Saved in:
Bibliographic Details
Main Authors: Zhang, Weikang, Zhu, Zimo, Yang, Zhichuan, Huang, Chen, Lei, Wenqiang, Ng, See-Kiong
Format: Preprint
Published: 2026
Subjects:
Online Access:https://arxiv.org/abs/2604.12210
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1866915940195631104
author Zhang, Weikang
Zhu, Zimo
Yang, Zhichuan
Huang, Chen
Lei, Wenqiang
Ng, See-Kiong
author_facet Zhang, Weikang
Zhu, Zimo
Yang, Zhichuan
Huang, Chen
Lei, Wenqiang
Ng, See-Kiong
contents Simulating Standardized Patients with cognitive impairment offers a scalable and ethical solution for clinical training. However, existing methods rely on discrete prompt engineering and fail to capture the heterogeneity of deficits across varying domains and severity levels. To address this limitation, we propose StsPatient for the fine-grained simulation of cognitively impaired patients. We innovatively capture domain-specific features by extracting steering vectors from contrastive pairs of instructions and responses. Furthermore, we introduce a Stochastic Token Modulation (STM) mechanism to regulate the intervention probability. STM enables precise control over impairment severity while mitigating the instability of conventional vector methods. Comprehensive experiments demonstrate that StsPatient significantly outperforms baselines in both clinical authenticity and severity controllability.
format Preprint
id arxiv_https___arxiv_org_abs_2604_12210
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Beyond Prompt: Fine-grained Simulation of Cognitively Impaired Standardized Patients via Stochastic Steering
Zhang, Weikang
Zhu, Zimo
Yang, Zhichuan
Huang, Chen
Lei, Wenqiang
Ng, See-Kiong
Artificial Intelligence
Computation and Language
Simulating Standardized Patients with cognitive impairment offers a scalable and ethical solution for clinical training. However, existing methods rely on discrete prompt engineering and fail to capture the heterogeneity of deficits across varying domains and severity levels. To address this limitation, we propose StsPatient for the fine-grained simulation of cognitively impaired patients. We innovatively capture domain-specific features by extracting steering vectors from contrastive pairs of instructions and responses. Furthermore, we introduce a Stochastic Token Modulation (STM) mechanism to regulate the intervention probability. STM enables precise control over impairment severity while mitigating the instability of conventional vector methods. Comprehensive experiments demonstrate that StsPatient significantly outperforms baselines in both clinical authenticity and severity controllability.
title Beyond Prompt: Fine-grained Simulation of Cognitively Impaired Standardized Patients via Stochastic Steering
topic Artificial Intelligence
Computation and Language
url https://arxiv.org/abs/2604.12210