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

OBJECTIVE: Pediatric residency programs prioritize clinical learning environment components depending on resource availability, institutional constraints and culture, and accred-itation 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 environ-ment conceptual framework to craft a survey around the im-plementation 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 de-velopment, while components least likely to be implemented were scribes, onsite childcare, and hidden curriculum topics. The most mature components were resident retreats, anon- ymous systems for reporting patient safety events, and faculty-resident mentoring programs, while the least mature compo-nents were use of scribes and formalized mentorship for trai-nees 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 gran-ular data about learning environment components for pediatric residencies.