The ribbon has been good I think. It is a little frustrating to jump aroudn between tools, but I like the icons and the tooltips, I tell all users to pay attention and use them as reminders of how to use tools they don't use often, hopefully I'm right and it's a good idea.
In looking at our settings and way of work, not much has changed, but there are a few new little features thrown in that help those of us that "cad/bim manage" get to look into. Like the new option "Create New Local." Read this post in The Revit Clinic blog. It is a good idea, but most users don't use the Open dialog to open any files, most prefer to find the file in windows explorer then they double click, something I don't approve or prefer but it happens.
As I find more "little features" I'll pass them on. Oh yea, one I learned this week - Move the Options Bar below the drawing window. Just a right click over the area, doesn't make sense to do it but you can!