E. A part of his explanation for the error was his willingness to ENMD-2076 cost capitulate when tired: `I did not ask for any medical history or anything like that . . . over the telephone at three or 4 o’clock [in the morning] you simply say yes to anything’ pnas.1602641113 Interviewee 25. Regardless of sharing these similar traits, there have been some variations in error-producing situations. With KBMs, doctors were aware of their knowledge deficit at the time of your prescribing decision, unlike with RBMs, which led them to take certainly one of two pathways: approach others for314 / 78:2 / Br J Clin PharmacolLatent conditionsSteep hierarchical structures within medical teams prevented doctors from searching for help or certainly getting adequate help, highlighting the significance from the prevailing medical culture. This varied in between specialities and accessing suggestions from seniors appeared to be much more problematic for FY1 trainees working in surgical specialities. Interviewee 22, who worked on a surgical ward, described how, when he approached seniors for advice to stop a KBM, he felt he was annoying them: `Q: What created you assume that you simply could be annoying them? A: Er, just because they’d say, you EPZ015666 chemical information understand, initial words’d be like, “Hi. Yeah, what’s it?” you know, “I’ve scrubbed.” That’ll be like, sort of, the introduction, it wouldn’t be, you realize, “Any difficulties?” or something like that . . . it just does not sound incredibly approachable or friendly around the telephone, you understand. 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 approaches that they felt have been vital as a way to fit in. When exploring doctors’ causes for their KBMs they discussed how they had selected to not seek tips or information for fear of hunting incompetent, specifically when new to a ward. Interviewee two beneath 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 truly know it, but I, I assume I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was some thing that I should’ve known . . . because it is extremely effortless to obtain caught up in, in getting, you realize, “Oh I’m a Medical doctor now, I know stuff,” and with all the pressure of persons who’re perhaps, kind of, a little bit bit far more senior than you considering “what’s wrong 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 rather than the actual culture. This interviewee discussed how he ultimately discovered that it was acceptable to check data when prescribing: `. . . I discover it fairly good when Consultants open the BNF up within the ward rounds. And also you feel, properly I am not supposed to know each and every single medication there is, or the dose’ Interviewee 16. Medical culture also played a role in RBMs, resulting from deference to seniority and unquestioningly following the (incorrect) orders of senior doctors or skilled nursing employees. A good example of this was given by a physician who felt relieved when a senior colleague came to help, but then prescribed an antibiotic to which the patient was allergic, in spite of having currently noted the allergy: `. journal.pone.0169185 . . the Registrar came, reviewed him and mentioned, “No, no we must give Tazocin, penicillin.” And, erm, by that stage I’d forgotten that he was penicillin allergic and I just wrote it on the chart without considering. I say wi.E. Part of his explanation for the error was his willingness to capitulate when tired: `I did not ask for any healthcare history or something like that . . . more than the telephone at three or 4 o’clock [in the morning] you simply say yes to anything’ pnas.1602641113 Interviewee 25. In spite of sharing these similar characteristics, there had been some variations in error-producing circumstances. With KBMs, doctors were aware of their expertise deficit in the time in the prescribing decision, unlike with RBMs, which led them to take among two pathways: strategy others for314 / 78:2 / Br J Clin PharmacolLatent conditionsSteep hierarchical structures inside medical teams prevented physicians from searching for aid or certainly receiving adequate help, highlighting the importance on the prevailing health-related culture. This varied involving specialities and accessing suggestions 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 advice to prevent a KBM, he felt he was annoying them: `Q: What made you feel that you just may be annoying them? A: Er, just because they’d say, you understand, first words’d be like, “Hi. Yeah, what’s it?” you understand, “I’ve scrubbed.” That’ll be like, sort of, the introduction, it wouldn’t be, you know, “Any complications?” or anything like that . . . it just does not sound incredibly approachable or friendly on 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 ways that they felt had been vital as a way to match in. When exploring doctors’ reasons for their KBMs they discussed how they had chosen not to seek advice or data for fear of searching incompetent, specifically 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 didn’t genuinely know it, but I, I think I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was a thing that I should’ve recognized . . . since it is very straightforward to acquire caught up in, in getting, you understand, “Oh I’m a Doctor now, I know stuff,” and with the pressure of individuals that are maybe, sort of, somewhat bit more senior than you thinking “what’s wrong with him?” ‘ Interviewee 2. This behaviour was described as subsiding with time, suggesting that it was their perception of culture that was the latent condition rather than the actual culture. This interviewee discussed how he at some point learned that it was acceptable to verify data when prescribing: `. . . I discover it quite nice when Consultants open the BNF up in the ward rounds. And you believe, effectively I’m not supposed to know every single medication there is, 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 skilled nursing employees. An excellent instance of this was given by a physician who felt relieved when a senior colleague came to help, but then prescribed an antibiotic to which the patient was allergic, despite having already noted the allergy: `. journal.pone.0169185 . . the Registrar came, reviewed him and stated, “No, no we really should give Tazocin, penicillin.” And, erm, by that stage I’d forgotten that he was penicillin allergic and I just wrote it around the chart devoid of pondering. I say wi.