E. Part of his explanation for the error was his willingness to capitulate when tired: `I did not ask for any medical history or anything like that . . . more than the phone at three or four o’clock [in the morning] you just say yes to anything’ pnas.1602641113 Interviewee 25. In spite of sharing these related characteristics, there had been some variations in error-producing conditions. With KBMs, physicians were conscious of their knowledge deficit at the time of the prescribing selection, as GS-4059 site opposed to with RBMs, which led them to take one of two pathways: approach other individuals for314 / 78:2 / Br J Clin PharmacolLatent conditionsSteep hierarchical structures within healthcare teams prevented physicians from in search of help or indeed getting sufficient enable, highlighting the importance with the prevailing healthcare culture. This varied amongst specialities and accessing guidance from seniors appeared to be additional problematic for FY1 trainees functioning in surgical specialities. Interviewee 22, who worked on a surgical ward, described how, when he approached seniors for tips to prevent a KBM, he felt he was annoying them: `Q: What made you XAV-939 biological activity believe that you may be annoying them? A: Er, just because they’d say, you understand, first words’d be like, “Hi. Yeah, what’s it?” you know, “I’ve scrubbed.” That’ll be like, kind of, the introduction, it wouldn’t be, you know, “Any issues?” or anything like that . . . it just does not sound extremely approachable or friendly around the phone, you realize. They just sound rather direct and, and that they were busy, I was inconveniencing them . . .’ Interviewee 22. Healthcare culture also influenced doctor’s behaviours as they acted in methods that they felt were required so as to fit in. When exploring doctors’ factors for their KBMs they discussed how they had chosen to not seek guidance or facts for fear of searching incompetent, in particular when new to a ward. Interviewee 2 below explained why he didn’t verify the dose of an antibiotic regardless of his uncertainty: `I knew I should’ve looked it up cos I didn’t truly know it, but I, I feel I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was one thing that I should’ve identified . . . because it is quite quick to have caught up in, in being, you know, “Oh I’m a Medical professional now, I know stuff,” and together with the pressure of individuals who are possibly, kind of, just a little bit additional senior than you thinking “what’s wrong with him?” ‘ Interviewee two. This behaviour was described as subsiding with time, suggesting that it was their perception of culture that was the latent condition as opposed to the actual culture. This interviewee discussed how he at some point discovered that it was acceptable to verify details when prescribing: `. . . I discover it really good when Consultants open the BNF up in the ward rounds. And you feel, effectively I am not supposed to know just about every single medication there is, or the dose’ Interviewee 16. Medical culture also played a part in RBMs, resulting from deference to seniority and unquestioningly following the (incorrect) orders of senior physicians or skilled nursing employees. An excellent instance of this was provided by a medical professional who felt relieved when a senior colleague came to help, but then prescribed an antibiotic to which the patient was allergic, regardless of getting already noted the allergy: `. journal.pone.0169185 . . the Registrar came, reviewed him and stated, “No, no we should give Tazocin, penicillin.” And, erm, by that stage I’d forgotten that he was penicillin allergic and I just wrote it on the chart with no thinking. I say wi.E. A part of his explanation for the error was his willingness to capitulate when tired: `I did not ask for any health-related history or something like that . . . over the telephone at three or four o’clock [in the morning] you simply say yes to anything’ pnas.1602641113 Interviewee 25. In spite of sharing these similar qualities, there have been some differences in error-producing conditions. With KBMs, medical doctors have been aware of their information deficit in the time of the prescribing choice, as opposed to with RBMs, which led them to take one of two pathways: strategy other people for314 / 78:two / Br J Clin PharmacolLatent conditionsSteep hierarchical structures within health-related teams prevented medical doctors from in search of assist or certainly receiving sufficient assist, highlighting the importance from the prevailing healthcare culture. This varied amongst specialities and accessing advice from seniors appeared to be much more problematic for FY1 trainees operating in surgical specialities. Interviewee 22, who worked on a surgical ward, described how, when he approached seniors for assistance to stop a KBM, he felt he was annoying them: `Q: What made you believe that you just might be annoying them? A: Er, just because they’d say, you realize, very first words’d be like, “Hi. Yeah, what is it?” you understand, “I’ve scrubbed.” That’ll be like, kind of, the introduction, it would not be, you know, “Any challenges?” or something like that . . . it just doesn’t sound extremely approachable or friendly around the telephone, you know. They just sound rather direct and, and that they have been busy, I was inconveniencing them . . .’ Interviewee 22. Health-related culture also influenced doctor’s behaviours as they acted in strategies that they felt were vital as a way to fit in. When exploring doctors’ reasons for their KBMs they discussed how they had selected not to seek advice or information and facts for fear of searching incompetent, especially when new to a ward. Interviewee 2 under explained why he did not check the dose of an antibiotic regardless of his uncertainty: `I knew I should’ve looked it up cos I did not truly know it, but I, I consider I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was some thing that I should’ve identified . . . because it is very easy to have caught up in, in getting, you know, “Oh I’m a Medical doctor now, I know stuff,” and using the pressure of men and women who’re possibly, sort of, a little bit far more senior than you considering “what’s incorrect with him?” ‘ Interviewee 2. This behaviour was described as subsiding with time, suggesting that it was their perception of culture that was the latent situation instead of the actual culture. This interviewee discussed how he at some point learned that it was acceptable to check facts when prescribing: `. . . I obtain it rather nice when Consultants open the BNF up in the ward rounds. And you believe, nicely I’m not supposed to understand every single medication there’s, or the dose’ Interviewee 16. Medical culture also played a part in RBMs, resulting from deference to seniority and unquestioningly following the (incorrect) orders of senior doctors or skilled nursing staff. A good instance of this was given by a medical professional who felt relieved when a senior colleague came to help, but then prescribed an antibiotic to which the patient was allergic, regardless of having currently noted the allergy: `. journal.pone.0169185 . . the Registrar came, reviewed him and stated, “No, no we ought to give Tazocin, penicillin.” And, erm, by that stage I’d forgotten that he was penicillin allergic and I just wrote it on the chart devoid of considering. I say wi.