139 - Evaluating the Impact of the CLEAR Portal on Pediatric Resident Perceptions of Respect and Safety in the Clinical Learning Environment

Publication Number: 4136.139

Cory A. Ransom, The Children's Hospital at Montefiore, Bronx, NY, United States; J. Nicholas Charla, Albert Einstein College of Medicine, Bronx, NY, United States; Patricia Hametz, Children's Hospital at Montefiore Einstein, New York, NY, United States; Brenda I.. Anosike, Albert Einstein College of Medicine, Bronx, NY, United States

Background: While studies on the impact of anonymous online reporting systems on pediatric residency programs are scarce, existing evidence supports that these systems increase reporting rates of concerns, facilitate timely interventions, and promote a culture of professionalism. The Clinical Learning Environment Accountability Report (CLEAR) portal was launched at our children's hospital to provide a secure, anonymous online platform through which residents and fellows can report concerns about threats to an environment conducive to learning, without fear of retaliation.

Objective: To evaluate the impact of the CLEAR portal on the perceived safety and responsiveness on the clinical learning environment as reported by pediatric residents before and after its implementation.

Design/Methods: This retrospective survey-based study was conducted in two phases: pre-implementation of the CLEAR portal and post-implementation. Anonymous electronic surveys were created using Qualtrics and distributed to all trainees via institutional email and QR code. Participation was voluntary, and no identifiers beyond post-graduate year were collected to maintain confidentiality and minimize response bias. Pre-implementation surveys were collected from 10/2024 through 12/2024, with a 6-week overlap between the CLEAR portal launch and the final pre-implementation responses. Post-implementation surveys were collected from 6/2025 to 10/2025. Data were analyzed using Pearson chi-square tests with significance set at p < 0.05. Incomplete surveys were included in the analysis for the domains that were completed.

Results: A total of 32 pre-survey responses and 21 post-survey responses were collected (Tables II, III), with no significant difference in response distribution across post-graduate years (Table I). Responses were grouped into thematic domains. While changes in the Respect from Others domain were not statistically significant, strongly positive perceptions of respect from attending physicians approached significance (p=.058). No significant differences were observed in the other domains.

Conclusion(s): Implementation of the anonymous CLEAR portal was associated with a trend toward residents having more positive perceptions of respect from attending physicians, though most domains showed no change one year after portal implementation. Further study is warranted to assess perceptions of other learners, including fellows, and also whether culture change is achieved through continued engagement, accountability, and awareness over a longer time period.

Table I. Participants by Post-graduate Year
* Participants who completed the post-survey after July 1, 2025, were instructed to identify their post-graduate year based on the 2024-25 academic cycle.

Table II. Respect from Others


Table III. Respect for Identities