Date of Award

January 2026

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Janet Hafler

Abstract

During medical school, students are exposed to a vast amount of knowledge they are expected to learn, understand, and apply to the care of patients. Various study strategies have been adopted by students over the years to facilitate this process, such as spaced repetition flashcards, the use of learning aids such as mnemonic devices, and the use of third-party resources to supplement their learning in the classroom. Instructors have also recognized the value in certain formats of classroom instruction, such as case-based learning or team-based learning, in keeping students more engaged and in reinforcing their learning in an interactive manner. However, an aspect of medical education that remains understudied is the practice of medical student note-taking both inside and outside of the classroom and throughout the different years of medical school. This thesis explores how medical students take and make use of their notes for their own learning throughout their medical education.To investigate this question, we designed an exploratory study using a qualitative constructivist approach for data collection and analysis. The study design is phenomenological, utilizing interviews to explore student experiences. Upon interviewing 8 students on their note-taking experiences in the Yale School of Medicine, we have identified similarities and differences in note-taking approaches between students as well as five themes that better inform our understanding of the role of note-taking in medical education. The main theme identified in our study is note-taking as a developmental trajectory across medical training. Students not only took different note-taking approaches depending on their stage of training (e.g., carrying over their undergraduate habits vs. relying more on curated study resources), but also recognized important note-worthy information in different ways depending on their learning stage (e.g., instructor cues vs. clinical relevance). The second theme is that note-taking serves the dual purpose of encoding and storing information, with most students relying more on note-taking as an encoding tool to process their knowledge rather than a long-term storage tool. The third theme is that note-taking tools and modalities evolve over time to include not only different means of writing notes (e.g., pen & paper, laptop, tablet), but also expanding definitions of what counts as a “note” (e.g., AI-generated notes, third-party resources as notes). The fourth theme is that teaching/learning community influences learning and note-taking, both through curricular practices such as incorporating guided workshops and student-led practices such as collaborative student sessions. The fifth theme is the existence of barriers to effective note-taking, such as cognitive overload and note loss. Taken together, these five themes give more insight into how medical students take and make use of their notes for their own learning and can inform future recommendations to both students and instructors for optimizing medical learning both inside and outside of the classroom.

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This is an Open Access Thesis.

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