Clinical Learning Environment Review (CLER)

The Accreditation Council for Graduate Medical Education (ACGME) recognizes the public's need for a physician workforce capable of meeting the challenges of a rapidly evolving health care environment.

The ACGME has responded to this need by implementing the CLER program as a part of its Next Accreditation System. The CLER Program is designed to provide US teaching hospitals, medical centers, health systems, and other clinical settings affiliated with ACGME-accredited institutions with periodic feedback that addresses the following six Focus Areas: Patient Safety; Health Care Quality; Teaming; Supervision; Well-Being; and Professionalism.

The feedback provided by the CLER Program is designed to improve how clinical sites engage resident and fellow physicians in learning to provide safe, high quality patient care.

The only accreditation requirement associated with this program is that each Sponsoring Institution must undergo a CLER site visit every 24 months (+/-6) to maintain accreditation.

News and Announcements

CLER Interim Report of Findings: The COVID-19 Pandemic and Its Impact on the Clinical Learning Environment

November 2021 - The CLER Program is pleased to share an interim report of selected findings from the special CLER COVID site visit protocol currently underway. This yearlong protocol is assessing the impact of the COVID-19 pandemic on the clinical learning environment to identify related challenges and opportunities for optimizing patient care and graduate medical education into the near future. Of note, this report is an interim look at data gathered partway through the protocol (approximately two-thirds completed) with a focus on selected findings. The CLER Program will release a comprehensive final report upon conclusion of the protocol in 2022.

Click here to view the report

CLER National Report of Findings 2021

October 2021 - The CLER Program is pleased to announce the release of the CLER National Report of Findings 2021. This report presents findings from the third cycle of CLER visits conducted from June 2017-February 2020. It is the first CLER report to include data from the clinical learning environments (CLEs) of both large and small Sponsoring Institutions in the same document (encompassing 566 Sponsoring Institutions in total). The report features an enhanced section on trend data as well as information on the new CLER Focus Area of Well-being. Of note, the report presents a snapshot of our nation’s CLEs in the years leading up to the start of the Covid-19 pandemic—an important lens through which to view the current opportunities and challenges facing those US healthcare care organizations that serve as CLEs.

Click here to view the report

CLER Zoom Call Series

October 2021 - Recordings are available for the ACGME National Learning Community for Sponsoring Institutions’ special CLER Zoom Call Series highlighting findings and trends from the various CLER site visit protocols. These recordings are available to watch in Learn at ACGME. Click the title of each presentation to watch the recordings.

CLER National Report of Findings 2021
Wednesday, October 13, 2021
Catherine Kuhn, MD; Robin Newton, MD; Robin Wagner, RN, MHSA; Kevin Weiss, MD

CLER COVID-19 Protocol Interim Findings
Thursday, November 18, 2021
Staci Fischer, MD; Nancy Koh, PhD; Robin Wagner, RN, MHSA; Elizabeth Wedemeyer, MD; Kevin Weiss, MD

CLER Subprotocol for Operative and Procedural Areas
Tuesday, December 7, 2021
Stanley Ashley, MD; Marian Damewood, MD; Alice Krumm, RN, DNP; Robin Newton, MD; M. Christine Stock, MD; James Zaidan, MD

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CLER Report of Findings 2021: Subprotocol for Operative and Procedural Areas

February 2021 - The CLER Program is pleased to announce the release of a special report of findings from the CLER Subprotocol for Operative and Procedural Areas. The report provides new insights into these key clinical areas through the lens of their roles as clinical learning environments for our nation’s resident and fellow physicians. As with the larger CLER national reports, 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 the clinical learning environment.

Click here to view the report

Contact CLER Staff

Director, CLER Site Visit Program
Kristen Ward Hirsch

Senior Vice President, Clinical Learning Environment Review (CLER)
Robin Wagner, RN, MHSA