Hi Jamie! When creating a doctype, there is a distinct difference between the two. When selecting something as an Element, you make it so that that item shouldn't be used in the content tree, but should be used as part of a Nested Content/Block List/Block Grid element instead of a content item.
Compositions on the other hand is like inheritance, where you define a "base" doctype, which you want your other pages to be based off of (Like a generic Page document with some SEO info, and a specific Blog item that is composed of Page)