zettelkasten connections and medical learning
i have been training for a job in the medical field (maybe a bit of an understatement in regards to the cost and mental toil, but saying i'm in med school has its implications because i'm really not.) and about two-and-a-bit months ago, i decided to start a zettelkasten. i learned all about it and wrote notes about the underlying philosophy in the zettelkasten itself, and things started off fantastic! MOCs and hub notes feel like a dream for my personal organization. higher-order learning seemed extremely necessary. disregarding the idea of separate disciplines in lieu of an understanding rooted in existing knowledge seemed very helpful.
now it's been a couple months and my zettelkasten contains over 100 zettels; i'd say about 20 regarding personal knowledge management and then about 80 medical notes. that is the problem, though. i look at other notemakers' obsidian graphs and they're one big ideaverse of notes radiating from the center. my notes, conversely, are separated into blobs by discipline or level of abstraction from reality. (e.g. anatomy [tangible] vs. study concepts [intangible]) in essence, i want to keep watching my zettelkasten grow--it is helping me retain information--but i'm a bit scared that i'm not implementing higher-order learning correctly.
this is making me unsure whether a traditional, luhmann-esque zettelkasten is the best idea for medical study. what do you think? does anyone else have trouble connecting tangible, business-related zettels to more abstract zettels?
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@skirtspinda, you are right that notes want to gather in an "ideaverse." I'd think you'd need much more than a hundred notes to see the patterns you discribe. If I look at my first hundred notes, I'd likely see the same blobs of disassociated note threads. Give your notes more time.
I do think that medical study is suited to The Zettelkasten Method. As far as connecting "tangible, business-related" ideas to "abstract" ideas, it depends on the ideas. Frankly, I'm having a hard time thinking about what you mean by the connection from tangible to abstract. Are you thinking that knowledge management is tangible and medicine is abstract?
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I must keep doing my best even though I'm a failure. My peak cognition is behind me. One day soon I will read my last book, write my last note, eat my last meal, and kiss my sweetie for the last time.
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thank you so much for the advice! i was moreso thinking the opposite. the business of medicine seems more immediately tangible to me. though, that might just be because i have more experience with it than PKM. i completely understand either way of thinking.
you're definitely right that i should give it more time. it would make sense that i just haven't yet written about enough subjects from different disciplines to connect them all in a truly higher-order way. i'm very glad there's still a lot i have to process about everything.
As a surgeon and medical educator, I've thought a lot about this! Here's a blog post I wrote on using the ZK (aka smart notes) to learn medicine. Enjoy! (and I'd love to hear your feedback!) https://wellnessrounds.org/2022/07/18/learning-medicine-smartnotes/
I'm not in a medical field, but can share what I've seen that may be relevant.
Last year I saw a nursing student's online note system (in Obsidian Publish). I just googled it again to find out more about it, and Google informed me that its creator mentioned it in a Reddit comment here and that there are some critical comments about it in this Reddit discussion. I would like to see more public examples like this one, though I understand why people keep their notes private, as I do.
There are some relevant discussions on the Obsidian forum, such as "Obsidian for medicine/academics?" (2021), where the participants discussed using standard medical classification systems such as Unified Medical Language System.
Here on this forum, there is the discussion "Zettlekasten to memorise medical information #almostadoctor" (2020), where one participant recommended against using a Zettelkasten for "learning for exams". But, regarding how to learn best, it would be better to consult what the science of learning and medical education says instead of relying on random people on Internet forums!
In a recent discussion here, someone asked about question notes again, and that may be another way to think about your higher-order learning: What kinds of questions are you asking yourself using your note system? How do you categorize those questions? (Or are questions not relevant for what you're doing?)
That's all I have, but I am interested in seeing more resources. Surely more students in the medical fields must be discussing this online? @mlbrandt, that's a great blog post, thanks!
@mlbrandt @Andy thank you so much for the discussion links, everyone! all extremely helpful references that made me think very deeply about the ins and outs of this system. it's very funny that you bring up medical classification, because my studies definitely fall within that field.
as much as i understand i should take an approach to notemaking that mixes bottom-up and top-down thinking, i definitely have been prioritizing bottom-up. the idea of naturally finding connections between notes and watching everything eventually clump together into an ideaverse is very satisfying. at this point, it's what my mind immediately goes to when i think about what learning truly looks like. maybe integrating more top-down thinking would help to structure my notes in a way more relevant to the field? i am excited to experiment!
@skirtspinda I find it's a bit weirder to observe the magic of a Zettelkasten unfold in a field where I already know quite a bit of stuff as opposed to learning a new field with the Zettelkasten. I can imagine that starting a Zettelkasten late in the process then can feel a bit odd!
If I already know a couple of things, they exist in my head, not in the Zettelkasten. So I can't find everything inside "the box." Thanks to years of working with the Zettelkasten, I still look there, first, by sheer force of habit, even though nothing comes up -- but I can imagine it'd be much more discouraging to start with an empty box and without the habits, because why bother? There's never anything cool inside anyway.
An example from a couple years ago was home server setup. Needed to learn new terms and concepts and 'recipes', but I was okay with computers like it, so the department on the topic isn't that large and well connected. I don't need to create a Zettel for how to turn on the machine or how to log into it, so none of these basics things informed my process of learning or found a way into notes. Logging into a computer remotely would be fancy and new for a while but eventually trickle down and become the sediment of the department -- not getting in the way, but forming the foundation of details I know by heart but could look up if needed.
If I know nothing about a field, I can track my overall progress with the Zettelkasten very well and have lots of sandboxes to play around in
A very recent example is to learn more about pregnancy, it's possible complications, and child birth. Again, many new topics, terms, and concepts -- but this time there's virtually nothing to help learn about these things. None of my """computer notes""" apply (at least not easily) for a change. So this starts all from scratch, including how do you even count the weeks of pregnancy properly. Many basics, and different structure notes (including totally new kinds of structures for my archive, like timelines, which I believe I never before needed).
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Don't worry about it. 100 notes is not enough to show the correct or incorrect implementation. Also: There is no empirical evidence or evidence whatsoever how to use a graph to assess the correctness of the implementation of a linked note-taking system.
The centralised graph is just a by-product of people creating and tending a home note in the majority of cases.
If anything, the graph should look natural and organic, almost like a chaotic, yet fractal-esque structure.
If you want to use the Zettelkasten Method in a way that it trains your mind, the focus should be on thorough processing of each individual idea (atomic thinking), making meaningful connections (connected thinking) between the atomic ideas and creating wholes like entry points, narrative overviews etc. (holistic thinking).
I am a Zettler