Download & Print

The Culture of Residency Project Summary (PDF)

C - Change Resident Survey Services (PDF)


1Pololi L, Evans A, Civian J, Shea S, Brennan R. Assessing the Culture of Residency Using the C - Change Resident Survey: Validity Evidence in 34 U.S. Residency Programs. J General Internal Medicine. 2017;32:783-789. doi:10.1007/s11606-017-4038-6.

2Kohli AR. Capsule commentary on Pololi et al., Assessing the culture of residency using the C-Change resident survey: Validity evidence in 34 US residency programs. J Gen Intern Med. 2017; ;32:799. doi:10.1007/s11606-017-4056-4.


Residents’ Perceptions of the Clinical Learning Environment and Professionalism in 14 representative US Academic Health Centers. Presented at the 2016 ACGME Annual Educational Conference. February, 2016

Contact Us

Please contact or Dr. Linda Pololi at for further information about use of the C - Change Surveys.

C - Change Resident Survey

Leaders in resident training have recently recognized the critical role that the culture or clinical learning environment plays in the training of physicians, their well-being, and the provision of safe, high quality patient care. The C - Change Resident Survey© assesses the clinical learning environment and the culture of professionalism from the perspective of resident physicians. The survey directly aligns with the new ACGME Pathway.

The C - Change Resident Survey, with demonstrated evidence of validity1 in U.S. residency programs nationally, assesses 13 dimensions of the culture: Vitality, Relationships/Inclusion/Trust, Self-Efficacy in Career Advancement, Values Alignment, Ethical Moral Distress, Institutional Support, Respect, Mentoring, Gender Equity, Minority Equity, Work-Life Integration, Leadership Aspirations and Competencies. In addition to documenting the culture of residency programs, the survey is a credible and powerful tool for facilitating improvement.2  The C - Change Resident Survey can be used to:

  • Document the environment for learning and professionalism of residents.
  • Examine associations among resident perceptions of the organizational culture and demographic characteristics such as gender, ethnicity/race, and year of residency training, program specialty and site.
  • Assess diversity needs.
  • Assess the effectiveness of programmatic interventions/changes.
  • Identify dimensions of culture requiring improvement.
  • Address well-being.
  • Initiate change activities for improvement.


The C - Change Resident Survey is offered on an institution-by-institution basis to best fit the needs of residency programs, GME and hospitals. The C - Change research team has developed a streamlined process to manage survey data collection, analysis, and reporting.

Services provided include:

  • Consultation on institutional needs.
  • Customization of the C - Change Resident Survey for the program.
  • Drafting announcements and cover communications.
  • Survey administration.
  • Reminders to achieve high response rates.
  • Management of e-mail communications with respondents.
  • Confidential data collection and storage.
  • Data analysis.
  • Reporting: summary report; detailed item report; scorecard.
  • Comparison with national benchmark data.