title: Junior doctors' perceptions of their self-efficacy in prescribing, their prescribing errors and the possible causes of errors.
abstract: OBJECTIVE
  The aim of the study was to explore and compare junior doctors' perceptions of their self-efficacy in prescribing, their prescribing errors and the possible causes of those errors.
  
  
  METHODS
  A cross-sectional questionnaire study was distributed to foundation doctors throughout Scotland, based on Bandura's Social Cognitive Theory and Human Error Theory (HET).
  
  
  RESULTS
  Five hundred and forty-eight questionnaires were completed (35.0% of the national cohort). F1s estimated a higher daytime error rate [median 6.7 (IQR 2-12.4)] than F2s [4.0 IQR (0-10) (P = 0.002)], calculated based on the total number of medicines prescribed. The majority of self-reported errors (250, 49.2%) resulted from unintentional actions. Interruptions and pressure from other staff were commonly cited causes of errors. F1s were more likely to report insufficient prescribing skills as a potential cause of error than F2s (P = 0.002). The prescribers did not believe that the outcomes of their errors were serious. F2s reported higher self-efficacy scores than F1s in most aspects of prescribing (P < 0.001).
  
  
  CONCLUSIONS
  Foundation doctors were aware of their prescribing errors, yet were confident in their prescribing skills and apparently complacent about the potential consequences of prescribing errors. Error causation is multi-factorial often due to environmental factors, but with lack of knowledge also contributing. Therefore interventions are needed at all levels, including environmental changes, improving knowledge, providing feedback and changing attitudes towards the role of prescribing as a major influence on patient outcome.
authors.affiliation: School of Pharmacy, Queen's University Belfast, Belfast, UK.
authors.forename: Cristín
authors.initials: C
authors.lastname: Ryan
authors.forename: Sarah
authors.initials: S
authors.lastname: Ross
authors.forename: Peter
authors.initials: P
authors.lastname: Davey
authors.forename: Eilidh M
authors.initials: EM
authors.lastname: Duncan
authors.forename: Shona
authors.initials: S
authors.lastname: Fielding
authors.forename: Jill J
authors.initials: JJ
authors.lastname: Francis
authors.forename: Marie
authors.initials: M
authors.lastname: Johnston
authors.forename: Jean
authors.initials: J
authors.lastname: Ker
authors.forename: Amanda Jane
authors.initials: AJ
authors.lastname: Lee
authors.forename: Mary Joan
authors.initials: MJ
authors.lastname: MacLeod
authors.forename: Simon
authors.initials: S
authors.lastname: Maxwell
authors.forename: Gerard
authors.initials: G
authors.lastname: McKay
authors.forename: James
authors.initials: J
authors.lastname: McLay
authors.forename: David J
authors.initials: DJ
authors.lastname: Webb
authors.forename: Christine
authors.initials: C
authors.lastname: Bond
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000592:standards* / Q000706:statistics & numerical data; D008508:Medication Errors / Q000523:psychology* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D012606:Scotland; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D016526:Workload
keywords: human error theory; junior doctors; patient safety; prescribing errors; self-efficacy