Is the “expectations” question, the most important one? (Judy Walker Associates, June 2025)

Summary

Judy Walker believes that the 'expectations' question in After Action Reviews is the one that has the most potential to bring about change and improve a culture. 

*This article was first published in The After Action Review Newsletter June 2025 written by Judy Walker Associates Ltd.

Content

Each of the four AAR questions has its strength, but I believe that it is the expectations question that is the one that has the most potential to bring about change and improve a culture. 

This is because it is the one we are least likely to ask and yet it is the one which uncovers the powerful assumptions that were guiding the behaviour and beliefs of those involved in any action. Expectations are included in what Shorrock describes as “work as imagined” and “work as prescribed” but they go even deeper. Our cultural norms, professional roles, experiences at work as well as policy and practice shape what we expect to have happen, but much of this happens outside of our conscious awareness. Being asked it in an AAR enables us to hear our own and others’ expectations, usually for the first time. This is where the first learning takes place in an AAR. You can literally see the light bulbs switching on as the synapse connections are made.

What is particularly interesting is that when teams use AAR routinely, the expectations concept starts to infiltrate how they think, and it becomes a question that is asked elsewhere to good effect. For example, “I wonder what the patient is expecting will happen today?” or “What are you expecting from your first week on the ward?” to bring the underlying assumptions to light. Asking the question creates double loop learning about how our expectations may all be different unless we stop to explore them.

I learned a huge amount from the many people I have taught to use AAR over the past 15 years. In one team that used AAR regularly to learn from clinical events, I saw an amazing application of the expectations question to a recruitment process. 

To ensure that they received a high number of recruits to the Registrar posts at a Level 3 Neonatal Intensive Unit, the Neonatal Consultant was very efficient and got an advert out early. This meant they were overwhelmed with top class applicants, and in preparing for the interviews, the Consultant realised that many would meet the Essential Criteria specified by the organisation’s’ interview process, so she developed some key questions for the Desirable criteria, one of which was “What do you expect it will be like working in a city centre Tertiary Neonatal Unit?”. 

This question got a wide range of responses, such as “I expect there will be good Consultant support, for it to be stressful at times, with some weekend shifts, perhaps one in 6 weekends.” Others answered, “I expect to be able to call Consultants if needed, for it to be very emotionally demanding work and to work one in four weekends”. The Registrar posts were awarded to those who met all the Essential Criteria and whose expectations most closely matched the harder reality, and at the end of their year on the ward, a surprising thing happened. The GMC National Training Survey scores for the unit were the highest in the country. The appointed Registrars who had expected it to be tough work, had realistic expectations about their workload and the emotional demands entailed. In other words, there was no gap between their expectations and the reality, and possibly the work experience was better than they expected, so their satisfaction with their training position was positive.

Have you found a useful application of the Expectations Question? We would love to hear about it and share it with others in the AAR community. Please get in touch [email protected]