HACASE: A simple and versatile framework for session design and delivery

We have developed a simple framework, HACASE, for session design and delivery, based on established educational principles such as constructive alignment. The HACASE framework was primarily designed for new educators, but can also be used by experienced educators. Sessions designed using HACASE can be delivered to students, colleagues, patients and their families. Its versatility and sound educational foundations make it appropriate for single sessions, through to workshops, modules and beyond.


Introduction
Designing and delivering teaching or training is often simultaneously exciting and terrifying. Many healthcare professionals are expected to teach undergraduates and postgraduates, or train colleagues, patients and their families, with little or no formal training in providing education themselves (Hartford, Nimmon and Stenfors, 2017). This can lead to a lack of confidence in this vital aspect of their role. We have developed a simple framework to design, deliver and evaluate effective teaching or training sessions that embeds and promotes fundamental educational principles. Educational interventions that introduce these principles have been shown to enhance teaching abilities and inspire educators to extend their teaching and training activities (Foster and Laurent, 2013).
Within healthcare education in particular, it is important to introduce educational concepts in an accessible, concise and relevant way (Trumble, 2013), thereby anchoring practice to theory. Recognising this need, the simple framework we have constructed, using the acronym HACASE, captures the elements we consider essential for Hollis V, Woods-Townsend K, Fernandez B, Holloway J MedEdPublish https://doi.org/10.15694/mep.2020.000152.1 Page | 2 successful education: Hook, Aims & learning outcomes, Content, Assessment, Summary and Evaluation (see Figure  1). Although originally designed to be a simple model for educators at the beginning of their educational career, HACASE is appropriate for educators with any level of experience. It can be applied to multiple learning formats, from short sessions through to workshops, credit-bearing modules and entire degree programmes. HACASE is also applicable to a range of educational settings and learners well beyond healthcare.

H is for Hook
The framework begins with a Hook, designed to focus the learners' attention and engage them with the subject matter (Easton, 2016). The start of any educational interaction is critical to the engagement of the learners (Exley and Dennick, 2004), so for maximum effectiveness the hook should be delivered at the very outset, even prior to introductions, where appropriate. Adult learners, in particular, need to understand the motivation for learning in order to take ownership of the process (Mukhalalati and Taylor, 2019). For example, the hook could take the form of a simple yet challenging question to the learners, or the presentation of a thought-provoking image. Coupling the hook with an initial 'ice-breaker' activity (Holbert, 2015), can further help to set up a supportive and proactive Hollis V, Woods-Townsend K, Fernandez B, Holloway J MedEdPublish https://doi.org/10.15694/mep.2020.000152.1 Page | 3 learning environment, in which learners are encouraged from the start to participate in the entire session.

A is for Aims and learning outcomes
Following the hook, the educator sets up the Aims and learning outcomes the learner should be able to achieve having completed the session. Learning outcomes should be SMART (Specific, Measurable, Attainable, Relevant and Timebound) and include active verbs that cover a range of cognitive skills, as defined by Bloom's Taxonomy (Krathwohl, 2002;Chatterjee and Corral, 2017). The cornerstone of an effective session is the 'constructive alignment' of teaching and learning activities and assessments with the learning outcomes (Biggs, 1996). By ensuring alignment between these three components (see Figure 1), learners are given ample opportunity to construct and demonstrate achievement of their learning. Sharing learning outcomes at the beginning of the session helps clarify expectations and encourages learners to take responsibility for their own learning. Although HACASE starts with the hook in terms of delivery, when designing an educational session the pivotal step is in defining the learning outcomes, to which the content and assessment can then be constructively aligned and an appropriate hook chosen.

C is for Content
The Content of the educational session includes the teaching and learning activities and resources, constructively aligned (Biggs, 1996) to allow learners to achieve the outcomes. Activities should be selected carefully and tailored to meet the needs and wants of the learners (Mills and Alexander, 2013). The mode or method of delivery should also be thought of as part of the session content, such as the use of technology-enhanced learning (Sandars et al., 2015). In choosing a variety of activities and delivery modes for the session, the educator should further aim to reinforce a safe and engaging learning environment that is appropriate for all learners (Butcher, Davies and Highton, 2006).

A is for Assessment
Assessment of learning accompanies or follows content delivery within a session and must be constructively aligned to the learning outcomes (Biggs, 1996). Too often educators state "by the end of this session you will be able to achieve these learning outcomes," without ever determining whether that is so. However, even short sessions can include assessments, such as learner demonstration, Q&A via audience response systems or peer marking/feedback (Butcher, Davies and Highton, 2006). Selecting an appropriate method for assessment of each learning outcome is vital to ensure that learners can demonstrate their ability, whilst allowing the educator to determine whether the learners have achieved the learning outcomes.

S is for Summary
Ending a session with an effective Summary helps the learners to understand the progression of the session they have just participated in and to put into context the key take-home messages (Gullo, Ha and Cook, 2015). It serves as a final reminder for learners, helping to cement the learning in their memory (Webster, Connolly and Schempp, 2009). By including a summary as part of the HACASE framework, the educator is obliged to consider their goals in advance and to reflect in the moment on whether the session met those requirements. Asking the learners to give the Hollis V, Woods-Townsend K, Fernandez B, Holloway J MedEdPublish https://doi.org/10.15694/mep.2020.000152.1 Page | 4 summary can be a useful tool in revisiting their learning, whilst highlighting to the educator any areas that may need reinforcing.

E is for Evaluation
The final element of the framework is the Evaluation of the session, which is essential in maintaining and improving the quality of the learning experience and important for the professional development of the educator. There are numerous evaluation techniques to choose from, many of which use a combination of quantitative and qualitative methods (Goldie, 2006). To encourage learners to provide rich and honest feedback, it is important they be made aware of why and how their evaluations will be used (Griffin and Cook, 2009). In particular, learners need to trust that their input will be considered by the educator, who can then further enrich the impact of the evaluation data through their own reflective practice (Kogan and Shea, 2007).

Conclusion
Our HACASE framework for session design and delivery ( Figure 1) provides educators with a simple yet versatile tool to plan effective educational or training sessions. The framework is based on fundamental educational concepts, including constructive alignment, that promote a rich and productive learning environment. By adhering to the elements of the HACASE framework, educators at any level of experience can become more effective in their teaching. Moreover, like others (Foster and Laurent, 2013;Lipczynska and Crowley, 2015), we have observed that an awareness of the importance of these educational concepts motivates educators to challenge themselves when designing and delivering their own educational sessions. We believe this simple tool provides both new and established educators with a versatile framework that enables them to deliver excellent learning experiences, thereby inspiring them to continue on their journey as an educator with confidence.

Take Home Messages
HACASE is a simple framework for session design and delivery that comprises a novel combination of established educational tools and techniques. Based on fundamental educational theories such as constructive alignment, HACASE enables the successful design and delivery of a teaching or training session. HACASE is straightforward for novice educators to use and an understanding of its core educational strategies can inspire even long-standing educators to extend their session design and delivery. The versatility of HACASE means it can be used to design and deliver sessions for a range of educational settings.