“What Could You Have Done Better?” Reframing a Question Healthcare Professionals Dread.

Kimesha Blackwood BScN, MEd

February 2, 2026

As a nurse I have been apart of a few Quality of Care (QC) reviews and needless to say it draws the same dread and anxiety for me as it would for anyone else who has had to participate in one. A QC typically entails a deep dive in to care provided whether it was safe, timely, patient centered, equitable and if care was according to the organizations policies. In healthcare, few questions feel as loaded as: “What could you have done better?”

It’s asked during incident reviews, performance evaluations, clinical debriefings, interviews, and reflective assignments. For many healthcare professionals, it triggers defensiveness, guilt, or self-doubt especially in environments where mistakes can carry serious consequences.

It has been my experience when approached correctly, this question is not an accusation. It is an invitation to grow. I know this may not true for the masses, but I suppose it's about perspective.

Why This Question Feels So Uncomfortable

Healthcare professionals are trained to be competent, precise, and accountable. We work in systems where errors can affect patient outcomes, professional licenses, and team trust. As a result, we often equate “doing better” with “failing.”

The reality is this: Perfection is not the standard but continuous improvement is.

When the question is framed constructively, it encourages:

• Clinical insight

• Professional maturity

• Patient safety awareness

• Lifelong learning

The Purpose Behind the Question

When leaders, educators, or interviewers ask “What could you have done better?”, they are often assessing your ability to:

• Reflect honestly on practice

• Recognize system-level factors

• Learn from experience without self-blame

• Apply insight to future care

This is a cornerstone of safe, high-quality healthcare.

Shifting From Self-Criticism to Reflection

Effective reflection is not about listing personal failures. It’s about identifying opportunities for improvement while acknowledging context.

Instead of thinking:

“How could I missed that, I should have known better.”

Reframe to:

“Based on the information I had at the time, I acted appropriately. however in hindsight, here’s what I would do differently.”

This subtle shift protects professional confidence while promoting accountability.

Examples of Thoughtful Reflection

Here are professional, growth-oriented ways healthcare professionals can answer this question:

• Communication:“I could have clarified expectations earlier with the interdisciplinary team to prevent delays in care.”

• Clinical Judgment:“I would reassess sooner and escalate concerns earlier if I encountered similar symptoms again.”

• Time Management:“I could have prioritized patient education more effectively by delegating non-urgent tasks.”

• Advocacy:“I could have voiced my concerns more assertively when I recognized a potential risk.”

Each response shows insight without assigning blame.

Recognizing System Factors

Healthcare does not exist in a vacuum. Staffing levels, workload, policies, and communication structures all influence outcomes.

A strong reflective response acknowledges this:

“While system constraints played a role, I recognize where my actions could be optimized within those limits.”

This demonstrates professionalism and situational awareness key traits in leadership and advanced practice roles.

Why This Question Actually Makes You a Better Clinician

Healthcare professionals who can answer “What could you have done better?” thoughtfully tend to:

• Adapt faster to complex situations

• Communicate more effectively

• Improve patient outcomes

• Experience less burnout through self-compassion

• Earn trust from colleagues and leadership

Reflection is not weakness it is clinical strength.

In conclusion

The next time you are asked “What could you have done better?”, pause before reacting emotionally. This question is not about proving your inadequacy it’s about demonstrating your commitment to excellence. In healthcare, growth does not come from being flawless. It comes from being reflective, accountable, and willing to improve for yourself, your team, and your patient's outcome. Dedicate time to review research material that supports best practices, review the policies of your workplace and ensure familiarity, talk to other colleagues about your concerns and seek clarifications if unsure about a task. Be the expert in your field of practice, understand you are only human, mistakes will happen and something will go wrong regardless of your best efforts. And finally but most importantly be gentle with you, please give yourself grace and remember that the world is better because you’re in it. Even on your hardest days, you are enough, thank you for all you do!.

Blackwood's Healthcare Learning Center

Ontario Canada