The Rolfe reflective model: What? So what? Now what? with a worked example

Some reflective models ask you to work through six or more stages. The Rolfe model does the opposite. It reduces reflection to three short questions, asked in order.

• What? What happened.
• So what? What it means.
• Now what? What you will do next.

The framework was set out by Gary Rolfe, Dawn Freshwater and Melanie Jasper in their 2001 book Critical reflection in nursing and the helping professions. They drew on an older idea from the American educator Terry Borton, who used the same three prompts in his 1970 book Reach, Touch and Teach, and on John Driscoll, who adapted them for clinical practice in 1994. What Rolfe and colleagues added was a set of cue questions under each heading, so the three plain words open out into a full structured reflection.

The appeal for busy clinicians is obvious. Three questions are easy to hold in your head at the end of a shift, and the model fits almost any event, from a brief interaction to a complex case that unfolded over weeks.

The three levels of thinking

It helps to see the three questions as three levels, each one deeper than the last.

1. What? is descriptive. You set the scene and state the facts.
2. So what? is where analysis happens. You make sense of the event and connect it to knowledge, evidence or standards.
3. Now what? is action-orientated. You decide what changes, and this is the part that actually improves practice.

Most weak reflections stall at the first level. They describe an event in detail and then stop, which reads as a diary entry rather than a reflection. The value of Rolfe is that the second and third questions force you to move on from what happened to what it means and what you will do about it.

What? Describing the event

Keep this section short and factual. Rolfe and colleagues (2001) suggest cues such as these:

• What was the situation, and what was my role in it?
• What was I trying to achieve, and what did I actually do?
• How did other people respond?
• What were the consequences, for the patient, for others and for me?
• What was good or difficult about the experience?

Resist the urge to explain or justify yet. That belongs in the next section.

So what? Making sense of it

This is the analytical heart of the reflection, and it is where marks, or audit credibility, are won or lost. Useful cues include:

• So what does this tell me about myself, my assumptions or my practice?
• So what was going through my mind at the time, and what did I base my actions on?
• So what other knowledge, evidence or guidance is relevant here?
• So what could I have done differently to make it better?

This is also the natural home for any references. If a standard, a piece of research or a local policy shaped what you did, or should have shaped it, name it here. Linking your experience to something beyond your own opinion is what turns a personal story into professional reflection.

Now what? Deciding what changes

The final question is the one that matters most, and the one people tend to rush. Push yourself to be specific:

• Now what will I do differently next time, in concrete terms?
• Now what do I need in order to make that change, for example training, a conversation with my team or a change to a process?
• Now what might get in the way, and how will I handle it?

A vague "I will be more careful" is not an action. "I will use a structured handover tool for every escalation, and I have asked to review our policy at the next team meeting" is.

A worked example

Here is a short reflection built on the three questions. It uses roles only, with no names, dates or details that could identify anyone.

What? During a late shift, I was looking after a patient whose early warning score had crept up across two sets of observations. I recorded the readings but did not escalate straight away, because I assumed the team already knew from the earlier handover. By the time I called the senior nurse, around forty minutes had passed. So what? Looking back, I acted on an assumption rather than a check. The patient came to no harm, but the delay was avoidable. Structured tools such as SBAR exist so that concerns are raised clearly and early, and my local deterioration policy sets a threshold for when a rising score must be escalated. I knew the policy, yet I let a handover assumption override it. My knowledge was fine. My habit under pressure was not. Now what? I will treat any rising early warning score as mine to escalate, whatever I assume others know, and I will use SBAR to make the call. I have asked to revisit our escalation policy at the next team meeting so we agree who owns escalation when a patient has just been handed over. If I catch myself assuming again, that is my cue to stop and check.

Notice how brief the description is, and how much of the writing goes into meaning and action. That balance is the mark of a strong Rolfe reflection.

Strengths and limits

The strength of the Rolfe model is its simplicity. It is quick, memorable and flexible, which makes it a good default for regular reflection and for events that are more about judgement than emotion.

That simplicity is also its risk. Because there are only three questions, it is easy to answer each one thinly and call it done. If your "so what" is only a sentence or two, you have probably not finished thinking. Models with an explicit step for feelings, such as Gibbs, can suit emotionally charged events better. Choosing the right tool for the event is itself a sign of a reflective practitioner.

Using it for the HCPC and the NMC

Neither regulator requires a particular model. The HCPC states that there is no set way to record your reflection, and that how you do it depends on the event, your learning style and your purpose. The NMC asks you to record five written reflective accounts on its official form, in your own words, and does not set a word count or mark them pass or fail.

The Rolfe questions map cleanly onto both. For an HCPC CPD profile, the three headings give you a ready structure. For an NMC reflective account, your "what" feeds the description of the event, your "so what" and "now what" feed what you learned and how you changed your practice, and you then link the account to the relevant themes of the Code.

A note on difficult events

Rolfe is often reached for after something has gone wrong, so it is worth drawing a clear line between reflection and rumination. Reflection moves forward. It asks what the event means and what you will do, then it closes. Rumination loops over the same distress without resolution. If you notice yourself going round in circles, or an event is weighing on you, that is a sign to seek support rather than to keep writing. Your occupational health service and your trade union can help, and the Samaritans are available free at any time on 116 123.

Turning the three questions into a finished account

The Rolfe model gives you the scaffolding. Filling it in honestly, in your own words, is still the work. Reflectory does that part with you. It interviews you about the event, one question at a time, then drafts a reflective account in your own words, with identifiable details screened out and an AI-assistance disclosure built in. You stay the author. If a blank form is where you usually get stuck, it is a faster route to a finished reflection you would be comfortable putting your name to.