E. A 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 . . . over the phone at three or four 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 variations in error-producing circumstances. With KBMs, medical doctors were conscious of their knowledge deficit at the time from the prescribing decision, as opposed to with RBMs, which led them to take among two pathways: strategy other folks for314 / 78:two / Br J Clin PharmacolLatent conditionsSteep hierarchical structures inside healthcare teams prevented medical doctors from looking for support or indeed getting sufficient assistance, highlighting the value from the prevailing healthcare culture. This varied in between specialities and accessing advice 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 tips to stop a KBM, he felt he was annoying them: `Q: What made you believe which you could be annoying them? A: Er, simply because they’d say, you realize, initially words’d be like, “Hi. Yeah, what’s it?” you realize, “I’ve scrubbed.” That’ll be like, kind of, the introduction, it would not be, you understand, “Any troubles?” or something like that . . . it just doesn’t sound incredibly approachable or friendly around the telephone, you know. They just sound Fexaramine 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 strategies that they felt had been essential to be able to fit in. When exploring doctors’ causes for their KBMs they discussed how they had chosen not to seek guidance or details for worry of seeking incompetent, particularly when new to a ward. Interviewee 2 under explained why he didn’t check the dose of an antibiotic regardless of his uncertainty: `I knew I should’ve looked it up cos I didn’t really know it, but I, I think 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 quite quick to have caught up in, in becoming, you understand, “Oh I am a Doctor now, I know stuff,” and with the pressure of people A1443 web who’re possibly, kind of, just a little 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 instead of the actual culture. This interviewee discussed how he ultimately discovered that it was acceptable to check facts when prescribing: `. . . I come across it fairly nice when Consultants open the BNF up inside the ward rounds. And you feel, well 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 physicians or experienced nursing employees. A great example of this was offered 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 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 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 medical history or anything like that . . . over 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 equivalent qualities, there were some variations in error-producing conditions. With KBMs, doctors were conscious of their information deficit in the time on the prescribing selection, as opposed to with RBMs, which led them to take among two pathways: approach other people for314 / 78:2 / Br J Clin PharmacolLatent conditionsSteep hierarchical structures inside health-related teams prevented doctors from looking for help or certainly getting sufficient enable, highlighting the importance from the prevailing medical culture. This varied amongst specialities and accessing suggestions from seniors appeared to become far more problematic for FY1 trainees operating 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 produced you assume that you simply might be annoying them? A: Er, just because they’d say, you realize, 1st 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 understand, “Any challenges?” or anything like that . . . it just does not sound incredibly approachable or friendly on the telephone, you understand. 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 methods that they felt were needed in order to fit in. When exploring doctors’ causes for their KBMs they discussed how they had chosen to not seek guidance or details for worry of seeking 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 truly know it, but I, I think I just convinced myself I knew it becauseExploring junior doctors’ prescribing mistakesI felt it was some thing that I should’ve recognized . . . since it is very easy to obtain caught up in, in becoming, you realize, “Oh I am a Physician now, I know stuff,” and with all the pressure of folks who are maybe, kind of, a little bit bit extra senior than you pondering “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 an alternative to the actual culture. This interviewee discussed how he ultimately discovered that it was acceptable to check facts when prescribing: `. . . I obtain it pretty good when Consultants open the BNF up in the ward rounds. And also you believe, well I am not supposed to understand every single medication there is certainly, or the dose’ Interviewee 16. Health-related culture also played a role in RBMs, resulting from deference to seniority and unquestioningly following the (incorrect) orders of senior doctors or knowledgeable nursing employees. A fantastic example of this was provided 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 possessing currently 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 on the chart devoid of pondering. I say wi.
