publication.