The purpose of this study was to examine the use and cognitive load associated with Open Educational Resources (OERS) and Affordable Digital Textbook (ADT) among pre- licensure Baccalaureate of Nursing students in an asynchronous on-line health policy course. OERS and ADT provide low student cost curriculum options for nursing faculty. The participants in this study were 171 pre-licensure nursing students who used both an OERS and ADT in their health policy course. A Convergent Mixed Methods design was used. Quantitative and qualitative data was gathered using a participant completed survey that measured textbook usability, cognitive load, and information about how the textbook were used and whether confusion arose while using the textbooks. The results revealed that most students used both textbooks throughout the course to complete assignments and understand course content. A paired sample t-test revealed no statistically significant difference in perceived cognitive-load scores between the textbooks. Students did report confusion related to navigating the texts and managing high volumes of content when using each of the textbooks. A statistically significant difference was found in textbook usability scores that suggests participants found the ADT provided greater usability. A MANOVA was performed. The number of civics courses and the number of policy courses had a main effect on cognitive load when using the ADT. An interaction effect between race and number of civics courses was observed when analyzing cognitive load when using the ADT. This study suggests that OERS and ADT are cost effective curricular choice in pre-licensure health policy courses.