# Addressing the challenges of field notes in medical education: a qualitative study of resident experiences

## TL;DR

This study explores challenges residents face with field notes in medical training and suggests improvements to make them more effective.

## Contribution

The study identifies specific operational challenges and proposes practical solutions for improving field note use in medical education.

## Key findings

- Residents found field notes redundant, complex, and time-consuming for preceptors.
- Suggestions included mobile-friendly platforms and clearer guidelines for use.
- Integrated feedback systems and streamlined functionality were recommended for improvement.

## Abstract

Evaluating resident physicians’ competencies is critical in medical education to ensure high standards of patient care and professional development. Field notes are increasingly used as reflective tools in postgraduate medical education. Despite their growing use, skepticism about their effectiveness persists. This study aims to identify challenges with learner engagement in field notes and gather suggestions for operational improvements.

A qualitative study was conducted in the Department of Family & Community Medicine at the University of Toronto. Semi-structured interviews were conducted with seven postgraduate year one and year two family medicine residents. The interviews focused on residents’ experiences and challenges with field notes. Data were analyzed using inductive thematic analysis to develop a comprehensive codebook, in alignment with Braun and Clarke’s framework.

Several key challenges with the use of field notes were identified including the redundancy of feedback, sporadic utilization, and time constraints for preceptors. Residents also expressed uncertainty about the expectations for using the tool and identified it as complex and cumbersome. Operational suggestions for improvement included the development of a mobile-friendly platform, streamlined functionality, a standardized and integrated feedback system, and clearer guidelines for use.

The study highlighted significant challenges in the use of field notes within family medicine training programs and underscored the need for technological and procedural innovations to improve their effectiveness. Addressing these challenges through user-friendly design, clear guidelines, and integrated support systems could transform field notes into a more robust tool for competency-based medical education, benefiting residents, preceptors, and the broader medical community.

The online version contains supplementary material available at 10.1186/s12909-025-07578-w.