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The ACGME defines each CLER focus area in CLER Pathways to Excellence: Expectations for an Optimal Clinical Learning Environment (Executive Summary). Journal of Graduate Medical Education: September 2014, Vol. 6, No. 3, pp. 610-611.

S Pathway 1: Education on supervision

S Pathway 2: Resident/fellow perception of the adequacy of supervision

S Pathway 3: Faculty member perception of the adequacy of resident/fellow supervision

S Pathway 4: Roles of clinical staff other than physicians in resident/fellow

S Pathway 5: Patients and families and graduate medical education supervision

S Pathway 6: Clinical site monitoring of resident/fellow supervision and workload

The findings illustrate the inherent difficulty that CLEs have in achieving the appropriate level of supervision, an issue that is necessarily complicated by the need for different degrees of supervision at different stages of training.

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