Three Proven Strategies to Supercharge Digital Note-Taking in Physician Assistant/Associate Education

Abstract

Introduction

Research on note-taking strategies in the higher education setting has been in existence since the 1920s. While both pros and cons exist for handwritten and digital note-taking techniques, recent research has focused on novel ways to optimize digital note-taking. With more students using laptops or tablets with a stylus, educators need to be equipped to coach students on evidenced-based ways to improve their digital note-taking.

Methods

PubMed, ERIC, and CINAHL databases were searched on January 6, 2025, using combinations of the following key words: digital, technology, analogue, note-taking, cognition, memory, laptop, stylus, and tablet. Studies were included if they were performed with adult learners in the higher education setting with a primary focus on note-taking.

Results

Three hundred thirty records were screened with 25 included in final review. Thematic analysis identified three emerging themes: (1) collaborative/group note-taking, (2) outlines, and (3) mind mapping, concept maps, or matrixes.

Discussion

Physician assistant/associate faculty can educate students on ways to conduct collaborative or group note-taking, create outlines, and generate mind maps, concept maps, or matrixes. These evidence-based digital note-taking strategies can be conducted independently or as a group. By supplementing these strategies with basic retrieval practices outside of the classroom, students will increase their likelihood of academic success.

INTRODUCTION

Health science education has pivoted over the course of time from passive, didactic instructional techniques to active-based learning where students are the primary drivers of their education and faculty serve as facilitators or guides. Furthermore, there has been an explosion of instructional technology offerings available for both inside and outside of the classroom ranging from online learning management systems, instructional videos, digital polling or gamification, survey response systems, and more. Throughout these immersive learning experiences, students often strive to take adequate notes to both reinforce learning and prepare for examinations. One recently published study of 577 university students showed 96% reported taking notes during class.¹ In addition, 4 of 5 university students connect 2 or more devices daily to campus Wi-Fi systems.² These statistics tell us that most students in the higher education setting are taking notes, and many are likely doing so with electronic devices.

Note-taking involves extensive demands on cognitive resources to simultaneously perform active listening and information processing.³ As such, researchers have been interested in identifying the optimal note-taking method to offload the cognitive burden while also enhancing long-term knowledge retention. To that end, some studies have shown longhand (aka analogue or handwritten) note-taking to be more effective than laptop note-taking.^1,4 On the contrary, other research has shown laptop note-taking to be more effective.^5,6 Regardless of note-taking method, research supports note-taking as means to improve both memory recall and comprehension of subject matter, while contributing toward academic success.⁷

While research on student note-taking in the higher education setting dates to the 1920s, technological advancements have changed students note-taking preferences from handwritten to digital methods through laptop or a tablet with stylus.⁸ Technology usage within the classroom continues to be commonplace and is continuously evolving. To date, there are no publications providing a thematic analysis of evidence-based strategies learners may use to optimize their digital note-taking. As such, this manuscript aims to fill the gap by summarizing the existing evidence on digital note-taking strategies in the hopes of benefitting both students and faculty. Faculty will gain an understanding of ways to incorporate various digital note-taking methodologies both inside and outside of the classroom. In addition, recommendations are provided to aid faculty as they advise students on note-taking best practices to improve long-term knowledge retention and academic success.

METHODS

PubMed, ERIC, and CINAHL databases were searched on January 6, 2025, using combinations of the following key words: digital, technology, analogue, note-taking, cognition, memory, laptop, stylus, and tablet. Studies were included if they were performed with adult (age 18 years or older) learners within the higher education setting with a primary focus on note-taking. The findings of the literature review search strategy are outlined in Figure 1.

Figure 1.

Literature review search strategy results. *Records were excluded for not meeting any of the following inclusion criteria: adult (18 years or older) learners, higher education study setting, and digital note-taking strategies

RESULTS

Three hundred thirty total records were identified. After removal of duplicates, 315 records were screened. Two hundred eighty-two records were removed due to one or more exclusion criteria (nonhigher education setting, nonadult learner, or non–note-taking focus). Thirty-three records were sought for retrieval, and 25 were included in final review. Three primary themes to optimize digital note-taking strategies were identified: (1) collaborative/group note-taking, (2) outlines, and (3) mind mapping, concept maps, or matrixes.

