Engineering framework for curiosity-driven and humble AI in clinical decision support.

We present BODHI (Balanced, Open-minded, Diagnostic, Humble, and Inquisitive), an engineering framework for curiosity driven and humble clinical decision support artificial intelligence (AI) systems. Despite growing capabilities, large language models (LLMs) often express inappropriate confidence, conflating statistical pattern recognition with genuine medical understanding. BODHI addresses this through a dual reflective architecture that: (1) decomposes epistemic uncertainty into task specific dimensions, and (2) constrains model responses using virtue based stance rules derived from a Virtue Activation Matrix. We validate the framework through controlled evaluation on 200 clinical vignettes from HealthBench Hard, assessing GPT-4o-mini and GPT-4.1-mini across 5 random seeds (2000 total observations). Statistical analysis included bootstrap resampling, paired t tests, and effect size computation. BODHI improved overall clinical response quality (GPT-4.1-mini: +16.6 pp, p