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Actions have consequences. On the surface, consequences may be quite obvious. Others be less so. Imagine throwing a pebble into a pond. The splash is the immediate consequence and the ripples spreading out are further consequences both short‐term and long‐term that are less easy to perceive.

To ask the question – ‘was I effective?’ requires the practitioner to have a grasp of what effectiveness would look like. Some situations can be observed or measured, for example wound healing. Other situations less so, such as giving advice whereby judging effectiveness is subjective and best perceived from the patient’s perspective.

Considering effectiveness in terms of consequences facilitates the development of foresight‐ the ability to weigh up the likely consequences of actions as part of the decision making process. Foresight is intuitive, for how can consequences be known given the uncertainty of everyday practice? Aristotle (2004) termed this ability as phronesis or practical wisdom – being mindful of the best way to respond within a particular situation considering the ethical consequences of such response.