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Affordability can be as a significant barrier to higher education entry as tuition. While adoption of Open Educational Resources (OER) is frequently cited as one possible solution for rising student costs, OER have yet to disrupt the traditional publishing model. Faculty still struggle with finding efficient and effective pedagogical approaches when replacing textbooks with OER and require significant institutional support when making the transition. This systematic literature review was conducted on 51 studies, published between 2009 to 2019, investigating the barriers to adoption, efficacy of materials, and instructional strategies used when incorporating OER. Findings debunked the conception that open connotes poor quality and recommended further research to address the gap in pedagogical implications and collaborative opportunities for integration.