Evaluating active learning strategies among physiotherapy students: a comparison of note- taking and multiple-choice question writing on summative examination performance

Background The education of health professionals plays a crucial role in developing the competence-based learning that is essential for their future practice. Increased student engagement and participation has been shown to significantly enhance academic achievement compared to passive knowledge integration during lectures or tutorials. However, the effectiveness of different learning strategies can vary depending on the individual and the context. This study investigated the impact of note-taking and generating multiple-choice questions (MCQs) on physiotherapy students' performance in summative examinations, as well as their preferences for using these methods. Methods A cluster-randomised controlled crossover study was conducted among first-year undergraduate physiotherapy students enrolled in a psychology course at a Polish medical university. The study included 173 students (116 females, 57 males), aged 18–23 years. Following the psychology module, students completed a homework assignment, either a written note or an MCQ, which was subsequently reviewed by instructors. These materials were intended to support students’ preparation for the final psychology examination. The effectiveness of each method as a tool for knowledge consolidation was evaluated using summative exam scores. Additionally, students provided qualitative feedback on their preferred learning method via an open-ended question. Results There was no statistically significant difference at the 5% level in students’ summative exam performance between the two learning methods. Overall, students expressed a preference for note-taking over the MCQ format, citing greater familiarity due to its use during their secondary education. However, students who began the learning process with the MCQ method demonstrated a slightly higher preference for that approach. Conclusions Given the diversity of student preferences, the integration of note-taking and MCQ learning methods may optimise the educational experience in psychology training in the psychotherapy course. Further research should investigate their equivalence, taking into account students' choice of learning method.