Modern health care is complex, multidisciplinary, dynamic, expensive, and stressful. All these elements make it challenging for trainees. As such, the well-being of trainees has long been recognized as worthy of explicit examination. Interestingly though, formal examination has typically avoided procedural areas, namely operating rooms, which are arguably the most complex, multidisciplinary, dynamic, expensive, and stressful. Thus, the special update from the Clinical Learning Environment Report (CLER) for the sponsoring institutions accredited by the Accreditation Council for Graduate Medical Education (ACGME) is welcomed. The report has recently been made public and includes six focus areas: patient safety, quality/disparities, care transitions, supervision, well-being, and professionalism. Data informing the findings were derived from group and individual interviews combined with walk rounds, including observation of trainees in the operating room and perioperative care spaces. Importantly, both physicians (anesthesiologists and surgeons) and nurses were interviewed and involved in the assessment.

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