Effectiveness of Self-Reflective Prompting in Safety-Critical Medical Settings

Determine whether self-reflective (self-corrective) prompting enhances the reliability of large language models for medical question answering in safety-critical clinical settings.

Background

The paper investigates whether prompting LLMs to critique and revise their own reasoning (self-reflection) improves performance and reliability in medical multiple-choice question answering. Prior work suggests chain-of-thought prompting can improve reasoning transparency and sometimes accuracy, but the efficacy of iterative self-correction in high-stakes medical contexts is uncertain.

This uncertainty motivates the study’s comparative analysis of chain-of-thought versus self-reflective prompting across MedQA, HeadQA, and PubMedQA. The authors explicitly note that despite claims about improved reliability, the true effectiveness of self-reflection in safety-critical medical settings is still unclear, framing a central unresolved question addressed empirically in the paper.

References

LLMs have achieved strong performance on medical question answering (medical QA), and chain-of-thought (CoT) prompting has further improved results by eliciting explicit intermediate reasoning; meanwhile, self-reflective (self-corrective) prompting has been widely claimed to enhance model reliability by prompting LLMs to critique and revise their own reasoning, yet its effectiveness in safety-critical medical settings remains unclear.

— Can Large Language Models Self-Correct in Medical Question Answering? An Exploratory Study  (2604.00261 - Zhan et al., 31 Mar 2026) in Abstract

Whether agents benefit from reflection remains unsettled: it can improve agentic performance~\citep{shinn2023reflexion}, but models may overlook their own errors or degrade correct answers~\citep{huang2023selfcorrect,kamoi-etal-2024-LLMs}.

— Ascent: An Agentic System over the Model Context Protocol for Real-World Clinical Data Analysis  (2609.24620 - Ziletti et al., 21 Sep 2026) in Section 2, Related Work, paragraph “Ambiguity and reflection”