Pediatric adverse event rates associated with inexperience in teaching hospitals: a multilevel analysis.

Provider inexperience and frequent handoffs create unique safety hazards in teaching environments. This multilevel modeling study investigated predictors of pediatric adverse events at children's hospitals. Investigators noted more adverse events under the following circumstances: earlier in the academic year (the July phenomenon), in hospitals offering more technically complex services, and in hospitals with a higher number of resident physicians for each patient. A PSNet perspective discussed the appropriate balance between autonomy and supervision for training physicians.