Exploring the impact of note taking methods on cognitive function among university students

Abstract

Background

Taking notes during lectures plays a vital role in enhancing learning outcomes. With technological advancements, digital note-taking has gained popularity among university students in recent years due to its convenience, ease of storage, sharing, and searching. Different versions of digital note-taking have been introduced, including the use of styluses on tablets, which offer a blend of traditional handwriting and digital advantages. However, the use of digital devices may introduce distractions, such as access to social media, potentially disrupting focus and impacting learning effectiveness. Therefore, their impact on learning and cognition remains a topic of ongoing exploration. This study aimed to investigate the differences in cognitive functions between university students practicing either longhand or styluses digital note-taking methods in the United Arab Emirates.

Methods

One hundred students participated in this cross-sectional study. Sociodemographic information, including age, sex, nationality, and study year were obtained. Participants reported the note-taking method they use (longhand vs. digital note-taking with styluses). A battery of cognitive tests was used in this study to assess different cognitive functions, including the Montreal Cognitive Assessment (MoCA), the Symbol Digit Modalities Test (SDMT), the Brief Visuospatial Memory Test-Revised (BVMT-R), and the Stroop Color and word test. The Mann-Whitney U tests were used to assess differences in different cognitive domains between participants following longhand and styluses digital note-taking.

Results

Students that used longhand note-taking demonstrated significantly higher overall cognitive scores (MoCA, p = 0.005), along with superior information processing speed, working memory (SDMT, p = 0.045), and better visual memory (BVMT-R, p = 0.01), compared to those who used styluses digital note-taking. However, students using styluses digital note-taking exhibited better inhibitory cognitive control (Stroop test, p = 0.020).

Conclusions

Although using styluses offers a hybrid experience by combining the tactile benefits of handwriting with the digital advantages of electronic devices, students who employed longhand note-taking demonstrated significantly higher cognitive scores across several domains compared to their peers using stylus-based digital methods. However, while these differences were statistically significant, the effect size was small. Longitudinal cohort studies are needed to further examine the predictive, mediating, and confounding factors related to note-taking methods and cognitive abilities in students.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12909-025-07593-x.

Background

Note-taking during lectures is an essential skill for academic achievement, playing a pivotal role in how students process and retain information [1]. Students often cite the primary purpose of note-taking as aiding in the retention of presented material, as well as enhancing the encoding and storage of information for later retrieval [2]. Effective note-taking necessitates active listening, sustained attention, and the ability to focus on key concepts while filtering out irrelevant information [1]. It also demands cognitive flexibility, enabling students to adapt to varying learning styles and organize their notes efficiently [3]. This multifaceted process requires students to keep pace with the lecture, identify the most important information to record, and later organize and comprehend their notes effectively [4]. Thus, cognitive function is crucial to the quality of note-taking [5]. Moreover, the act of note-taking itself has the potential to enhance cognitive function by strengthening neural pathways associated with memory, organization, and comprehension [5]. This reciprocal relationship underscores how the practice of taking notes not only depends on cognitive abilities but can also improve them through regular engagement and practice [5].

In recent years, the rise of technology has led to a shift toward digital note-taking, especially among university students [6]. Many students now select digital note-taking taking advantage of the ability to easily store, search, and share their notes [7, 8, 9, 10], in addition, to facilitating idea diversity, enhancing better academic writing skills, promoting interactive learning environment, and improving writing strategies [11]. Digital note-taking can reduce the cognitive load associated with handwriting, enabling students to focus more on active listening and immediate recall [12]. Moreover, digital note-taking has a direct influence on attention and motivation [13]. However, despite these advantages, digital note-taking is not without its challenges [14, 15]. The digital writing can introduce distractions by enabling more possibility in multitasking, such as notifications from social media or text messages, which may hinder sustained attention and negatively impact the effectiveness of note-taking [14, 15]. Multitasking involves dividing attention across various sources of information and switching between tasks across multiple media forms [16]. Whether multitasking may or may not impair performance depends on the cognitive cost involved [17], as the human brain has limited processing capacity, that is known as the working memory, as explained by Cognitive Load Theory [18]. On the other hand, traditional handwritten note-taking tends to involve fewer distractions and has been shown to enhance comprehension, improve memory retention, and facilitate a more personalized style of notation, providing students with a visual guide that may aid their understanding [19].

