E. Part of his explanation for the error was his willingness to capitulate when tired: `I didn’t ask for any health-related history or something like that . . . over the phone at three or four o’clock [in the morning] you simply say yes to anything’ pnas.1602641113 Interviewee 25. Regardless of sharing these comparable characteristics, there were some differences in error-producing conditions. With KBMs, doctors have been conscious of their knowledge deficit in the time of your prescribing selection, unlike with RBMs, which led them to take one of two pathways: approach others for314 / 78:two / Br J Clin PharmacolLatent conditionsSteep hierarchical structures inside health-related teams prevented physicians from seeking help or certainly receiving adequate aid, highlighting the significance of the prevailing TLK199 custom synthesis Medical culture. This varied amongst specialities and accessing tips from seniors appeared to be a lot more problematic for FY1 trainees functioning in Acetate surgical specialities. Interviewee 22, who worked on a surgical ward, described how, when he approached seniors for guidance to stop a KBM, he felt he was annoying them: `Q: What made you consider that you may be annoying them? A: Er, just because they’d say, you know, 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 realize, “Any troubles?” or something like that . . . it just does not sound very approachable or friendly on the telephone, you realize. They just sound rather direct and, and that they have been busy, I was inconveniencing them . . .’ Interviewee 22. Medical culture also influenced doctor’s behaviours as they acted in ways that they felt have been important to be able to fit in. When exploring doctors’ motives for their KBMs they discussed how they had selected to not seek guidance or info for fear of searching incompetent, particularly when new to a ward. Interviewee 2 below explained why he didn’t verify the dose of an antibiotic despite his uncertainty: `I knew I should’ve looked it up cos I didn’t actually know it, but I, I believe I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was some thing that I should’ve known . . . since it is very uncomplicated to have caught up in, in becoming, you know, “Oh I am a Physician now, I know stuff,” and with the pressure of persons who’re perhaps, sort of, a little bit far more senior than you pondering “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 situation as opposed to the actual culture. This interviewee discussed how he eventually learned that it was acceptable to verify details when prescribing: `. . . I discover it fairly good when Consultants open the BNF up within the ward rounds. And also you consider, properly I am not supposed to understand every single medication there’s, or the dose’ Interviewee 16. Healthcare culture also played a part in RBMs, resulting from deference to seniority and unquestioningly following the (incorrect) orders of senior medical doctors or experienced nursing employees. A good instance of this was given by a medical doctor who felt relieved when a senior colleague came to assist, but then prescribed an antibiotic to which the patient was allergic, despite getting already noted the allergy: `. journal.pone.0169185 . . the Registrar came, reviewed him and mentioned, “No, no we need to give Tazocin, penicillin.” And, erm, by that stage I’d forgotten that he was penicillin allergic and I just wrote it around the chart with no pondering. I say wi.E. Part of his explanation for the error was his willingness to capitulate when tired: `I didn’t ask for any health-related history or something like that . . . more than the telephone at 3 or 4 o’clock [in the morning] you just say yes to anything’ pnas.1602641113 Interviewee 25. In spite of sharing these similar characteristics, there were some differences in error-producing circumstances. With KBMs, medical doctors were aware of their understanding deficit in the time in the prescribing decision, in contrast to with RBMs, which led them to take among two pathways: approach other people for314 / 78:2 / Br J Clin PharmacolLatent conditionsSteep hierarchical structures within health-related teams prevented medical doctors from in search of assistance or indeed getting sufficient enable, highlighting the importance on the prevailing healthcare culture. This varied involving specialities and accessing assistance from seniors appeared to become additional problematic for FY1 trainees working in surgical specialities. Interviewee 22, who worked on a surgical ward, described how, when he approached seniors for suggestions to prevent a KBM, he felt he was annoying them: `Q: What made you consider that you just might be annoying them? A: Er, simply because they’d say, you understand, 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 realize, “Any problems?” or anything like that . . . it just doesn’t sound pretty approachable or friendly around the telephone, you realize. They just sound rather direct and, and that they have been busy, I was inconveniencing them . . .’ Interviewee 22. Medical culture also influenced doctor’s behaviours as they acted in approaches that they felt have been vital to be able to fit in. When exploring doctors’ causes for their KBMs they discussed how they had selected not to seek guidance or info for fear of hunting incompetent, especially when new to a ward. Interviewee 2 below explained why he didn’t verify the dose of an antibiotic in spite of his uncertainty: `I knew I should’ve looked it up cos I didn’t actually know it, but I, I think I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was one thing that I should’ve recognized . . . since it is extremely easy to get caught up in, in being, you know, “Oh I’m a Medical professional now, I know stuff,” and together with the pressure of men and women that are possibly, sort of, a bit bit much more senior than you thinking “what’s incorrect with him?” ‘ Interviewee two. This behaviour was described as subsiding with time, suggesting that it was their perception of culture that was the latent situation as opposed to the actual culture. This interviewee discussed how he eventually learned that it was acceptable to verify information when prescribing: `. . . I discover it really nice when Consultants open the BNF up in the ward rounds. And you consider, properly I’m not supposed to know every single single medication there is, or the dose’ Interviewee 16. Healthcare culture also played a role in RBMs, resulting from deference to seniority and unquestioningly following the (incorrect) orders of senior medical doctors or experienced nursing employees. A good example of this was given by a medical doctor who felt relieved when a senior colleague came to help, but then prescribed an antibiotic to which the patient was allergic, regardless of getting currently noted the allergy: `. journal.pone.0169185 . . the Registrar came, reviewed him and stated, “No, no we need to give Tazocin, penicillin.” And, erm, by that stage I’d forgotten that he was penicillin allergic and I just wrote it around the chart without considering. I say wi.