Curiosity. Are you curious enough to read on?
Authors: Ami Schattner
Journal: Journal of the Royal Society of Medicine (2015)

Curiosity is a universal and omnipotent, predominantly human trait. It underlies child development and plays a major role in learning, discovery and art. In between, it is the spice of daily life and a strong bonding element between people. For clinicians, curiosity makes the difference between tiresome ‘automatic pilot’ practice and keenly expecting to meet a new challenge, a new learning opportunity and a new person on each encounter. To feel and be able to impart this element of renewal and enthusiasm is perhaps the greatest achievement of medical educators, and curiosity is the sine qua non of this and of any meaningful research. No wonder that curiosity (i.e. ‘inquisitiveness’) is an established primary goal of medical education and an acknowledged component of professional competence. Yet, ‘curiosity’ as a key attribute to success is not mentioned during residencies and research fellowships. Although curiosity and Observation (importantly, one begets the other) can be acquired and cultivated, its ingrained presence must be a valuable asset, but it is not evaluated among medical school candidates. In tandem with the scarcity of curiosity as a focus of teaching or training, but the term is relatively poorly represented in the medical literature. A PubMed search for ‘curiosity’ AND ‘medical education’ yields only few publications, mostly irrelevant. Although highly humanistic physicians identified a genuine sense of being curious about their patients as an essential fuel sustaining their humanism, and the patients’ perspective is no different, research evidence is practically non-existent. Considering the key role of curiosity in medicine (Figure 1), these deficiencies are surprising. If defined as an innate attitude of sincere, widely applied interest in other persons encountered and in things observed, curiosity is associated with a desire to know more and ideally has seven important characteristics. It is omnipresent, and not just clinical. It is target-independent and applies to numerous everyday observations and encounters, often to small details, and not only to grand or unique experiences. It is a lifelong trait, and not temporary or occasional. It is friendly, and not intrusive, felt by the other person and very likely to elicit a warm response. It is bidirectional, mostly directed outward but also bearing inwards as in introspection, reflection and mindfulness. It is conceived as pleasurable, and not a nagging duty. Importantly, it always leads to thought and action, and is not just passive. In the patient–provider encounter, these broad characteristics ensure substantial curiosity-driven cognitive advantages for the physician, as well as emotive opportunities for both parties (Figure 1). Their application will yield better quality of communication and elicitation of the patient’s history, concerns and signs (Figure 1A), and frequent search for patient-tailored evidence yielding improved decisionmaking. Curiosity also underlies tracking belated tests and verifying patient outcomes, establishing curiosity as key to imperative feedback, habitual learning and advancement (Figure 1B). Moreover, the physician’s interest will soon translate to knowing and acknowledging the patient, and correctly identifying common emotional and contextual problems that need attention. Increasing empathy and commitment naturally follow. Thus, curiosity begets emotional engagement and greater therapeutic efficacy: patients are quick to sense when their provider truly cares (Figure 1D, bidirectional arrow) and respond by better coping and increased satisfaction, trust and adherence, that may achieve significant improvement in patient’s quality of life and clinically important ‘hard’ health outcomes. A curiositybased approach can therefore advance health outcomes by two distinct mechanisms, cognitive and emotive, strongly enhancing a currently hampered patient–provider relationship and the provision of patient-centred care, a major Institute of Medicine goal (Figure 1A, B, D). These substantial multiple benefits contrast with the often-prevailing cursory history and examination; infrequent search for evidence-based solutions; inattention to patients’ concerns or feelings; and inadequate patient-centred care or shared decisions. Expected providers’ gains are no less important. Up to 60% of physicians report symptoms of burnout (defined as emotional exhaustion, low