As faithful readers of Safely Speaking are aware, culture-how clinicians think and behave- is a crucial component to patient safety. A recent study looked at preventing Clostirium difficile and clinicians' perception of risk. If it is not believed there is a high risk of harm to the patient or themselves, clinicians may not follow guidelines. The analysis found that overall knowledge of C difficile's microbiologic aspects, risk factors, diagnosis, treatment and prevention was low among health care professionals and was lower in senior physicians and nurses, compared to trainees. Nurses also reported lack of confidence that it is possible to prevent the spread of the disease, and demonstrated poor infection control practices. As this study clearly demonstrates, one must believe in what one is doing, or compliance will likely be low.