Research has explored various note-taking methods and their impacts on cognitive functions, particularly among children and college students [20, 21]. These studies typically compare handwritten notes with digital note-taking methods, such as those involving laptops or mobile phones [19, 20]. However, much of the existing research has focused primarily on how different note-taking techniques influence memory-related outcomes [20, 21, 22, 23]. While these studies provide valuable insights into how various note-taking methods support memory, they often overlook other equally important cognitive domains, including attention, executive functions, processing speed, and cognitive inhibition. These cognitive aspects play a crucial role in academic performance, and a more comprehensive exploration of how different note-taking methods influence them is essential. By addressing this gap, the present study seeks to broaden our understanding of how note-taking techniques, including those that combine traditional and digital elements, affect a wide array of cognitive functions that are fundamental to learning and academic achievement.

Despite the valuable insights provided by previous studies, a notable gap in the literature remains regarding the using the styluses as a note-taking method and their impact on cognitive functions. A stylus, a digital pen used on touchscreen devices, enables users to create handwritten notes that can be saved, organized, converted to text, and edited [7, 24]. Stylus-based note-taking shares physical similarities with longhand (handwriting), producing notes comparable in word count, complexity, flexibility, and spatial strategies [25, 26, 27], suggesting potential for similar cognitive benefits. While some studies, such as Morehead et al. (2019), found no significant differences in performance across stylus, keyboard, and longhand methods [25], others, like Osugi et al. (2019), reported that stylus use may enhance learning compared to longhand [28]. Furthermore, although tablets with styluses uniquely combine the tactile benefits of traditional handwriting with the digital advantages of electronic devices—such as ease of storage, sharing, and searchability—there remains limited research exploring their influence on critical cognitive domains, including attention, memory, and executive functions. This gap underscores the need for further investigation to better understand how this note-taking approach can affect cognitive engagement.

Given these gaps, the present study aims to investigate whether differences exist in cognitive functions, such as memory, attention, executive functions, processing speed, visuospatial skills, and cognitive inhibition, among university medical students in the United Arab Emirates who use longhand versus digital stylus note-taking methods. We hypothesize that significant differences will emerge across these cognitive domains depending on the note-taking technique used. This research aims to provide a better understanding of how different note-taking methods might affect the cognitive performance, contributing to the broader discussion on effective study strategies in academic settings.

Methods

Study design and participants

This study followed a cross-sectional design and was conducted at the College of Health Sciences, University of Sharjah, United Arab Emirates. Third- and fourth-year medical college students were invited to participate. Inclusion criteria required that students had consistently used either longhand (pen and paper) or digital stylus (tablet and stylus pen) note-taking methods for at least one academic year. Freshman and sophomore students were excluded to ensure a minimum level of academic exposure and familiarity with note-taking practices. Additionally, students who reported using both methods interchangeably were excluded to reduce confounding effects. The Extended Nordic Musculoskeletal Questionnaire (NMQ-E) was administered to identify and exclude participants with upper limb musculoskeletal disorders that could affect handwriting or tablet use.

A total of 100 students met the eligibility criteria and participated in the study, with an age range of 20–24 years. All participants were from health-related academic programs to ensure comparable academic backgrounds.

Note-taking behavior was determined through a structured self-report questionnaire that assessed the method used, duration and frequency of use, and exclusivity. To enhance classification validity, self-reported data were cross verified with participants’ written examples and verbal confirmations during intake interviews. Although no direct classroom observations were conducted, these verification steps were implemented to minimize misclassification. Ethical approval for the study was obtained from the Research Ethics Committee of the University of Sharjah (Reference number: REC-23-02-21-04-S).

Study procedure

The aims and procedure of the study were explained to the participants, before receiving their signed informed consent. Sociodemographic information such as age, sex, nationality, and year of university education were considered. Lastly, The Edinburgh Handedness Inventory (EHI) was used to determine the handedness of each participant. Then participants were asked to identify the type of note-taking they were using, whether they took notes using their hands and/or digital styluses note-taking method.

