I'm not sure there's an agreed upon design pattern. At Prismatic we've adopted a component-based system where a component is essentially the MVC for a single logically-grouped part of the application. Its defined as a record that binds its own events and renders markup from it's template. We try to push mutability and asynchronous functions (xhr, file io, etc.) as far up as possible to avoid unnecessary state manipulation and callbacks everywhere. The idea of reactive programming in ClojureScript is also very interesting as it would make event-handling much more manageable, simplifying event-dom glue code and removing unwieldy callback chains.