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We investigated effects of the format (outline versus concept map) and the specificity (specific versus general) of the feedback on students' perceived difficulty and the generation of cohesive texts.
While the results demonstrate that student learning was not impacted when the module was converted from the workbook to the tutorial format, we cannot separate the effects of the format change itself from the many other substantive revisions to the module content we made as part of the iterative design-based research process (see Additional file 1: Tables S1 and S2).
To evaluate the negative effects of the format change, we surveyed the stressfulness of the conference, the ability to take a break in their day and to eat lunch.
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Another strength of the survey is that we did not restrict it to questions related to how satisfied the fellows were with the AHD format; we also included the effects of the AHD format on secondary and tertiary levels, as defined in the Kirkpatrick model [ 17].
Learners' visuo-spatial abilities had a positive effect on learning outcomes, but did not moderate the effects of the presentation format.
The aim of the current study was to examine the effects of providing support in the form of tools for constructing representations, and in particular the differential effects of the representational format of these tools (conceptual, arithmetical, or textual) in terms of perceived affordances and learning outcomes.
This study has contributed to understanding the effects of the AHD format on trainees.
The perceived effects of the same format can diverge across unit actors differing in attitudes, skills and length of stay in the system.
It is important to continue investigating the effect of the AHD format on knowledge retention, concentration, and clinical performance to ensure that this format is beneficial to the learners.
However, an important question is how the effects of the narrative information format in health education materials relate to the effects of the non-narrative information format that is traditionally used.
Our results contribute to further understanding the effect of the AHD format on trainees.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com