In this study, cognitive function is operationally defined as the performance outcomes derived from a series of standardized neuropsychological tools, each targeting specific domains of cognition. These tools were selected based on their established validity, reliability, and sensitivity to detecting variations in cognitive abilities across healthy individuals and different populations. The specific domains assessed include global cognition, information processing speed, visuospatial memory, and inhibitory control. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), the Symbol Digit Modalities Test (SDMT), the Brief Visuospatial Memory Test-Revised (BVMT-R), and the Stroop test.

All cognitive assessments were conducted in a quiet room with the examiner present to ensure a controlled environment. Identical instructions were provided to all participants for each cognitive test to maintain consistency. To avoid the effects of fatigue and order effects, all tests were given in a random order to our participants.

Outcome measures

Cognitive assessment

The MoCA is a brief, yet comprehensive cognitive screening tool designed to evaluate several cognitive domains, including orientation, attention, language, visuospatial abilities, memory, and executive function. It consists of 30 items and takes approximately 10 min to complete, making it practical and time-efficient [29]. The MoCA is widely used in both clinical and research settings to screen for cognitive impairments across diverse age groups, including younger individuals [30]. Scores range from 0 to 30, with scores of 26 or higher considered normal and scores below 26 indicating potential cognitive impairment [31]. This tool has been validated for identifying cognitive function in the range of mild cognitive impairment, demonstrating excellent sensitivity and acceptable specificity [32, 33]. Its practicality and applicability make it particularly suitable for assessing cognitive function in young healthy adults [29, 34, 35].

The BVMT-R is a measure of visuospatial learning and memory. For 10 s, participants were shown a matrix of six simple designs, followed by an unaided recall. Participants are instructed to duplicate the drawings using paper and pencil, taking as much time as needed. Based on the accuracy and location grading criteria, each design earned a score of 0, 1, or 2, for a maximum of 12 for each trail. Delayed recall (completed in 25 min) measures long-term visuospatial memory skills and the ability to retrieve information from long-term memory. The total recall score reflects the overall level of visual memory [36].

The SDMT-Oral Version is a measure of information processing speed and working memory. Participants are provided with a sheet with nine symbols, each paired with a number on top of the page. The remaining of the page consists of a randomized, sequential assortment of these symbols. Participants are asked to verbally respond with the number that corresponds to each symbol. The dependent variable is the total number of correct answers in 90s [37].

The Stroop test is one of the most widely administered neuropsychological assessments, praised for its efficiency in evaluating a variety of cognitive processes, including selective attention, information processing speed, response inhibition, and cognitive flexibility [38]. It is designed to assess an individual’s ability to inhibit cognitive interference, a phenomenon known as the Stroop effect [39]. The test is conducted in two stages: the Stroop Color test, where participants are asked to name the ink color of a series of Xs (XXXXX) within a set time, and the Stroop Word test, where participants must name the ink color of a series of color words printed in incongruent ink colors (e.g., the word “RED” printed in blue ink), also within a set time [40]. The Stroop effect occurs when individuals are presented with incongruent color-word stimuli (e.g., a word like “red” printed in blue ink) and are required to name the ink color instead of reading the word. This task requires the inhibition of an automatic behavior (i.e., reading) in favor of a less practiced one (i.e., naming the color of the ink). The interference caused by this attempt to inhibit automatic behavior results in longer reaction times, thus demonstrating the Stroop effect [39, 41]. The Stroop test is frequently utilized in studies involving young adults to assess various cognitive functions [38]. The interference score was calculated and used in the analysis. The interference was derived by calculating the difference in performance between the Stroop Word and Stroop Color stages, reflecting the degree to which cognitive interference from conflicting information impacts task performance. Test scores of 40 or less are considered low, indicating significant difficulty with cognitive inhibition and interference [40, 42].

