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The Accreditation Council for Graduate Medical Education (ACGME) established the Clinical Learning Environment Review (CLER) Program in 2012. The purpose of the CLER Program is to provide the clinical learning environments (CLEs) that serve as the sites for the education of more than 120 000 residents and fellows in ACGME-accredited programs with periodic feedback that addresses 6 focus areas: patient safety, health care quality, care transitions, supervision, duty hours/fatigue management and mitigation, and professionalism. The aim is to present information to promote discussions and actions to optimize the educational experience of residents and fellows in the CLER focus areas and to improve patient care. CLER staff surveyed designated institutional officials (DIOs) from the initial round of CLER visits to assess early perceptions of the CLER Program and its initial effects. CLER site visits are structured to involve interviews with graduate medical education (GME) and CLE executive leadership, the organization’s leaders in patient safety and health care quality, residents and fellows, faculty members, and program directors, along with observations and interview data gathered during walking rounds of the site’s clinical units. At the conclusion of the visit, GME and CLE executive leadership receive an oral report of findings in the 6 focus areas, followed by a written report with a detailed set of observations to help target improvement efforts. As part of a systematic effort to improve the CLER Program, an online survey was distributed in September 2015 to DIOs of the 297 ACGME-accredited sponsoring institutions (SIs) with 3 or more ACGMEaccredited core programs that had an initial CLER visit (September 2012–March 2015). The purpose was to assess perceptions of the first round of CLER visits and the changes made by each institution to improve its CLE.

Early Impressions of the CLER Program: A Survey of the Designated Institutional Official Community