title: The Clinical Learning Environment Review as a model for impactful self-directed quality control initiatives in Clinical Practice.
abstract: The Clinical Learning Environment Review (CLER) program was designed to assess the learning environment in residencies and fellowships accredited by the Accreditation Council for Graduate Medical Education (ACGME). The program's focus is preventing harm to patients. This effort was purposely separated from the residency survey process so that training programs would be open to identifying and preventing errors without fear of jeopardizing their accreditation status. In our dermatology residency program, we established a resident-centered project for quality assessment/quality improvement (QA/QI). We identified areas of potential patient harm, designed methods to quantifiably assess the problems, and developed focused and cost-effective initiatives to improve patient safety. A new initiative was presented at each monthly faculty meeting. This project jump-started QA/QI efforts in our department and has improved patient safety. Our QA/QI project also has enhanced resident/faculty communication and provided trainees with experience in designing QA/QI efforts. It could serve as a model for postresidency efforts to prevent patient harm.
authors.affiliation: Department of Dermatology, University of Mississippi Medical Center, Jackson, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Saul
authors.affiliation: Department of Dermatology, University of Mississippi Medical Center, Jackson, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Casamiquela
authors.affiliation: Department of Dermatology, University of Mississippi Medical Center, Jackson, USA.
authors.forename: Nancye
authors.initials: N
authors.lastname: McCowan
authors.affiliation: Department of Dermatology, University of Mississippi Medical Center, Jackson, USA.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Jackson
authors.affiliation: Departments of Dermatology and Pathology, University of Mississippi Medical Center, Jackson, and the University of Rochester School of Medicine and Dentistry, New York, USA.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Brodell
mesh_terms: D000068:Accreditation; D003142:Communication; D003479:Curriculum; D003880:Dermatology / Q000193:education*; D004503:Education, Medical, Graduate / Q000592:standards*; D005257:Fellowships and Scholarships / Q000592:standards*; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D007858:Learning; D061214:Patient Safety; D058996:Quality Improvement