ACGME Releases CLER Findings for Operative and Procedural Areas

April 7, 2021

The Accreditation Council for Graduate Medical Education (ACGME) is pleased to present the Clinical Learning Environment Review (CLER) Report of Findings 2021: Subprotocol for Operative and Procedural Areas. The CLER Program provides leaders of hospitals, medical centers, and other clinical settings with formative feedback through site visits that explore six Focus Areas: Patient Safety; Health Care Quality; Care Transitions; Supervision; Well-Being; and Professionalism. 

The findings were gleaned from a subset of ACGME-accredited Sponsoring Institutions for which the CLER site visit was enhanced with a subprotocol that facilitated access to and in-depth exploration of operative and procedural areas. The report provides new insights into these areas through the lens of clinical learning environments for our nation’s resident and fellow physicians. 

“As a surgeon who has followed the remarkable impact of the CLER Program in other areas, it is very exciting to see it now move into the operating room and the procedural areas,” noted Dr. Stanley W. Ashley of Brigham and Women’s Hospital. “The initial CLER observations are insightful and will lead to new standards that will be hard to ignore.”

As with the larger CLER Reports of Findings, the key findings of the subprotocol highlight a mixture of strengths and opportunities for improvement, some unique to the perioperative environment, and some that are similar to other places in the clinical learning environment.

“This report reveals unexpected attributes of the learning environment that may spur new thinking about opportunities to improve the operative and procedural experiences for residents and fellows while simultaneously optimizing patient safety and improving the quality of patient care,” said ACGME President and Chief Executive Officer Dr. Thomas J. Nasca.

“Of note, anesthesiology residents and fellows spend the vast majority of their clinical education in operative and procedural areas. Thus, getting that learning environment ’right’ is critical to their education,” said Dr. Christine Stock, professor emeritus of anesthesiology at Northwestern University.

For more information about the CLER Program, visit the CLER webpage.