near-significantp = 0.054
This comparison highlights how the framework’s educational purpose diverges from its clinical counterparts while retaining the ABCDE acronym’s intuitive structure for learner accessibility. Limitations Our study has three main limitations: 1) The near-significant association between recommendation reasons and NPS categories (p = 0.054) necessitates larger-scale validation; 2) While the GLMM controlled for individual differences, unexamined variables like learning preferences motivation require exploration to optimize framework adaptability; 3) Qualitative findings were limited to self-reported responses potentially influenced by social desirability effects.