Background/Purpose: In 2015, the American College of Rheumatology (ACR) began Advocacy 101 in person-education for Fellows in Training (FIT) and physicians to encourage participation in federal regulatory and legislative issues that relate to access to care, research funding, and contemporaneous matters. However, FIT participation has been undersubscribed, with 50% – 80% of adult and pediatric trainees unexposed, particularly in single-Fellow programs. Though knowledge of the Advocacy process improved by 30%, there was minimal increase in ACR Advocacy awareness (5%), or increased investment in the Rheum PAC® (3%). FIT reported that while in-person training was acceptable, 48% were receptive to on-line training. To date, no web-based Advocacy Training tool exists.

Objective: To evaluate the impact of a web-based Rheumatology Advocacy Training tool on Increasing Awareness in Early Career.

Methods: Early career rheumatologists who attended the 2019 ACR-Advocacy 101 were invited to participate. Email notification for the 9-step, case-based, web-hosted Advocacy training program was sent every 28 days. Content included ACR and other sources of legislative and regulatory material. Tasks related to improving access to care, writing letters of appeals were included. Single multiple-choice questions were assigned to each case scenario, with continuing medical education credit. Participants were invited to 2 web-based teleconferences; 1) at mid-point – to clarify technical questions, 2) at completion – to review and discuss cases, responses, and obtain feedback from participants. Outcomes of pre- and post-questionnaires, completed, correct answers, narrative summations of responses, and suggestions for improvement were collected.

Results: Early Career Rheumatology physicians (≤ 2years) from 9 academic institutions accepted the invitation to participate. Of 20 trainees who started the program, 75% completed all 9 cases. Correct CME answers were scored on 85% of cases. Overall educational quality of content received a mean rating of 4.3 (Likert scare: 1-5). Seven of the 9 cases achieved positive ratings related to relevance of case content, achievement of training goal, objectivity and helping improve competence. Cases relevant to Medicare drug coverage structures, Tele-Health, Biosimilars, Medicare Sequestration, Prior Authorization, and how to translate Advocacy training into action, were rated as having the greatest impact. All cases were assessed free of bias. Feedback indicated ~ 30 minutes was dedicated for completion of each case, and that a combination of skill set and content learning to be most effective. Pre- and post-questionnaire scores indicated significant improvement in knowledge of advocacy matters (p< 0.0001,Table).

Conclusion: A web-based, case-scenario Advocacy tool permitted access to training, increased participation and awareness of pertinent federal regulatory and legislative issues related to the care of rheumatic patients. A follow-up evaluation 2 years post-training to assess enduring Advocacy engagement is planned.

Table 1: Rating of Educational Quality of 9 case scenarios

Table 2: Pre- and Post-course Questionnaire scores for Advocacy Training

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/increasing-awareness-of-advocacy-during-early-career-a-web-based-educational-program/