Engaged curiosity: "Hot spots" for clinical reasoning in complex patient encounters.

Objective: This study explores how, if at all, engaged curiosity - a genuine, emotionally engaged interest in learning more about the complexity of another's particular emotional perspective - emerges in the clinical reasoning process and its relationship with contextual factors and clinical reasoning performance. Methods: Think-alouds transcripts from nineteen physicians in internal medicine from three military training facilities were thematically analyzed for instances of engaged curiosity and examined through the lens of contextual factors and clinical reasoning performance. Results: Our findings indicate that engaged curiosity can be likened to placeholders that physicians employ early on to "bookmark" sources of patient concern. These sources, or hot spots, deserve follow up, particularly when cognitive resources are unavailable to "attend" to a deeper understanding of the patient's experience. Conclusion: Engaged curiosity provides a unique lens for better understanding the relationship between empathy and clinical reasoning and warrants further research on its impact on the patient and their care. Innovation: Engaged curiosity could serve as a novel way to train physicians to think and engage more empathically with their patients.