ACGME Releases Version 2.0 of CLER Pathways to Excellence

4 December 2019

The ACGME's Clinical Learning Environment Review (CLER) Program is pleased to announce the publication of Version 2.0 of its CLER Pathways to Excellence: Expectations for an Optimal Clinical Learning Environment to Achieve Safe and High-Quality Patient Care. The CLER Pathways serve as a tool to promote discussions and actions to optimize the clinical learning environment. The document is organized according to the six CLER Focus Areas of Patient Safety, Health Care Quality, Teaming, Supervision, Well-being, and Professionalism.

This version also introduces the new CLER Focus Area of Teaming. The concept of teaming recognizes the dynamic and fluid nature of how many individuals come together in the course of providing patient care to achieve a common vision and goals. Teaming recognizes the benefits of purposeful interactions in which team members quickly identify and capitalize on their various professional strengths—coordinating care that is both safe and efficient. In high-performance teaming, team members collaborate and share accountability to achieve outstanding results and continuously learn in the process.

“This updated version of the CLER Pathways highlights the important role of the clinical learning environment in optimizing learning and patient care,” said Thomas J. Nasca, MD, ACGME president and chief executive officer.

The CLER Pathways to Excellence continuously evolves, keeping up with the dynamic needs of clinical learning environments. In keeping with this evolution, Version 2.0 differs from previous versions in that it frames each of the pathways and their associated properties from the perspective of the clinical learning environment. This change recognizes that health care organizations create and are therefore primarily responsible for the clinical learning environment.

“We are excited to announce the new CLER Focus Area of Teaming,” said John Patrick T. Co, MD, MPH, co-chair of the CLER Evaluation Committee that authored the document. “The introduction of this new Focus Area reflects its importance for meeting the needs of our nation’s clinical learning environments and offers an immense opportunity for addressing provider well-being, patient safety, and quality.”

Kevin Weiss, MD, ACGME chief Sponsoring Institution and clinical learning environment officer, noted that, “With this new focus on Teaming comes the opportunity to explore the patient’s role in engaging with clinical learning environments to optimize learning and health care quality. We look forward to adding this new perspective to the CLER site visit program.”

In all of its activities, the CLER Program remains committed to continuous improvement toward the goal of optimizing the delivery of safe, high-quality patient care. The CLER Pathways to Excellence is part of the ACGME’s efforts to help shape a physician workforce capable of meeting the challenges of a rapidly evolving health care environment. The full document is available here.