Clinical reasoning in naturopathic medicine: A scoping review of conceptual elements, influencing factors and developmental strategies

Introduction Clinical reasoning is central to safe, effective, and patient-centred healthcare. While clinical reasoning has been extensively examined across many health professions, comparatively limited attention has been given to how it is conceptualised, enacted, and supported within naturopathic medicine (NM), an important discipline within integrative healthcare systems. This scoping review aimed to synthesise the literature on naturopathic medicine clinical reasoning (NMCR) and to clarify its conceptual foundations across clinical practice and education contexts. Methods A systematic scoping review was conducted using the Arksey and O’Malley framework and methodological guidance from the Joanna Briggs Institute. Bibliographic databases, profession-specific journals, and grey literature sources were searched for literature addressing NMCR in practice and education. Data were charted and synthesised using descriptive and narrative approaches. Results Twenty-five sources met the inclusion criteria. NMCR was described as a multifaceted and iterative process integrating holistic and systematic reasoning approaches. Six core elements were identified: patient centredness; naturopathic assessment; naturopathic diagnosis and hypothesis generation; naturopathic management; practice evaluation; and balancing scientific and traditional knowledge. Influences on NMCR were reported across practitioner-related, patient-related, contextual and system-level, and educational and epistemological domains. Strategies supporting the development of NMCR were described across multiple pathways, including clinical reasoning frameworks and conceptual models, educational and assessment-aligned approaches, cognitive and reflective strategies, and collaborative patient-centred practices. Conclusion Naturopathic medicine clinical reasoning is contextually grounded and professionally situated, shaped by the interaction of philosophical principles, practitioner judgement, patient engagement, and educational and system conditions. The predominance of practice-focused and non-empirical literature highlights the need for greater conceptual coherence and empirical investigation. This synthesis provides a foundation for further qualitative inquiry and the development of an integrated, empirically informed framework to support clinical reasoning within naturopathic education, practice, and integrative healthcare contexts.