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[Submitted on 22 Jul 2026] Title:From Discharge Notes to Patient Understanding: Persona-Grounded, Open-Ended Simulation of LLMs as Discharge Educators View a PDF of the paper titled From Discharge Notes to Patient Understanding: Persona-Grounded, Open-Ended Simulation of LLMs as Discharge Educators, by Won Seok Jang and 2 other authors View PDF HTML (experimental) Abstract:Hospital discharge education is an interactive teaching task: a clinician adapts a discharge plan to a patient's literacy, recall, and personality. Existing LLM evaluations target static or artifact-generation tasks and do not measure patient understanding under open-ended dialogue. We introduce DischargeBench, a persona-grounded simulation in which a candidate LLM educator conducts a multi-turn session with a Virtual Patient, while an Education Monitor Agent regulates patient realism without modifying the educator, protecting the evaluation signal. We curate MIMIC-IV-Ext-DischargeBench, 477 cases over 24 ICD chapters with persona axes (personality, education level, health literacy, past-medical-history recall) for stratified analysis. Each simulation is scored on four axes -- Conversation Quality, Topic Checklist, Comprehension, and Factual Consistency -- by an LLM-as-a-Judge aligned against physician annotations. Across closed- and open-source LLMs, aggregate scores conceal clinically relevant variation across ICD chapters and patient personas; difficult personas expose coverage failures, comprehension gaps, and reduced source-answer agreement. LLM evaluation for discharge education should center patient understanding, not text quality or answer accuracy alone. Subjects: Computation and Language (cs.CL) Cite as: arXiv:2609.20827 [cs.CL] (or arXiv:2609.20827v1 [cs.CL] for this version) https://doi.org/10.48550/arXiv.2609.20827 arXiv-issued DOI via DataCite Submission history From: Won Seok Jang [view email] [v1] Wed, 22 Jul 2026 13:24:24 UTC (5,705 KB) Full-text links: Access Paper: View a PDF of the paper titled From Discharge Notes to Patient Understanding: Persona-Grounded, Open-Ended Simulation of LLMs as Discharge Educators, by Won Seok Jang and 2 other authors View PDF HTML (experimental) TeX Source view license Current browse context: cs.CL new | recent | 2026-09 Change to browse by: cs References & Citations NASA ADS Google Scholar Semantic Scholar Loading... Data provided by: Bibliographic Tools Bibliographic and Citation Tools Bibliographic Explorer Toggle Bibliographic Explorer (What is the Explorer?) Connected Papers Toggle Connected Papers (What is Connected Papers?) Litmaps Toggle Litmaps (What is Litmaps?) scite.ai Toggle scite Smart Citations (What are Smart Citations?) Code, Data, Media Code, Data and Media Associated with this Article alphaXiv Toggle alphaXiv (What is alphaXiv?) Links to Code Toggle CatalyzeX Code Finder for Papers (What is CatalyzeX?) DagsHub Toggle DagsHub (What is DagsHub?) GotitPub Toggle Gotit.pub (What is GotitPub?) Huggingface Toggle Hugging Face (What is Huggingface?) ScienceCast Toggle ScienceCast (What is ScienceCast?) Demos Demos Replicate Toggle Replicate (What is Replicate?) Spaces Toggle Hugging Face Spaces (What is Spaces?) Spaces Toggle TXYZ.AI (What is TXYZ.AI?) Related Papers Recommenders and Search Tools Link to Influence Flower Influence Flower (What are Influence Flowers?) Core recommender toggle CORE Recommender (What is CORE?) Author Venue Institution Topic About arXivLabs arXivLabs: experimental projects with community collaborators arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website. Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them. Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs. Which authors of this paper are endorsers? | Disable MathJax (What is MathJax?)