Notability raises standard of stylus note taking apps and medical literature annotation

One of the most popular uses of the iPad is as a tool to take notes — especially for those of us in medicine. We use note taking apps for Grand Rounds, to annotate our favorite literature articles, Journal Club, and a host of other types of functionality.

We have previously chosen our favorite stylus based note-taking apps here and decided Note Taker HD was one of the best.

However, in response, many commentators suggested that we take a look at Notability, another popular note taking app offering many advanced features.

Read on for iMedicalApps review of Notability.



Notability is designed as an all around note taking app which can be used with a stylus.

Notability offers a range of useful features for annotating notes. Users can select a range of paper types as well as use a pencil, highlighter and eraser for annotating and making notes. There are standard options to change the color and width of the pencil as well as options to use highlighters etc.

In terms of using a stylus and making notes, Notability has a good quick system allowing you to make notes quickly and effectively. The quality of the input is high and notes are generally easy to read. There is a palm rest available so that you can write quickly and there is also a zoom box with auto-advance.

The zoom feature also offers options to undo text and you can simply drag the input box around the screen to your desired area. For all you left handed people out there, there is even an option for you.

Notabilty has another useful note-taking feature whereby it can record audio using the inbuilt microphone and syncs this with the notes you are taking. This is very useful when taking notes in meetings etc. Notability also has a good range of import and export options including to a range of cloud based storage providers.

Needless to say, Notability is not HIPAA compliant and thus shouldn’t be used to store or record sensitive information.

One feature strength of Notability is its ability to link to Dropbox using projects and notebooks which is very similar to Evernote. This can be setup to automatically sync and store notes in PDF files for maximum ability to transfer.


  • $0.99


  • Wide range of features
  • Ability to import and export from/to a wide range of sources
  • Ability to record audio and sync it with notes
  • Ability to sync a folder structure in Dropbox to easily build a collection of notes


  • No inbuilt template functionality


  • Notability is a fantastic note taking app that is feature laden and powerful whilst remaining simple and easy to use. The stylus input is effective and the ability to build up notebooks which sync is invaluable for many users. Well worth a look if you use your iPad to make notes with a stylus

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Tom Lewis


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15 Responses to Notability raises standard of stylus note taking apps and medical literature annotation

  1. Marc-Emile Plourde October 8, 2012 at 6:35 pm #

    Great post Tom. I get asked about apps like that all the time.

    Quite often though, I get the impression that people want to use their iPad to take notes and annotate documents using a stylus. (which is further confirmed by the very popular post on iPad stylus on this site). At rounds, I see someone doing it every few weeks. However, after a week or two, they all stop doing it.

    Question for the readers:
    Is there someone here that has been taking notes on their iPad with a stylus regularly for at least 6 months? and actually using those notes? I’m curious.

    • Edwin Hiatt, MD October 9, 2012 at 7:03 am #

      Yes, I agree, great post. I’ve tried most of the note-taking
      Apps, and Notabily has worked best for me. Your question about whether anybody has been using iPad with a stylus to take notes regularly for at least 6 months and is actually using those notes is a very pertinent question indeed, and it hits the nail right on the head. Oh how I’ve tried. But the truth is, I think, that the iPad in its present rendition was never intended to be used that way. The capacitive screen and the eraser-tipped, sausage-like styli that are required just don’t lend themselves to pen-on-paper quality note-taking (I’ve tried several styli as well). I’ve been writing on computer screens since the early days of the first convertible tablets and Office One Note. Nothing has really been ready for prime time, and I’ve always been left with the feeling that “this isn’t right yet, something better is going to have to come along.” Maybe Windows 8 and the new wave of tablets that are on the way will solve this. Maybe Apple will respond to that with products for healthcare and business users- tablets with digitizer screens and styli that make note-taking more natural. Or maybe not. Maybe that market is not one they are after. But whoever gets it right is going to win.

      • Edwin Hiatt, MD October 9, 2012 at 7:08 am #

        I should have included students and educators along with healthcare workers and business users, of course.

      • Iltifat Husain, MD October 9, 2012 at 12:15 pm #

        This is a great discussion. I still use my annotated PDF files, but over the past few months I have transitioned to Evernote. So even my annotated files I’ve put on Evernote, and I’ve started using Evernote exclusively for note taking.

  2. Tom Lewis October 9, 2012 at 3:03 pm #

    I know a few people who have used a stylus consistently however they have managed to learn how to enter notes quickly on the stylus (which is my shortcoming-I can type quicker than I can write legibly with a stylus). I echo what has been said above and my two cent explanation is that there is no feedback from using a stylus on a mobile device. There is also the somewhat annoying zoom lag when you have to wait for the zoom box to move along.

    One big issue that no one really talks about is the lack of consistent file format used by these apps. I think people should be concerned about the fact that it is very difficult to export/import notes as there is no common format. Evernote have got the greatest business model in the world because once you have embraced it, you can’t really leave even if you want. At least with notability all your notes are stored as PDF so you can export them easily.

    I do worry about the future of file format (sad aren’t I) on mobile devices as currently the only real cross-compatible format is PDF-a format unbelievably outdated!

    • Marc-Emile Plourde October 9, 2012 at 7:38 pm #

      Overall, I believe most people are (or were) hoping the iPad would be a great input device, but it is simply not.

