Just 10 “CLEQS” Yields Formative Evaluation of the Clinical Learning Environment
Bibliographic Data
Purpose: “Learning in a clinical context is foundational in the training of health professionals; there is simply no alternative” is the lead statement to a 2019 collection of papers exploring research and efforts to improve learning in the context of patient care. 1 The Accreditation Council on Graduate Medical Education’s (ACGME) Clinical Learning Environment Review (CLER) affirms this foundational role by regularly providing clinical settings affiliated with ACGME-accredited sponsoring institutions with periodic feedback to optimize a shared goal—learning to provide safe, high-quality patient care. 2 However, there are currently no tools available to evaluate the CLE that are: (1) appropriate for all health care team members; (2) informed by contemporary learning environment frameworks; and (3) are quick to complete. 3 Our purpose was to create a reliable, evidence-based, short (10 items, 0.83). The Cronbach alpha for each of the 4 CLE domains with the overall item ranged from 0.79 for social to 0.50 for personal. CLEQS scores varied by GME teams with GME leaders confirming that their respective team’s results were consistent with service line/unit/program data from other system-wide and accreditation surveys (safety, engagement, ACGME). Team leaders reported that survey data allowed them to focus on celebrating strengths and targeting improvement strategies specific to their teams with the ability to easily readminister the tool. Discussion: CLEQS is a short, reliable, evidence-based survey tool that can be completed by all participants in the clinical workplace to monitor its quality as a CLE. It can be used to monitor progress on team projects that occur in the CLE and/or to achieve standards associated with system-wide and/or GME accreditation tools that are administered annually. Significance: The evidence is clear that the quality of the CLE predicts quality of trainees’ care long after graduation and well-being. 1 All individuals contribute to the CLE’s quality and its learning climate. Having a quick, reliable perception tool aligned with 4-frame learning environment construct 4,5 and existing annual education and clinical data can provide process data to monitor quality of the CLE and guide improvement. Acknowledgments: The authors would like to thank (1) each of the 6 Aurora Health Care GME interprofessional team leaders and members for participating in the pilot as part of their Alliance of Independent Academic Medical Centers’ National Initiative VII (NI-VII) projects on Teaming for Interprofessional Collaborative Practice, and (2) Kayla Heslin, MPH, Aurora University of Wisconsin Medical Group (AUWMG)-Aurora Health Care for her statistical support
Accreditation · Formative assessment · Graduate medical education · Health care · Learning environment · Medical education · Patient safety · Pedagogy · Clinical Reasoning and Diagnostic Skills · Computer Science · Innovations in Medical Education · Interprofessional Education and Collaboration · Medicine · Psychology
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