Theme 1: Collaborative/Group Note-Taking

Recent research has begun to study the impact of digital collaborative/group note-taking. For example, in a research study with graduate students in science, technology, engineering, and mathematics fields, those who participated in completing online group Google Documents for collaborative note-taking performed better on weekly quizzes than those who took notes individually.⁹ Another study comparing a collaborative note-taking group with both a laptop note-taking group and longhand note-taking group found the collaborative group outperformed the other 2 styles by showing a significantly higher level of learning achievement.¹⁰ It is postulated that some of the benefits of collaborative note-taking result from a decreased cognitive load on the individual learner. For example, if the individual note-taker misses something said during a lecture, video, or classroom activity, another member of the group may be able to “fill in the gap.”^9,10 In addition, when group members collectively record information, the team can build off each other's ideas to improve the understanding of course concepts and deepen their overall learning.¹¹

Theme 2: Outlines

In 2019, researchers found that undergraduate students benefitted more from instructor-provided skeletal outline notes, which provided students with an organizational structure/framework, as compared with cloze notes which included most of the lecture content with intentional blank spaces requiring students to fill in the missing word.¹² Furthermore, this study showed that increasing the difficulty of skeletal outline notes led to students having better free memory recall and inference.¹² It is important to consider, however, that students rated the more difficult outline notes as less enjoyable, less helpful, and as leading to lower comprehension.¹² Therefore, the authors remind faculty of the concept of desirable difficulties and that students may not recognize or appreciate how more difficult outlines may lead to improved knowledge retention and greater learning.¹²

Theme 3: Mind Mapping, Concept Maps, or Matrixes

Prior research in physician assistant/associate education has investigated standard note-taking practices as compared with mind mapping with results showing an increase in the individual overall critical thinking scores in those students involved in mind mapping activities.¹³ Mind mapping is a written technique in which the learner visually illustrates connections between concepts in a nonlinear fashion (Figure 2).¹³ With availability of tablet devices with a stylus, mind mapping may now occur digitally. Similar ways to establish relationships among ideas, in a digital format, include concept maps or matrixes.^14,15 Mind maps, concept maps, or matrixes are also excellent opportunities for students to engage in a group activity and to collaboratively construct a graphical depiction of their knowledge (ie, leaning on ideas presented in Theme 1: Collaborative/Group Note-Taking). In addition to improved learning, prior research on mind maps has also shown they may contribute to a more joyful learning experience for students.¹⁶

Figure 2.

Example mind map of factors affecting learning.¹⁷ The figure was used under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License.

DISCUSSION

The Journal of Physician Assistant Education has previously published on digital note-taking in 2016 with proposed best practices before, during, and after class as well as a thorough review of digital note-taking applications available at that time.¹⁸ Other existing research, on the topic of note-taking, focuses on one particular note-taking methodology (ie, outlines, mind-mapping, collaborative notes, or other). Until now, a thematic analysis of existing evidence on digital note-taking methodologies has not been conducted. This manuscript adds to existing literature by summarizing the benefits of 3 evidence-based approaches to digital note-taking: collaborative or group notes, outlines, and mind mapping.

When coaching or mentoring student learners on note-taking strategies, faculty can suggest dividing up note-taking responsibilities with table or team-based learning group members (theme 1). Faculty can provide skeletal outlines for their various courses which allow students an organizational structure or framework to improve memory recall and inference (theme 2). Finally, instructors or academic advisors can provide students with sample mind maps, concept maps, or matrixes to facilitate discussion on the connection between various concepts or ideas (theme 3). These graphical depictions of knowledge also serve as excellent in-class or post-class activities which can be completed independently or as a group project. Studies on various note-taking methodologies have found nonlinear formats (ie, outlines, mind maps, concept maps, matrixes, or diagrams) to be superior to the linear recording of information.¹⁹

Finally, it has been proposed that note-taking should be thought of as a 3-stage process involving recording, revising, and reviewing.²⁰ As such, students need to exert effort not only to appropriately capture/record notes during the classroom session but also to adequately review and revise these notes once class has ended. Furthermore, this author would suggest the additional emphasis on retrieval as part of the note review process. For example, organized notes can be transferred into physical or digital note cards/flashcards for the purpose of self-quizzing.

Future Directions

Multiple digital note-taking applications are now available to learners. Both students and faculty would benefit from research showing head-to-head comparisons between these note-taking applications. Furthermore, it is possible that certain note-taking applications are more beneficial for specific subjects. Finally, while there is evidence both for and against longhand (also known as analogue or handwritten) vs. laptop note-taking methodologies, the introduction of digital tablets with a stylus opens the door to future research opportunities. For example, a study portraying specific characteristics or tendencies of learners who excel at taking notes with long-hand, laptop, or digital tablets with a stylus could prove incredibly valuable.

CONCLUSIONS

As technology continues to play a pivotal role in the classroom environment, it is exceedingly important for educators to evaluate how to improve its use for student success. As such, this manuscript conducted a review of existing literature to identify key themes of ways to optimize digital note-taking strategies. The themes of collaborative/group note-taking, outlines, and mind maps, concept maps, or matrixes were identified. Each of these 3 themes will allow for faculty members to advise students more clearly on how best to record or capture information from classroom sessions. Further coaching on the importance of note revision, review, and retrieval practice will lead to improved physician assistant/associate student academic performance.