Driscoll Model of Reflection: Healthcare Example & Guide
Every UK nursing and healthcare student is taught the Gibbs Reflective Cycle. It is a fantastic framework for deep, emotionally complex incidents. However, for fast-paced, acute ward scenarios, Gibbs can feel overly repetitive and descriptive.
If you are staring at a blank page trying to write a clinical placement essay or an NMC revalidation account, the Driscoll (2007) model is the ultimate action-oriented alternative. Based on Borton’s (1970) simple three-stem questions—What? So what? Now what?—this model strips away the fluff and forces you to focus on clinical outcomes.
Below, we explain exactly how to structure a Driscoll reflection and provide a complete, paragraph-by-paragraph healthcare example.
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Why Choose Driscoll Over Gibbs in Healthcare Assignments?
Students frequently lose marks in reflective writing by being too descriptive. They tell a long story about a shift, leaving no word count for critical analysis. Driscoll prevents this.
"University markers and clinical assessors prefer Driscoll for acute, procedural scenarios (like medication administration or a rapid patient deterioration). It forces you to get straight to the 'Now What?'—proving that you are a safe, adaptable practitioner ready for NMC registration, rather than just someone who can describe a busy shift."
The Golden Ratio for Grading: To secure a First-Class grade, aim for a strict word count distribution: 20% on WHAT (the story), 40% on SO WHAT (the analysis and evidence), and 40% on NOW WHAT (the future action plan).
The 3 Stages of the Driscoll Model
- 1. WHAT? (The Event): A brief, factual description of what happened. What was your role? What did you do?
- 2. SO WHAT? (The Analysis): How did it make you feel at the time? Why is this incident significant? How does it relate to the NMC Code or clinical literature?
- 3. NOW WHAT? (The Action Plan): What are the root consequences? What will you do differently next time? What local Trust policies do you need to review?
Concrete Healthcare Example: Driscoll Model in Action
Here is how a 3rd-year UK nursing student might use the Driscoll model to reflect on a medication near-miss.
"During a busy night shift on an acute medical ward, I was preparing to administer intravenous (IV) paracetamol to a post-operative patient. I checked the prescription chart and drew up the medication. As I approached the patient, my supervising mentor intervened and asked me to re-verify the patient’s weight. I realised I had calculated the dose based on a standard adult weight, failing to note the patient weighed only 45kg, which required a weight-adjusted dose. No harm came to the patient as the error was intercepted before administration."
Stage 2: SO WHAT? (Critical Analysis & Evidence)"Initially, I felt a profound sense of shock and embarrassment that I had nearly caused a medication error. Reflecting on the systemic factors, the ward was severely understaffed, and I felt rushed to complete the medication round. However, the NMC (2018) Code strictly mandates that nurses must prioritize people and practice effectively, which includes safe medication administration. This near-miss highlighted a flaw in my personal practice: allowing ward pressure to bypass standard safety checks. Literature by Smith et al. (2021) suggests that task-fixation during high-stress shifts significantly increases the risk of calculation errors in student nurses."
Stage 3: NOW WHAT? (The Action Plan)"Going forward, I must ensure that external ward pressures do not compromise my adherence to the 'Five Rights' of medication administration. I have formulated a two-step action plan. First, I will strictly implement an independent double-check with a registered nurse for all IV calculations, regardless of how busy the ward is, as supported by current Trust policy. Second, I will complete an additional CPD module on pharmacology and weight-based calculations via the e-Learning for Healthcare (e-LfH) portal before my next clinical placement to rebuild my clinical confidence."
Academic Tip: The "First-Person" Rule
A common question we receive from students seeking reflective essay help is: "Can I use 'I' in an academic essay?"
For reflective writing, the answer is yes, but you must shift your tone strategically:
- Use First-Person ("I felt", "I observed"): Strictly in the What and the beginning of the So What stages.
- Use Third-Person / Literature ("Evidence suggests", "The NMC dictates"): When moving into your critical analysis and justifying your Now What action plan. Never justify a clinical change based purely on your feelings; ground it in research.
Driscoll vs. Rolfe: Which Model Should You Use?
You may have noticed that the Rolfe et al. (2001) framework also uses the exact same What, So What, Now What structure. Which one should you pick?
They are essentially interchangeable in UK grading rubrics. The main difference is that Rolfe designed his model specifically for nursing and included a series of highly specific "cue questions" under each heading to prompt deeper clinical thinking. Driscoll (2007) adapted the framework to be slightly broader for all healthcare and clinical practice professionals. Pick the one your module handbook explicitly mentions; if neither is specified, either is perfectly acceptable.
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Connect with a Clinical Mentor via WhatsAppFrequently Asked Questions
What is the difference between Gibbs and Driscoll?
Gibbs is a 6-stage cycle that places a heavy emphasis on emotional processing and deep evaluation of the experience. Driscoll is a concise 3-stage model focused heavily on rapid analysis and establishing an immediate clinical action plan.
Can I use the Driscoll model for my NMC Revalidation?
Absolutely. The NMC does not mandate a specific reflective model for your five written reflective accounts. Driscoll is highly recommended because it clearly demonstrates to your confirmer exactly what you learned and how you will change your future practice (the "Now What" stage).
How do I reference the Driscoll model in Harvard format?
If you are using standard UK Harvard referencing, it should look like this: Driscoll, J. (ed.) (2007) Practicing clinical supervision: a reflective approach for healthcare professionals. 2nd edn. Edinburgh: Baillière Tindall Elsevier.