Implementation and Maturity of Clinical Learning Environment Components Across Pediatric Residency Programs

Eric Zwemer, Janet R. Serwint, Kira Sieplinga, Paria M. Wilson, Sarah Webber, Elizabeth Rodriguez Lien, Jessica C. Babal, Kathleen M. Donnelly, Michele Holloway Nichols, Maneesh Batra, Alan Schwartz, Jennifer W. Reese

Research output: Contribution to journalComment/debatepeer-review

2 Scopus citations


Objective: Pediatric residency programs prioritize clinical learning environment components depending on resource availability, institutional constraints and culture, and accreditation requirements. However, there is limited literature on the landscape of implementation and maturity of clinical learning environment components across programs nationally. Methods: We used Nordquist's clinical learning environment conceptual framework to craft a survey around the implementation and maturity of learning environment components. We performed a cross-sectional survey of all pediatric program directors enrolled in the Pediatric Resident Burnout-Resiliency Study Consortium. Results: Components with the highest implementation rates were resident retreats, in-person social events, and career development, while components least likely to be implemented were scribes, onsite childcare, and hidden curriculum topics. The most mature components were resident retreats, anonymous systems for reporting patient safety events, and faculty-resident mentoring programs, while the least mature components were use of scribes and formalized mentorship for trainees underrepresented in medicine. Learning environment components included in the Accreditation Council of Graduate Medical Education Program Requirements were significantly more likely to be implemented and mature than nonrequired components. Conclusions: To our knowledge, this is the first study to use an iterative and expert process to provide extensive and granular data about learning environment components for pediatric residencies.

Original languageEnglish (US)
Pages (from-to)1301-1306
Number of pages6
JournalAcademic Pediatrics
Issue number7
StatePublished - Sep 1 2023


  • clinical learning environment
  • education
  • pediatric residency

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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