Statistical analysis

The normality of cognitive outcome variables was assessed using the Shapiro-Wilk test, which indicated that the data were not normally distributed. Sociodemographic data were presented as frequencies and percentages, while cognitive test scores were represented by mean ranks. Differences in cognitive function between students using longhand and digital note-taking were analyzed using the Mann-Whitney U test for each outcome measure of interest because the data were not normally distributed. All data were analyzed with a predetermined significance level of 0.05. All data analyses were performed using the IBM SPSS Statistics version 26. Effect size was calculated using a correlation coefficient (r) calculated as z/√N where z refers to z score and N refers to the total number of observations from both groups [43]. The r values of 0.10, 0.30, and 0.50 are interpreted as small, medium, and large effects, respectively [43].

Results

Descriptive data

A total of 100 students completed the study. The demographic characteristics of the participants are presented in Table 1. Descriptive statistics were used to summarize the sociodemographic characteristics of all students.

Table 1.

Demographic characteristics of participants

Participants Characteristics		Frequency (%)
Sex	Male	19 (19%)
	Female	81 (81%)
Nationality	Emirati	23 (23%)
	Non-Emirati, Arab	64 (64%)
	Non-Arab	13 (13%)
Study Year	3rd Year	31 (31%)
	4th Year	69 (69%)
Type of note-taking	Longhand 3rd year 4th year	58 (58%) 15 43
	Digital styluses note-taking 3rd year 4th year	42 (42%) 16 26

Table 2 illustrates the differences in cognitive scores across various domains between the note-taking groups. The results showed higher Mean cognitive scores in the overall cognitive scores (MOCA), information speed processing and working memory (SDMT), and BVMT-R (recall test) among longhand note-taking students compared to digital styluses note-taking students. On the other hand, digital styluses note-taking students had higher inhibitory cognitive control scores (Stroop test), compared to longhand note-taking students.

Table 2.

The mean ranks and statistical significance in cognitive function between longhand and digital styluses note-taking

Cognitive tests	Type of note-taking mean ranks median (IQR)		Z value	P-value	Effect size
	Longhand Writing (N = 58)	digital styluses note-taking (N = 42)
MoCA test (total score)	27.00 (3.25)	26.00 (4.00)	-2.835	0.005*	0.28**
SDMT test (correct at 90 sec)	59.50 (11.50)	55.50 (15.5)	-2.009	0.045*	0.20**
BVMT-R (delayed recall)	12.00 (1.00)	11.00 (2.00)	-2.565	0.01*	0.26**
Stroop test (interference score)	0.23 (0.14)	0.29 (0.17)	-2.322	0.020*	0.23**

MOCA: Montreal Cognitive Assessment; SDMT: Symbol Digit Modalities Test; BVMT-R the Brief Visuospatial Memory Test-Revised

*Statistically significant

**Small effect size

Discussion

To the best of our knowledge, this study is the first to investigate differences in cognitive function between university students using two distinct note-taking methods: longhand and digital styluses, assessed through standardized cognitive evaluation tools. Our findings provide insights into how these methods may influence cognitive abilities across various domains, including memory, processing speed, and inhibitory control. We have found that participants who used longhand note-taking demonstrated superior global cognitive abilities, as measured by the MoCA. Additionally, longhand note-takers performed better in key cognitive domains, such as information processing speed, working memory, and visuospatial memory. However, students who employed digital stylus note-taking showed higher inhibitory cognitive control, as measured by the Stroop test, compared to those using longhand.

Previous studies on note-taking methods have primarily focused on memory, with mixed results [44, 45, 46]. Some studies suggest that handwriting may enhance memory performance, particularly in tasks related to recall and letter recognition, while others indicate that digital note-taking can lead to better memory outcomes [44, 45, 46]. However, these studies have mainly been conducted with children, and their findings may not fully apply to university students [44]. Our research expands this discussion by not only exploring the impact of note-taking methods on memory but also assessing their effects across a broader range of cognitive domains, including processing speed, inhibitory control, and working memory, in an adult student population.

