The "Recommendations" section concludes the report by describing ways in which the ACGME can prepare GME stakeholders for the future of health care and education in SIs with new structures and functions. § Readers are encouraged to view the components of this report as modular; that is, many sections are interrelated or self-contained, and it is not necessary to read them in a particular sequence. Some may find it useful to start with the particular findings; others may prefer to skip to the recommendations before reading the details derived from the listening activities.
Graduate medical education (GME) as a whole and the ACGME as an organization have been on a remarkable and accelerating path of change In recent years alone, we have seen the implementation of a new accreditation system; the establishment of resident training milestones; a collaboration with the American Osteopathic Association and American Association of Colleges of Osteopathic Medicine to establish a single accreditation system; and the development and roll out of the Clinical Learning Environment Review (CLER) Program GME and the ACGME are undergoing these changes concurrently with substantial transformation in the greater health care environment, including expanded access to health care under the Affordable Care Act We are also adapting to the increasing needs of the public and private insurance market to demonstrate accountability and value in patient care, based in part on the quality and safety of that care I am very excited about the advances in the transparency of our clinical and educational systems Using aggregated data, the ACGME is increasingly facilitating the ability of the public to peer inside the delivery and education system to ensure that we practice and teach evidence-based medicine and professionalism at the highest achievable standard of quality In this regard, I believe the CLER Program is making a significant impact that will lead to tangible positive patient outcomes With the release of this first National Report of Findings for the CLER Program, the ACGME is further contributing to transparency and accountability in health care It provides the GME community and others with the first national data on how well residents and fellows, faculty members, and GME leadership are engaged with their clinical learning environments to provide specialty and subspecialty care As with any first time inquiry it brings a wealth of new information-a baseline-upon which we will begin to shape our future understanding as to what excellence means in clinical learning environmentsThis report provides us with data that identifies some aspects of resident and fellowship training in which our nation's teaching hospitals, medical centers, and clinics are achieving success at educating our future workforce across the six focus areas of CLER The report identifies some noteworthy challenges and opportunities for improvement It also gives us insight into how other professionals are learning in these same clinical learning environments However, perhaps the greatest theme in this report is the large degree of variability that was reported both between and within clinical learning environments across many elements of the six focus areas In a sense this should not be surprising; GME like all significant human endeavors develops organically at the leading edge The findings require further investigation to determine the extent to which this variability best serves patient care and GME Through ongoing study and collaboration with our teaching hospitals, medical centers, and clinics we will learn more about what underlies t...
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