CLER Visit #3
Monday, April 23, 2018

Media Release

Chattanooga, TN

April 23, 2018


3rd ACGME CLER Site Visit for Chattanooga
May 1st and 2nd, 2018


The UT College of Medicine Chattanooga Campus and our major affiliated teaching hospital, Erlanger Health System, will be undergoing our 3rd ACGME CLER Site Visit on Tuesday and Wednesday, May 1 and 2, 2018 to conduct a Clinical Learning Environment Review (CLER) for both the Sponsoring Institution for our GME Programs (the University) and our hospital (Erlanger Health System).  We will host a group of three surveyors from the ACGME CLER Program.  The CLER Team will meet with Erlanger and UT leadership, Patient Safety and Quality Officials, Wellness leaders and representatives, peer-selected Residents and Fellows, Faculty representatives, and Program Directors over the two-day period.  The CLER Team will also conduct three Walking Rounds throughout the hospital at various times in hopes of observing the learning environment in clinic areas, on patient floors, and observing handoffs as different physician teams share information about the patients they are treating.


According to the ACGME, over the years, it has become readily apparent that the clinical setting in which residents and fellows learn directly impacts the quality of their training. In order to better understand these environments, the ACGME established the CLER Program. The CLER Program is designed to provide graduate medical education (GME) leaders of Sponsoring Institutions and the executive leadership of clinical learning environments (CLEs) with formative feedback on six areas of focus:

  • Patient Safety
  • Health Care Quality (including health care disparities)
  • Care Transitions
  • Supervision
  • Well-being
  • Professionalism

The underlying premise of the CLER Program is that when GME leaders and the executive leadership of the CLEs are presented with detailed information on how they are addressing the six focus areas, they will use it to build upon their strengths, and identify and act on opportunities for improvement with the ultimate goal of improving patient care while optimizing the educational experience for resident and fellow physician learners.


The site visits are structured to gather evidence that will help answer five key questions:


  1. What is the clinical learning environment's infrastructure for addressing the six focus areas?
  2. How integrated is the GME leadership and faculty within this infrastructure?
  3. How engaged are the resident and fellow physicians in working with the clinical learning environment's infrastructure to address the six focus areas?
  4. How does the clinical learning environment determine the success of its efforts to integrate GME into its infrastructure?
  5. What areas have the clinical learning environment identified as opportunities for improvement?


The initial visits of the CLER Program revealed a number of broad, overarching themes that appeared to be common across many of the CLEs and the six focus areas:

  • Clinical learning environments vary in their approach to and capacity for addressing patient safety and health care quality, and the degree to which they engage residents and fellows in these areas.
  • Clinical learning environments vary in their approach to implementing GME. In many clinical learning environments, GME is largely developed and implemented independently of the organization's other areas of strategic planning and focus.
  • Clinical learning environments vary in the extent to which they invest in continually educating, training, and integrating faculty members and program directors in the areas of healthcare quality, patient safety, and other systems-based initiatives.
  • Clinical learning environments vary in the degree to which they coordinate and implement educational resources across the healthcare professions.

These themes speak to the importance of taking a systems-based approach to improving the CLE. The CLER Program will continue to explore how best to address these variations in order to promote excellence in the CLE and advance patient care.






UT College of Medicine Chattanooga     960 East Third Street, Suite 100     Chattanooga, TN 37403     (800)947-7823, ext 6956

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