Driscoll's model of reflection: What? So what? Now what?

Driscoll’s model structures a reflection around three questions: What? (describe what happened), So what? (make sense of it: what it meant, what you felt, what it says about your practice) and Now what? (decide what you’ll do differently). It covers the same ground as Gibbs in half the scaffolding, which makes it the model many students reach for once reflection has become a habit rather than an assignment.

The three questions, with prompts

What?: return to the situation

Describe the episode factually and briefly. Prompts:

• What happened, and what was your part in it?
• Who was involved (roles only, never names or identifying details)?
• What did you do, and what did others do?

Keep it to a few sentences. As with Gibbs, the discipline is description without interpretation. The sense-making belongs in the next question.

So what?: understand the meaning

The heart of the model, folding Gibbs’ feelings, evaluation and analysis into one movement. Prompts:

• What were you thinking and feeling at the time, and now, looking back?
• What was good and what was troubling about the experience?
• Why did things unfold the way they did? What knowledge, guidance or evidence bears on it?
• What does this tell you about your practice: a strength you didn’t know you had, or a gap you now can’t unsee?

This is where the marks live, and more importantly where the learning lives. A “so what?” that stops at “it made me realise communication is important” hasn’t finished the job; push through to why it mattered and what specifically you now understand differently.

Now what?: decide the response

Turn the insight into behaviour. Prompts:

• What will you do differently in the same situation?
• What do you need to learn, practise or ask for to make that possible?
• How will you know it’s worked, and what would you expect your next similar episode to look like?

Specific and checkable beats noble and vague, always.

A compact worked example

What? During a busy medication round on my second placement, a patient asked me what one of their tablets was for. I didn’t know, said so, and told them I’d find out. I checked with my supervisor, looked it up, and returned with an explanation the patient was satisfied with.

So what? In the moment I felt caught out. I was administering under supervision and felt I should have known. Reflecting, the honest answer served the patient far better than a bluffed one: medicines information is safety-critical, and guessing would have been indefensible. My discomfort points at a real gap, though. I’d been focusing on the calculation and administration side of the round and treating the why of each medicine as someone else’s knowledge. People have every right to understand their own treatment, and answering well is part of the job, not extra credit.

Now what? For each new placement I’ll build a short personal formulary of the ward’s ten most common medicines (action, common doses, key side effects) within the first fortnight, and review it before medication rounds. Next time a patient asks, I want the first answer to be mine, checked rather than supplied by my supervisor.

Around 200 words, complete, honest, actionable, and a form that suits a busy placement week far better than no reflection at all.

Driscoll or Gibbs: which should you use?

Use whichever your university specifies, first and always. Where it’s your choice:

• Choose Gibbs when the episode is emotionally loaded or complicated: the six stages force slower, fuller processing, and the separate feelings stage stops emotion leaking into analysis. It’s also the safer scaffold when you’re new to reflective writing. See the full worked Gibbs example.
• Choose Driscoll for quick, frequent reflection: end-of-week notes, small moments, skills practice. Three questions are easy to hold in your head at the bus stop.

They map cleanly onto each other: What? ≈ description; So what? ≈ feelings + evaluation + analysis; Now what? ≈ conclusion + action plan. Learning one strengthens the other, and either produces reflections that work as proficiency evidence.

Frequently asked questions

Who created the What? So what? Now what? model? The three-question sequence was popularised for healthcare practice by John Driscoll, building on Terry Borton’s earlier framework. In nursing programmes it’s near-universally known simply as “Driscoll”.

Is Driscoll acceptable for university assignments? Usually, but check your brief. Some modules specify a model; if it’s Gibbs, use Gibbs.

Can I use Driscoll for NMC revalidation later? Yes. Revalidation requires written reflective accounts but doesn’t mandate a model, so the habit you build now transfers directly.

How long should a Driscoll reflection be? As short as ~150 words for a quick note or as full as any Gibbs piece. The worked example above is about 200 words; assignments will specify their own length.

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Keep the habit light. PlaceMate gives you guided, structured reflections you can link to shifts and proficiencies, free.