CLEARSHIFTS
For Fellowship Programs · Residencies · Universities · Inpatient Teams

Find the friction.
Make development visible.

Before any training day, ClearShifts maps where cognitive load and mis-sequencing form in your team's workflow — across Load, Signal, Sequence, and Return. Then the competency platform makes a cohort's development visible, documented, and discussable. Built to the standard a GME office can approve.

01 · Diagnostic First

See the friction pattern before anyone trains on it.

Every engagement starts the same way: evidence about your program, not assumptions about programs in general.

The Shift Pattern Intake.

Brief pre-work your team completes before the engagement — the same four-domain reflection clinicians take individually, gathered across the program. It surfaces which domains press hardest: tracking load, urgency signal, working order, or recovery after interruptions.

A pattern readout.

The intake comes back as a friction pattern — where the day asks clinicians to hold too much in working memory, and where sequence is set by noise instead of consequence. A shared language for what needs attention now and what can safely wait.

Training shaped to the pattern.

The workshop emphasizes the domains your intake surfaced. A team drowning in tracking load gets more card practice; a team losing its order to interruptions drills the return.

02 · The Competency Engine

Documented, milestone-mapped formative signal.

Three evidence streams that never blend — so the committee works from documented signal instead of recall.

  • Studied — exposure and self-directed study. Context, never competence.
  • Tested — a knowledge-practice signal, shared only if the fellow links it. Never shown as observed performance.
  • Demonstrated — a preceptor's entrustment rating of a directly observed encounter, in your program's own scale. The only track that informs the committee.
Under 30s per rating Formative-only by design Append-only audit Mapped to ACGME C&A Milestones
Fellow C ADOLESCENT INPATIENT · WK 3

Development view — three evidence streams, never blended.

Studied
12
topics · exposure
Tested
Active
practice signal
Demonstrated
8
entrustment ratings
Entrustment trajectory · by week cobalt = observed
Committee determination · entered by faculty Milestone band recorded
Fellowship Competency Engine — development view. Representative UI; synthetic data.
03 · The Design Laws

The rules the system is built to obey.

Commitments to the program — several of them enforced at the database layer, not just promised.

Formative, not summative

Flags "appears below trajectory; recommend review." Never "not competent." Never triggers your remediation process.

No blending

Self-assessment, entrustment, and committee determination are labeled and rendered distinctly — never averaged into one score.

The blind rating path

No study or practice data appears on the path to an entrustment rating — observation captured free of anchoring.

No hidden signal

A flag a fellow can't see cannot be stored — the database rejects it. Anything the director sees, the fellow sees.

04 · Workshops & Pilots

Live training, in formats that fit how programs schedule.

Every format includes the Shift Pattern Intake, hands-on practice with scenarios from your setting, and a 30-day plan so the method survives the week after.

2 HOURS

Foundational Lab

Introduce the method to a small team or pilot site. The BPC moves, the one question, and a first card built in the room.

HALF DAY

Core Workshop

The flagship format. Diagnostic readout, card practice, scenario drills from your team's own interruption patterns, and a 30-day adoption plan.

FULL DAY

Implementation Day

An institutional engagement: the Core Workshop plus a leader debrief, adoption supports, and a structure for capturing what your program observes.

ONGOING

Train-the-Trainer

For institutions ready to embed the method. Your facilitators learn to run the intake, read the pattern, and teach the moves — so the capability stays in-house.

05 · Scope, Plainly

What this is — and what it isn't.

  • It is workflow and competency-development support. A method and a platform that help clinicians externalize routine tracking and make development visible, documented, and discussable.
  • It is specific to inpatient behavioral health. Built on real shifts in the setting your team works in.
  • It is not a wellness program, a staffing fix, or a replacement for clinical judgment, supervision, or institutional policy.
  • The software is in active development. A feasibility pilot is underway during 2026–27; we make no claims about its effects yet, and results are in preparation.

The Pilot

A year-long feasibility pilot is underway at a Child & Adolescent PMHNP fellowship during 2026–27. Results are in preparation.

The Next Step

Start with a
discovery conversation.

Twenty minutes about your program, your friction, and whether this is the right fit.

Book a discovery call