Naping Chen | Searcharxiv

arXiv2026

From GenAI Virtual Patient Dialogue Logs to Teacher-Interpretable Process Evidence: A Learning Analytics Study in Higher Education

Medical history taking is a dialogue-based clinical reasoning task in which learners must gather, organise, and integrate patient information while the consultation unfolds. Generative AI-powered virtual patients (GenAI VPs) make repeated history taking practice scalable and preserve full turn by turn dialogue. However, these logs are educationally difficult to use directly. Complete transcripts are too detailed for routine teacher review, whereas final scores obscure whether learners followed up patient cues, checked uncertainty, or used summaries to guide later questioning. This study examined whether coded GenAI VP dialogues can provide teacher-interpretable process evidence of clinical reasoning. We analysed 1{,}030 GenAI VP dialogues from 210 second-year medical learners across five weeks chest-pain cases. Each consultation was teacher-scored using a rubric assessing the full history taking dialogue, and consultations were classified within each week as high- or low-rated using the weekly median score. To explain how rated performance was reflected in the dialogue process, we applied three analytic layers to the same coded dialogue data: behavioural prevalence, local co-occurrence using Epistemic Network Analysis, and sequential transition using Transition Network Analysis. High-rated consultations involved more history taking activity, but differences were not simply about volume. High rated consultations more often connected information gathering and symptom exploration with communication, checking, organisation, and synthesis. Summarising and organising moves more often led to verification or mechanism-oriented follow-up. These findings show how layered analysis of GenAI VP dialogue logs can reveal process patterns associated with high rated history taking and support process-focused feedback in medical education.

cs.CL↗

arXiv2025

When LLMs fall short in Deductive Coding: Model Comparison and Human AI Collaboration Workflow Design

With generative artificial intelligence driving the growth of dialogic data in education, automated coding is a promising direction for learning analytics to improve efficiency. This surge highlights the need to understand the nuances of student-AI interactions, especially those rare yet crucial. However, automated coding may struggle to capture these rare codes due to imbalanced data, while human coding remains time-consuming and labour-intensive. The current study examined the potential of large language models (LLMs) to approximate or replace humans in deductive, theory-driven coding, while also exploring how human-AI collaboration might support such coding tasks at scale. We compared the coding performance of small transformer classifiers (e.g., BERT) and LLMs in two datasets, with particular attention to imbalanced head-tail distributions in dialogue codes. Our results showed that LLMs did not outperform BERT-based models and exhibited systematic errors and biases in deductive coding tasks. We designed and evaluated a human-AI collaborative workflow that improved coding efficiency while maintaining coding reliability. Our findings reveal both the limitations of LLMs -- especially their difficulties with semantic similarity and theoretical interpretations and the indispensable role of human judgment -- while demonstrating the practical promise of human-AI collaborative workflows for coding.

cs.HC↗