ArticleAdvances in simulation (London, England)2025
The Advocacy-Inquiry Rubric (AIR): a standard to build debriefing and feedback skills.
Article in Advances in simulation (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Teaching raters to see: A faculty development innovation for robust assessment in health professions education.Advances in simulation (London, England) · 2026Review
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10 authors.
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Abstract
backgroundTeaching and learning debriefing and feedback skills-especially to a level of mastery-is challenging without an agreed-upon standard. There are a number of rating scales and rubrics to identify and evaluate debriefing and feedback skills that focus on an entire feedback or debriefing conversation. However, there is no rubric to assess and provide feedback on one of these conversations' most widely used microskills, the Advocacy-Inquiry technique. This study aimed to develop and preliminarily test the Advocacy-Inquiry Rubric (AIR)-a tool designed to support the teaching, coaching, and assessment of Advocacy-Inquiry, a widely used yet challenging debriefing microskill-through an international expert consensus process.
methodUsing a four-round Delphi process, we achieved expert consensus on the behavioral markers of effective and ineffective Advocacy-Inquiry techniques. Thirty-nine experts from 13 countries identified and refined a set of key behavioral anchors for each of Advocacy-Inquiry's five elements: Preview, Observation, Point of View, Inquiry, and Listen. These descriptors were embedded first in a seven-point numeric Behaviorally Anchored Rating Scale, then in a three-point emoji-based version, and finally in a teaching and learning version. The AIR underwent two rounds of usability testing and inter-rater testing of the emoji version. Using an interpretation-use argument approach, evidence was collected for AIR's validity across scoring, generalization, extrapolation, and implication.
resultsThe Delphi process established descriptors for each element of Advocacy-Inquiry, categorized by proficiency level (beginner to advanced). Usability testing enhanced the AIR's graphic layout to support both numeric ratings and formative feedback. The AIR was adapted into three tailored versions: a numeric AIR for detailed evaluation and progress tracking, an emoji AIR for peer assessment, and a teaching and learning AIR. Evidence for validity was assessed, highlighting both strengths and gaps.
conclusionAIR is an empirical rubric based on expert-derived criteria to support teaching, coaching, and assessing Advocacy-Inquiry microskills. The AIR offers a structured framework for self-, peer-, and mentor-led feedback and assessment to enhance a core skill of facilitators. By anchoring assessments in clear behavioral descriptors, the AIR aims to improve the quality of feedback and debriefing conversations. Future work should focus on rater training, reliability testing, and exploring the AIR's impact on real-world outcomes.
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