1818 - Beyond the Bedside: Training Physiatrists for Peer-to-Peer Appeals with the P2Playbook Simulator

Objectives: What if the most critical barrier to patient care isn't clinical, but conversational? Navigating peer-to-peer (P2P) insurance appeals represents a critical physician competency, however formal training in this domain is a recognized deficit within graduate medical education. This quality improvement initiative was designed to address this educational gap by implementing and evaluating a novel AI-powered training tool. Our primary aim is to increase the mean self-reported confidence of PM&R residents in handling P2P calls. Secondary aims are to improve self-assessed competence and evaluate the feasibility of integrating the AI simulator into our residency curriculum.

Design: Utilizing the Plan-Do-Study-Act (PDSA) framework, a cohort of PM&R residents and early career physiatrists (n=20) completes a pre-intervention survey, engages with the P2Playbook, followed by a post-intervention survey. We analyze pre- and post-intervention survey data to measure changes in confidence and competence scores. Based on the results and qualitative feedback, we will refine the tool and plan for broader implementation across other departments.

Results: We anticipate a meaningful improvement in mean confidence scores from pre- to post-intervention, meeting our primary project aim. We also expect to see a corresponding increase in self-assessed competence. Qualitative feedback is projected to confirm the tool’s value and provide actionable insights for the next PDSA cycle, likely focusing on case variety and feedback specificity.

Conclusions: The P2Playbook offers a novel, scalable solution to better equip physicians with the advocacy skills needed "beyond the bedside." Our next steps involve refining the platform and expanding its use as a standard component of our GME curriculum to ensure all future physicians are prepared for this crucial aspect of patient advocacy. By integrating such targeted AI-driven tools into residency training, we can empower a new generation of physicians to navigate the complexities of the healthcare system with confidence and competence.