An Early Assessment of the ACGME CLER Program: A National Survey of Designated Institutional Officials

The Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review (CLER) is an innovative element of the ACGME's new accreditation system. To date, little information has been collected regarding the value of CLER.

The purpose of this study is to collect information on designated institutional officials' (DIOs') perspectives about the initial CLER visits conducted at their institutions.

The authors created and distributed a survey to DIOs about their initial CLER visits. Demographic data were compared across survey responses with Spearman's rank correlation and the Kruskal-Wallis test.

The authors received responses from 63% of DIOs (186 of 297) at institutions that participated in the initial CLER visits, with 88% (164 of 186) having served as DIO during the visit. Seventy-two percent (114 of 158) reported institutional changes to address CLER focus areas prior to the visit, yet only 32% (51 of 157) reported that additional resources were allocated to these areas after the site visit. Sixty-five percent (102 of 156) reported institutional executive leadership was positive about participating in CLER; 85% (134 of 158) reported that ACGME conducted the visits efficiently; 84% (133 of 158) reported that the site visit accurately assessed the institution's performance in the CLER focus areas; and 60% (93 of 156) reported CLER provided high-value information.

Survey results from DIOs suggest that CLER is an effective mechanism to improve the learning environment. Common concerns included limited advance notice for the site visit and disruptions of clinical practice.