Long Timothy R, Doherty Julie A, Frimannsdottir Katrin R, Rose Steven H
J Grad Med Educ. 2017 Jun;9(3):330-335. doi: 10.4300/JGME-D-16-00489.1.
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.
毕业后医学教育认证委员会（ACGME）的临床学习环境评审（CLER）是ACGME新认证体系中的一个创新元素。迄今为止，关于CLER的价值收集到的信息很少。
本研究的目的是收集指定机构官员（DIO）对其所在机构进行的首次CLER访问的看法。
作者创建并向DIO发放了一份关于其首次CLER访问的调查问卷。使用Spearman等级相关性和Kruskal-Wallis检验对调查回复中的人口统计学数据进行比较。
作者收到了参与首次CLER访问的机构中63%的DIO（297人中的186人）的回复，其中88%（186人中的164人）在访问期间担任DIO。72%（158人中的114人）报告在访问前对机构进行了调整以解决CLER重点领域的问题，但只有32%（157人中的51人）报告在现场访问后为这些领域分配了额外资源。65%（156人中的102人）报告机构行政领导对参与CLER持积极态度；85%（158人中的134人）报告ACGME高效地进行了访问；84%（158人中的133人）报告现场访问准确评估了机构在CLER重点领域的表现；60%（156人中的93人）报告CLER提供了高价值信息。
DIO的调查结果表明，CLER是改善学习环境的有效机制。常见的问题包括现场访问的提前通知有限以及临床实践受到干扰。