The results suggest that longhand note-taking facilitates deeper processing of information, enhancing memory retention and recall. Traditional handwriting is a multifaceted activity that involves significant cognitive effort [47]. This effort is due to the continuous interaction between various cognitive processes and motor skills required to produce handwritten text [47]. Studies have found that handwriting involves several executive functions, including working memory, attention shifting, and inhibition of prepotent responses [47, 48]. These functions are crucial for maintaining information, focusing attention, and controlling impulses during the writing process [47, 48]. The findings of the current study are consistent with the findings from previous studies [19, 21, 47, 48, 49], for example previous research by Mueller et al., found that university students using laptops for note-taking performed worse on conceptual questions compared to those who used longhand [19]. However, unlike previous studies, our research expands the understanding by assessing the impact of note-taking methods across a broader range of cognitive domains using standardized assessment tools. This approach may help to provide new insights into how different note-taking techniques can influence overall cognitive function, offering a fresh perspective for future studies to investigate in conjunction with other variables such as review, memory, achievement, and comprehension [22, 23].

Our study found that students using digital note-taking exhibited higher scores in inhibitory cognitive control compared to their longhand counterparts, as measured by the Stroop test. Although multitasking behavior was not directly measured in our study, this finding may align with prior research suggesting that frequent digital media engagement—often involving task-switching—could stimulate executive functions such as response inhibition and attentional control [50, 51, 52]. However, this interpretation remains speculative and should be approached with caution. Importantly, this possible cognitive benefit may come at the expense of deeper cognitive processing, as digital note-takers demonstrated lower recall and comprehension scores. Digital environments often introduce distractions—such as notifications and the temptation to multitask—which can fragment attention and increase cognitive load, especially given the limited capacity of working memory, as described by Cognitive Load Theory [17, 18]. In contrast, traditional handwritten note-taking typically involves fewer external distractions and promotes a more personalized and coherent notation style, potentially supporting deeper information encoding and better memory retention [6, 19, 21]. Future longitudinal studies should aim to directly measure multitasking behavior and account for individual differences to clarify these mechanisms further.

Interestingly, Belson et al., found that stylus note-taking increased the quality of notes and enhanced note-taking strategies among high school students with learning disabilities [53]. While our study focused on university students without learning disabilities, Belson et al., highlighted that the use of digital tools may offer benefits for certain populations or under specific conditions, which could suggest the potential for tailored note-taking approaches based on individual needs and learning profiles [53]. Future research may explore whether the advantages observed in populations with learning disabilities extend to broader academic settings or if certain features of digital tools (e.g., handwriting recognition, annotation, or recording functions) might enhance outcomes for different cognitive profiles.

Contrary to earlier studies, which have reported that stylus note-taking might provide similar benefits to longhand [54], our study observed differences in cognitive functions between students using longhand and those using digital stylus devices. These discrepancies may be attributed to variations in the methodologies used in different studies, including the cognitive domains assessed, measurement tools applied, and the types of note-taking strategies employed. Additionally, future research could benefit from a more homogeneous approach to examining these variables, including the standardization of measurement tools and a clearer specification of the cognitive domains being studied.

Practical stakes: implications of note-taking techniques in everyday life

Effective note-taking is an essential skill that extends beyond academic settings influencing professional, personal, and societal domains. The findings of this study provide insights into how different note-taking methods may impact cognitive processes critical for various real-world applications.

In professional environments, where retention, recall, and synthesis of information are crucial for decision-making and productivity [6, 18, 19, 20, 55], the superior cognitive outcomes associated with longhand writing, such as improved memory and comprehension, may have significant implications. For example, in a fast-paced workplace, the ability to efficiently obtain and organize information directly affects team communication, productivity, and decision-making [17]. Conversely, digital note-taking, which demonstrates enhanced inhibitory control, may be particularly useful in multitasking scenarios [16]. For instance, in collaborative digital work, managing competing stimuli becomes essential [6].

In addition, learning is a lifelong process which extends beyond the workplace. Note-taking also supports lifelong learning and personal development. Whether through workshops, training sessions, or self-directed study, acquiring new knowledge is an ongoing process. Understanding the cognitive impact of note-taking methods can help optimize these learning experiences [18].

As society undergoes rapid digital transformation in every aspect of daily life, from education to work, aligning note-taking strategies with specific cognitive and practical goals is increasingly important. This study emphasizes the need for a balanced approach leveraging strengths between traditional and digital methods to meet the demands of the digitally evolving world. By doing so, individuals can navigate the complexities of modern life while optimizing outcomes in various societal contexts.

