# Evaluating the Use of a Note-Taking App by Japanese Resident Physicians: Nationwide Cross-Sectional Study

## TL;DR

This study examines how Japanese resident physicians use a note-taking app and finds that users tend to have higher exam scores.

## Contribution

The first study in Japan to investigate the use of note-taking apps among physicians and its impact on clinical knowledge.

## Key findings

- App users had higher GM-ITE scores compared to non-users.
- App users were more likely to be in PGY 2, work in community hospitals, and use online resources.
- App use was associated with more time for self-study and general internal medicine rotations.

## Abstract

Note-taking is a method that has long been used to optimize studying. Recent innovations have seen the introduction of digital note-taking using software apps. Although the current state of digital note-taking has been verified mainly among students, the use and efficacy of digital note-taking by physicians in actual clinical practice remain unknown. Therefore, we sought to understand the characteristics of note-taking residents using a note-taking app and determine whether there is a difference in basic medical knowledge compared to that of nondigital note-taking residents.

This study investigated the use of a digital note-taking app by Japanese resident physicians.

This analytical cross-sectional study was conducted in resident physicians during the General Medicine In-Training Examination (GM-ITE), a clinical competency examination for resident physicians. The GM-ITE is a multiple-choice test with a maximum score of 80 points. Using a structured questionnaire, we collected data on the sociodemographic characteristics (sex, age, postgraduate year [PGY], or others), clinical training, GM-ITE scores, and the use of an app for note-taking to record case experience. The GM-ITE evaluated the scores by dividing them into 4 groups (groups 1‐4), in order from the lowest to the highest. We conducted a multivariate analysis of sociodemographic, clinical training, and GM-ITE score variables to determine the independent predictors of the use of a digital note-taking app.

This study included 3833 participants; 1242 (32.4%) were female, 1988 (51.8%) were PGY 1 residents, 2628 (68.6%) were training in a rural area, 3236 (84.4%) were in community-based hospitals, and 1750 (45.3%) were app users. The app users were more likely to be in their PGY 2, to work in a community-based hospital, to have general internal medicine rotation experience, to use online medical resources more frequently, and to have more time for self-study. The results showed that the app users group had a higher GM-ITE score than the nonapp users group (adjusted odds ratio 0.74, 95% CI 0.25 to 1.22; P=.003).

To the best of our knowledge, this is the first study to investigate note-taking by physicians in Japan using apps. The app users group had a higher GM-ITE score than the nonapp users, suggesting that they may have higher clinical skills. In the future, we would like to conduct more in-depth research on the facts of note-taking using apps, based on our results.