This article describes the effectiveness of open note quizzes in improving student outcomes in an introductory Human Anatomy and Physiology course. Results are discussed within the context of a teaching strategy called LETME (Link, Extract, Transform, Monitor and Extend), which was specifically developed for at risk community college students. The use of open note quizzes not only helped students "monitor" their progress, but also with note taking as they "extracted" and "transformed" information from the textbook and other sources. It also enabled them to "link" this information to previous knowledge and "extend" it to new concepts. In addition to achieving significantly higher test scores in the five lecture tests and overall grades, students exposed to LETME reported slightly better study habits in monitoring their own performance and their independent study skills. For instance, surveys indicated that they were more likely to use their textbook, take notes and be involved with study groups. The experimental group also reported that the open note quizzes helped them in preparing for exams and mastering the course. Students in the experimental group were also more likely to complete the course than the general student population.