The qualitative research interview has been a cornerstone of sociological inquiry for as long as sociology has existed as a discipline. Its purpose is not to extract facts but to access experience, to understand how the world looks and feels from another person’s vantage point. In healthcare investigation we call it investigative interviewing and we treat it as a formal process with structure and purpose. The principles, however, are identical.

When something goes wrong in healthcare, the instinct is to ask people what happened. Statements are gathered, formal interviews are conducted, accounts are recorded. This feels thorough. It follows a process most people recognise. The difficulty is that it frequently produces an incomplete picture, and sometimes a misleading one.

Witness statements are not unreliable because people are dishonest. They are unreliable because memory is reconstructive. Every time we recall an event we are rebuilding it, and that reconstruction is shaped by everything that has happened since. Conversations with colleagues, the emotional weight of the event, anxiety about blame, and the formal act of being asked to account for ourselves in writing all influence what ends up on the page. People edit, usually without realising it, towards accounts that are coherent and that reflect their intentions, even when they do not reflect what actually happened with the same accuracy.

There is a deeper problem. Formal interviews tend to focus on the moment things went wrong. They are structured around what happened, when, and who did what. What they rarely explore is the context surrounding that moment. What the day had been like. Whether the task was routine or unfamiliar. What the person was carrying into that room before anything went wrong. Without that context, the account is technically a record but practically incomplete.

The interviews that have taught me most have not followed a predetermined question list. They have been conversations with a direction, starting broad and moving slowly towards the specific, allowing the person to reconstruct their experience rather than report it. I ask what they remember about that day. Whether they usually enjoyed that kind of work. What about the task ever gave them pause on a normal day. I am not looking for answers so much as helping them paint a picture, and I am listening as much to what sits around the edges of what they say as to the words themselves.

Some months after a serious investigation had concluded I spoke informally with one of the clinicians involved. The questions I asked were simple and open. After a while they began to cry. When the silence settled they told me they wished they had been asked those kinds of questions at the time. Not the formal questions about what they did and when, but questions that helped them remember the whole of the experience rather than just the part the investigation needed them to account for. That moment has stayed with me. It is a reminder that good investigative interviewing is not about extracting information. It is about creating the conditions in which someone can genuinely reflect. What emerges is almost always richer, more honest, and more useful than anything a formal statement process produces. And for the person being asked, it can matter in ways that go well beyond the investigation itself.

Five Tips

1. Start with why they do their job. What is what it looks like on a good day, a bad day and the days in between. You need to help them to get into the place. This is not small talk its scene setting and its critical. Do this before talking about the day of the incident, if in fact the incident can be captured in a specific moment in time. Then what was the shift like, whether it was typical, what had happened earlier. Context is not background noise. It is often where the explanation lives.
2. Ask whether they usually enjoyed that work. It is a question that almost nobody asks in a formal investigation and it opens up something important about the person’s relationship with the task, their confidence, their familiarity, and what felt different on that day.
3. Sit with silence. When someone is searching for the right words, the instinct is to fill the space. Resist it. The pause before an answer is often where the most honest reflection happens.
4. Listen to what sits around the edges. Hesitations, qualifications, things mentioned briefly and then moved past. These are frequently the threads most worth following.
5. Remember that the person in front of you has almost certainly been carrying this. A good investigative conversation acknowledges that, not by making the interview therapeutic, but by approaching the person with the kind of curiosity and respect that makes honest reflection feel possible rather than dangerous.

I strongly recommend reading the book ‘Listen: how to find the words for tender conversations’ by Kathryn Mannix