      I think @Edwin Hiatt comment illustrate this concept well. I don’t think it’s an OS problem (won’t be solved by Windows 8), I think it’s an hardware problem. The millimetre or two of glass between your stylus and the “real” screen is what destroys the experience It’s forcing our brains to imagine an invisible track between the glass and the screen and that extra mental effort ends up not being worth it for most people. — *disclaimer: I’m not a pro; it’s just personal observation.

      Unfortunately, the keyboard is probably still the gold standard of note “creation” and will continue to be for the foreseeable future unless technologies such as writable e-ink takes off, IMO

      You’re right in being worried about file format. However, as more people use Evernote, maybe (?) it will become a pseudo standard like MS Word is, for example. Regardless, they have a great business model indeed. (and so does Facebook, Twitter, Apple and the likes)

      Tom, you think PDF is an outdated format? It’s old, but I don’t see it as outdated (like Flash is). I think it’s a file format that’s maturing well; It continues to be at the core of Mac OS, for example.

      • Tom Lewis October 11, 2012 at 2:59 am #

        Great points and I think you are right about the hardware being the issue.

        You are right that it is not outdated in the same way flash is. What I meant by my PDF outdated comment was that PDF was originally designed for printers to make sure that all documents looked the same. This was my outdated bit. I think we have found ourselves using PDF because it happens to be the best we have. My big issue with PDF is that it is not easy the core content of a PDF once it has been made. Annotations and notes are fine but at least with Word or other formats you can change the document.

        I think it would be very nice if Evernote or similar could become a de facto standard! I’m not going to hold my breath and wait anytime soon though!

        • Marc-Emile Plourde October 11, 2012 at 8:30 am #

          I see, I get your point and you’re right: we’re pushing the format (PDF) into doing things it was not originally designed to do.

          I’m not holding my breath for Evernote to become a “standard” soon either. I put quotes there because it likely will never be a real standard by definition.

  3. Jon Stoever October 9, 2012 at 4:49 pm #

    Good review! About 2/3 my med school class use ipads exclusively to take notes (the others use paper notes and computers). Most of us break down into two groups, those who use iAnnotate, and those who use notability. It seems like the females in our class love to use notability! Maybe this can be attributed to their handwriting being many levels of readability above the average male? I prefer iAnnotate because it is much faster at drawing the document, can full text search the PDF/entire library (which notability STILL can’t do), and IMHO has a much better organizational framework. There are little tricks I can do in iAnnotate like attach a pinned text note to an arrow or highlighted portion of a diagram and minimize it at will. This is great for neuro’s complicated cross-sections. While I doubt I’ll use my stylus much during clinical rotations, it is indispensable now for fast and accurate note taking. I’m hoping that the iPad mini comes out in time for my clinical rotations in the fall of next year!

  4. Frank October 10, 2012 at 5:00 pm #

    Perhaps another reason people quit using the ipad and leaving it at home is the colossal weight of the device. Standing and holding the ipad in one hand while writing with the other gets pretty tiring in about 20 seconds. These devices need to become smaller and lighter for ease of use.

  5. Lionel November 26, 2012 at 2:28 am #

    Your review mentioned Notability is not HIPAA compliant. Are there any HIpaa compliant note taking apps? Is note taker HD?

  6. Jessica Carlson January 1, 2013 at 11:59 pm #

    I am a third-year Mechanical Engineering student and the majority of us (a class of 20 people) use an iPad for our textbooks and notes. I have been using Notability for 5 months straight, and love it. Very handy for sketches, graphs, and paragraphs of information. The ability to send your notes via email or Dropbox is very handy. The most handy feature for me, is the ability to take a picture in the Notability app of something I am reading on a Powerpoint or the computer in front of me, and deposit it directly into the note. Additionally, in those 5 months I have used the Griffin stylus ($12) and am on my second one. Not bad for pages of notes each day. :)

    • Anne Nortcliffe January 3, 2013 at 6:13 pm #

      As an academic I have been using notability for 18 months, great tool for providing feedback on pdf assessment rubrics; ring student grades and type appropriate feedback for the students.

      Also, a useful tool for reading student dissertation, highlight sections for improvements and correlating with audio feedback one can record using audio tool in notability.

      One of my top ten academic tools!

  7. Gilda Bobele January 10, 2013 at 1:20 pm #

    I’m a MS4 and have been using my iPad for clinical rotations since October of my third year. I use the Ghostwriter app and a Pogo stylus for my patient notes (keeping my data as HIPPA friendly as would be a clipboard with the same information on paper) from the initial H&P to daily updates.

    Specifically, I created my own blank Scut sheets and scanned them into Dropbox, which I could then import into Ghostwriter. Thus, I have all my Scut sheets ready to go on my iPad, my white coat pockets aren’t stuffed, and my information stays organized.

    I guess everyone finds a method, and this one works really well for me. I think the biggest utility was not having to shuffle papers; while presenting, I could use the green/ red pens to note abnormal values or highlight something especially important. At the same time, I had journal articles downloaded into iAnnotate, and could easily reference those (because – really – attendings never ask for the literature when you have it printed and folded in your pocket).

    A lot of people argue that the iPad is too heavy to carry around… eh. The only times I felt my hands overly full is when donning the yellow gowns and pinching my iPad between my body and arm underneath it. Utility outweighs the burden for me.

    • Adam Lundy February 8, 2013 at 11:18 am #


      I’m a MS1 and heavily considering buying an iPad mini. How do you think it would stack up against the regular sized iPad for my clinical years?


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