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 just say yes to anything’ pnas.1602641113 Interviewee 25. In spite of sharing these similar characteristics, there had been some differences in error-producing circumstances. With KBMs, physicians were conscious of their know-how deficit at the time on the prescribing decision, in DMXAA contrast to with RBMs, which led them to take among two pathways: strategy other people for314 / 78:2 / Br J Clin PharmacolLatent conditionsSteep hierarchical structures within healthcare teams prevented physicians from searching for support or indeed receiving adequate assist, highlighting the significance with the prevailing health-related culture. This varied between specialities and accessing tips from seniors appeared to become extra problematic for FY1 trainees working in surgical specialities. Interviewee 22, who worked on a surgical ward, described how, when he approached seniors for guidance to prevent a KBM, he felt he was annoying them: `Q: What made you consider that you just could 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, sort of, the introduction, it wouldn’t be, you realize, “Any problems?” or anything like that . . . it just does not sound pretty approachable or friendly on the telephone, you understand. They just sound rather direct and, and that they were busy, I was inconveniencing them . . .’ Interviewee 22. Health-related culture also influenced doctor’s behaviours as they acted in methods that they felt have been necessary in an effort 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 seeking incompetent, specially when new to a ward. Interviewee two under explained why he didn’t check the dose of an antibiotic regardless of his uncertainty: `I knew I Hydroxydaunorubicin hydrochloride cost should’ve looked it up cos I did not seriously know it, but I, I believe I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was something that I should’ve identified . . . since it is extremely straightforward to have caught up in, in being, you understand, “Oh I’m a Physician now, I know stuff,” and using the pressure of folks who are maybe, sort of, slightly bit much more senior than you thinking “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 condition instead of the actual culture. This interviewee discussed how he at some point learned that it was acceptable to verify facts when prescribing: `. . . I locate it fairly good when Consultants open the BNF up within the ward rounds. And you feel, effectively I’m not supposed to know every single medication there is, or the dose’ Interviewee 16. Health-related culture also played a part in RBMs, resulting from deference to seniority and unquestioningly following the (incorrect) orders of senior doctors or knowledgeable nursing staff. A superb example of this was offered 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 should really 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 the need of pondering. I say wi.E. Part of his explanation for the error was his willingness to capitulate when tired: `I did not ask for any medical history or something like that . . . more than the telephone at 3 or 4 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 were aware of their expertise deficit at the time on the prescribing choice, in contrast to with RBMs, which led them to take among two pathways: strategy other individuals for314 / 78:two / Br J Clin PharmacolLatent conditionsSteep hierarchical structures inside health-related teams prevented doctors from searching for assist or indeed receiving adequate support, highlighting the value from the prevailing medical culture. This varied among specialities and accessing tips from seniors appeared to become more problematic for FY1 trainees operating 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 produced you believe that you could be annoying them? A: Er, simply because they’d say, you understand, initially 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 troubles?” or something like that . . . it just does not sound pretty approachable or friendly on the telephone, you know. They just sound rather direct and, and that they had been busy, I was inconveniencing them . . .’ Interviewee 22. Healthcare culture also influenced doctor’s behaviours as they acted in ways that they felt have been vital to be able to match in. When exploring doctors’ motives for their KBMs they discussed how they had chosen not to seek tips or information for worry of seeking incompetent, especially when new to a ward. Interviewee 2 beneath explained why he did not verify the dose of an antibiotic in spite of his uncertainty: `I knew I should’ve looked it up cos I did not seriously know it, but I, I believe I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was anything that I should’ve known . . . since it is very simple to acquire caught up in, in being, you realize, “Oh I’m a Physician now, I know stuff,” and with all the stress of people who’re maybe, sort of, a little bit bit additional 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 condition as opposed to the actual culture. This interviewee discussed how he at some point discovered that it was acceptable to check info when prescribing: `. . . I discover it fairly nice when Consultants open the BNF up inside the ward rounds. And also you think, effectively I am not supposed to understand each 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 physicians or seasoned nursing employees. An excellent 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, despite getting already noted the allergy: `. journal.pone.0169185 . . the Registrar came, reviewed him and said, “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 around the chart without the need of considering. I say wi.