Strength and limitations

Most previous studies have used questionnaires, free recall tests, or relied on educational scores to assess cognitive domain functions. However, the current study employed standardized cognitive assessment tools to assess overall cognitive function, information processing speed, working memory, visual memory, and inhibitory cognitive control domains.

While this study offers a comprehensive evaluation of cognitive performance, it also has certain limitations. One significant limitation is the use of a cross-sectional design, which prevents the establishment of causal relationships between note-taking methods and cognitive outcomes. While the study identifies associations between note-taking methods and cognitive performance, causality cannot be inferred from these findings. Furthermore, despite our findings, the small effect sizes also underscore the need for cautious interpretation. It is possible that individuals with higher cognitive abilities may naturally prefer certain note-taking methods, or that unmeasured factors, such as prior technology experience or personal preferences, may influence both the choice of note-taking method and cognitive outcomes. Consequently, the observed differences between longhand and digital note-taking groups may not be solely attributed to the methods themselves but could be influenced by other underlying factors such as their cognitive ability and their academic performance. Future longitudinal studies are recommended to better explore the temporal dynamics and causal relationships between note-taking methods and cognitive performance.

The study also focused on a specific age group, predominantly composed of females and individuals from the digital age era. This focus may have led to a selection bias, as these characteristics may not represent the broader population of students. Moreover, the exclusion of students who use a combination of note-taking methods reduces the ecological validity of the findings. Mixed methods are increasingly common in educational settings and excluding these participants may limit the applicability of the results to real-world practices. To address this, future studies should aim to include participants who use a variety of note-taking strategies to better reflect the range of methods employed by students in everyday academic environments. Another limitation of this study is the unequal group sizes between the longhand (n = 58) and digital stylus (n = 42) note-taking groups, which may affect the comparability and reliability of the findings. This group size imbalance introduces potential bias and underscores the importance of recruiting more balanced samples in future research. Additionally, we acknowledge the higher number of fourth-year students in the longhand group, which could influence cognitive outcomes, as academic year may be associated with differences in cognitive performance due to greater exposure to academic workload, learning strategies, and cognitive challenges. While third-year students were comparably represented in both groups, the overrepresentation of fourth-year students in the longhand group should be taken into account when interpreting the results.

Another avenue for improvement involves the examination of learning efficiency using more targeted and context-relevant cognitive assessment tools. While standardized assessments were used in this study, future research could benefit from incorporating more feasible methods such as direct measures of multitasking behavior, attentional control, and distraction susceptibility, particularly during note-taking tasks. Observational measures of task-switching and media use could provide a more ecologically valid understanding of cognitive engagement and information processing. These additions would offer deeper insight into the mechanisms through which different note-taking methods influence learning and performance in real-world academic settings.

Electronic supplementary material

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Abbreviations

NMQ-E

Extended Nordic Musculoskeletal Questionnaire

EHI

Edinburgh Handedness Inventory

MOCA

Montreal Cognitive Assessment

SDMT

Symbol Digit Modalities Test

BVMT-R

Brief Visuospatial Memory Test-Revised

Author contributions

All authors contributed to project conception, study design, data interpretation and analysis, and manuscript drafting. AA, RS, TO, RE, IW, WA, AOA, AAA, and NS contributed to the study design and data collection. AA, RS, AA, SR, AH, WBI, HH, MK, FH, and AN contributed to the study data analysis and interpretation. AA, RS, TO, RE, IW, WA, AOA, AAA, AA, SR, NS, AA, WBI, HH, MK, FH, and AN revised multiple manuscript drafts, including critical revision for important intellectual content. All authors read and approved the final manuscript.

Funding

No funding.

Data availability

The datasets used and analyzed during the present study are available fromthe corresponding author upon reasonable request.

Declarations

Ethics approval and consent to participate

This study was carried out according to the latest version of the Helsinki Declaration of the World Medical Association. Ethical approval was obtained from the Research Ethics Committee, University of Sharjah, United Arab Emirates (Reference number: REC-23-02-21-04-S). Informed consent was obtained from all participants prior to inclusion in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.