E. Part of his explanation for the error was his willingness to capitulate when tired: `I didn’t ask for any healthcare 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. In spite of sharing these comparable traits, there were some differences in error-producing circumstances. With KBMs, physicians had been aware of their understanding deficit at the time from the prescribing decision, as opposed to with RBMs, which led them to take among two pathways: approach other individuals for314 / 78:two / Br J Clin PharmacolLatent conditionsSteep hierarchical structures inside medical teams prevented doctors from looking for help or certainly getting sufficient aid, highlighting the importance of the prevailing healthcare culture. This varied between specialities and accessing advice from seniors appeared to be a lot more 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 stop a KBM, he felt he was HA15 supplier annoying them: `Q: What created you believe that you simply could be annoying them? A: Er, just because they’d say, you realize, initial words’d be like, “Hi. Yeah, what exactly is it?” you know, “I’ve scrubbed.” That’ll be like, kind of, the introduction, it wouldn’t be, you know, “Any problems?” or something like that . . . it just doesn’t sound quite approachable or friendly on the telephone, you realize. They just sound rather direct and, and that they had been busy, I was inconveniencing them . . .’ Interviewee 22. Health-related culture also influenced doctor’s behaviours as they acted in ways that they felt had been needed in an effort to match in. When exploring doctors’ reasons for their KBMs they discussed how they had chosen to not seek tips or info for fear of hunting incompetent, in particular when new to a ward. Interviewee two beneath explained why he didn’t check the dose of an antibiotic despite his uncertainty: `I knew I should’ve looked it up cos I didn’t really 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 recognized . . . because it is very straightforward to obtain caught up in, in becoming, you know, “Oh I am a Doctor now, I know stuff,” and together with the stress of folks who are perhaps, sort of, a bit bit a lot more senior than you pondering “HA15 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 discovered that it was acceptable to check data when prescribing: `. . . I obtain it very nice when Consultants open the BNF up within the ward rounds. And also you believe, nicely I’m not supposed to understand each and every single medication there is certainly, 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 seasoned nursing staff. An excellent example 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 having currently noted the allergy: `. journal.pone.0169185 . . the Registrar came, reviewed him and said, “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 thinking. 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 healthcare 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 equivalent traits, there have been some variations in error-producing conditions. With KBMs, medical doctors were aware of their knowledge deficit at the time in the prescribing selection, unlike with RBMs, which led them to take one of two pathways: method other individuals for314 / 78:2 / Br J Clin PharmacolLatent conditionsSteep hierarchical structures within healthcare teams prevented medical doctors from seeking aid or indeed receiving sufficient assistance, highlighting the value of your prevailing health-related culture. This varied amongst specialities and accessing suggestions from seniors appeared to become 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 suggestions to stop a KBM, he felt he was annoying them: `Q: What created you assume that you just might be annoying them? A: Er, simply because they’d say, you realize, first words’d be like, “Hi. Yeah, what exactly is it?” you understand, “I’ve scrubbed.” That’ll be like, sort of, the introduction, it would not be, you understand, “Any problems?” or anything like that . . . it just does not sound pretty approachable or friendly around the phone, 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 strategies that they felt had been vital in an effort to match in. When exploring doctors’ reasons for their KBMs they discussed how they had selected to not seek assistance or info for fear of seeking incompetent, in particular when new to a ward. Interviewee 2 below explained why he didn’t check 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 believe I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was one thing that I should’ve identified . . . since it is extremely straightforward to get caught up in, in becoming, you realize, “Oh I am a Physician now, I know stuff,” and with the pressure of individuals who are maybe, kind of, a little bit bit more senior than you considering “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 condition instead of the actual culture. This interviewee discussed how he ultimately learned that it was acceptable to verify information and facts when prescribing: `. . . I come across it really nice when Consultants open the BNF up in the ward rounds. And also you think, well 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 skilled nursing employees. A great instance 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 having already noted the allergy: `. journal.pone.0169185 . . the Registrar came, reviewed him and said, “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 with no thinking. I say wi.