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 four o’clock [in the morning] you just say yes to anything’ pnas.1602641113 Interviewee 25. Regardless of sharing these equivalent qualities, there were some differences in error-producing situations. With KBMs, medical doctors had been aware of their know-how deficit at the time with the prescribing choice, unlike with RBMs, which led them to take one of two pathways: approach other people for314 / 78:2 / Br J Clin PharmacolLatent conditionsSteep hierarchical structures within healthcare teams prevented medical doctors from seeking assist or indeed receiving adequate assist, highlighting the value from the prevailing health-related culture. This varied amongst specialities and accessing suggestions from seniors appeared to be far more problematic for FY1 trainees operating in surgical specialities. Interviewee 22, who worked on a surgical ward, Conduritol B epoxide custom synthesis described how, when he approached seniors for guidance to stop a KBM, he felt he was annoying them: `Q: What created you believe that you simply might be annoying them? A: Er, just because they’d say, you realize, initially words’d be like, “Hi. Yeah, what is it?” you realize, “I’ve scrubbed.” That’ll be like, kind of, the introduction, it would not be, you know, “Any difficulties?” or something like that . . . it just doesn’t sound really 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. Healthcare culture also influenced doctor’s behaviours as they acted in strategies that they felt have been vital in order to fit in. When exploring doctors’ factors for their KBMs they discussed how they had selected to not seek advice or data for fear of seeking incompetent, especially when new to a ward. Interviewee two under explained why he didn’t check the dose of an antibiotic despite his uncertainty: `I knew I should’ve looked it up cos I did not genuinely know it, but I, I consider I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was anything that I should’ve identified . . . because it is very straightforward to get caught up in, in becoming, you know, “Oh I am a Medical doctor now, I know stuff,” and with all the stress of people today who’re maybe, kind of, slightly bit far more senior than you pondering “CPI-455 web 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 rather than the actual culture. This interviewee discussed how he at some point discovered that it was acceptable to check info when prescribing: `. . . I come across it quite nice when Consultants open the BNF up within the ward rounds. And you consider, nicely I’m not supposed to understand every single 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 skilled nursing employees. A great 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 already 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 on the chart without considering. I say wi.E. A 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 4 o’clock [in the morning] you simply say yes to anything’ pnas.1602641113 Interviewee 25. In spite of sharing these equivalent qualities, there were some variations in error-producing situations. With KBMs, medical doctors were aware of their information deficit at the time in the prescribing choice, unlike with RBMs, which led them to take certainly one of two pathways: strategy others for314 / 78:two / Br J Clin PharmacolLatent conditionsSteep hierarchical structures within healthcare teams prevented medical doctors from in search of aid or indeed receiving adequate support, highlighting the value in the prevailing medical culture. This varied in between specialities and accessing guidance from seniors appeared to be a lot more problematic for FY1 trainees functioning in surgical specialities. Interviewee 22, who worked on a surgical ward, described how, when he approached seniors for assistance to prevent a KBM, he felt he was annoying them: `Q: What produced you assume that you just might be annoying them? A: Er, just because they’d say, you know, first words’d be like, “Hi. Yeah, what’s it?” you understand, “I’ve scrubbed.” That’ll be like, kind of, the introduction, it wouldn’t be, you know, “Any issues?” or something like that . . . it just doesn’t sound extremely approachable or friendly on the phone, you know. 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 strategies that they felt had been needed so as to fit in. When exploring doctors’ causes for their KBMs they discussed how they had chosen to not seek advice or data for fear of searching incompetent, especially when new to a ward. Interviewee two below 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 genuinely know it, but I, I assume I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was something that I should’ve recognized . . . since it is extremely uncomplicated to get caught up in, in being, you understand, “Oh I am a Physician now, I know stuff,” and using the stress of people that are perhaps, sort of, a bit bit much 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 condition as an alternative to the actual culture. This interviewee discussed how he eventually learned that it was acceptable to check info when prescribing: `. . . I locate it fairly good when Consultants open the BNF up in the ward rounds. And also you consider, nicely I’m not supposed to understand each and 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 physicians or skilled nursing staff. A good instance of this was provided by a doctor who felt relieved when a senior colleague came to assist, but then prescribed an antibiotic to which the patient was allergic, in spite of possessing already 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 on the chart without having thinking. I say wi.