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Research in clinical reasoning suggests that the specifics of the clinical situation, or contextual factors, can contribute to diagnostic errors while a physician’s empathy can lead to more accurate diagnoses and prognoses. Medical education literature, however, has yet to fully explore the intersection of empathy and clinical reasoning. Engaged curiosity has emerged as a dimension of empathy that thrives in the clinical reasoning setting, where emotions and distress impact cognition. We explored the relationship between engaged curiosity and clinical reasoning, particularly in the presence of contextual factors, using think-aloud transcripts. Results indicate that engaged curiosity flourishes in complex patient encounters and may serve as a precursor to a deeper and more comprehensive understanding of the patient experience.