TAMA: A Human-AI Collaborative Thematic Analysis Framework Using Multi-Agent LLMs for Clinical Interviews

Large Language Models (LLMs) offer new possibilities for scaling qualitative analysis, but existing applications often provide limited methodological transparency regarding how qualitative methods are translated into computational procedures. This paper presents an auditable and privacy-preserving computational operationalization of inductive and latent Thematic Analysis (TA). This paper first derives five design principles from the methodological requirements of TA and the conditions introduced by LLM-based inference: preserving interpretative context, maintaining traceable relationships between empirical material and analytical outputs, representing analytical constructs and reasoning explicitly, constraining LLM inference to interpretative tasks, and enabling privacy-preserving local deployment. Second, it presents a proof-of-concept for a two-phase workflow that operationalizes these principles by combining interpretative LLM inference with deterministic procedural control to generate codes, analytical justifications, themes, and theme descriptions while preserving explicit links to the source material. Third, it proposes an evaluation framework combining structural comparison with human-led TA and independent expert assessment of analytical quality. The evaluation is conducted on semi-structured Danish interview transcripts. and the results shows that the workflow produces code-level outputs with coverage broadly comparable to human annotations and highly rated analytical justifications, while generating a more compressed thematic structure characterized by fewer and broader themes. The findings demonstrate the feasibility of auditable LLM-supported TA through a modular workflow designed to scale to larger datasets, accommodate different LLMs, and support transfer across research domains, with domain adaptation primarily requiring adjustments to the prompting strategy.

Clinical education must prepare medical students to conduct safe and coherent patient interviews under conditions of uncertainty. Traditional standardized patient (SP) training is resource-intensive and difficult to scale. We developed a scaffolding-oriented multi-agent Large Language Model (LLM) AI Standardized Patient (AI-SP) training platform1. The system includes a patient agent for simulated dialog, a tutor agent providing Socratic prompts without disclosing diagnostic information, and a turn-level evaluator agent that monitors clinical progress without revealing summative scores. In a randomized controlled study (N = 100 medical students), participants were assigned to either a multi-agent (MA) scaffolding condition or a control condition. All students completed two learning sessions under their assigned condition followed by an examination conducted in a patient only environment. Performance was assessed using a standardized Objective Structured Clinical Examination (OSCE) based rubric. While no significant difference was observed in final diagnostic accuracy between groups, the multi-agent AI standardized patient system improved final examination scores compared to the control group utilizing structured progressive information disclosure; the most substantial and consistent improvements were observed in communication, the expression of empathy, and specific history-taking behaviors. These findings suggest that specialized LLM agents enhance the process quality of simulated clinical interviews without artificially inflating examination outcomes. To support future research, we release a multi-expert annotated dataset comprising transcripts, checklist annotations, turn-level evaluations, and OSCE-aligned scoring outcomes. This resource aims to facilitate the development of pedagogically grounded AI-SP systems and advance research on AI-supported clinical reasoning training.

Large language models (LLMs) are increasingly used for qualitative data analysis (QDA), yet their outputs often miss the depth and nuance of human analysis. We argue this gap reflects a missing credibility practice from human QDA: peer debriefing, in which an analyst seeks feedback from a disinterested peer and uses it to refine their coding. To bring this practice into LLM-assisted QDA, we propose Agent-as-Peer-Debriefer, a multi-agent QDA framework that builds peer debriefing into key coding steps. In our framework, a Hierarchical Coding Agent follows the standard QDA process to generate codes, sub-themes, and themes, along with self-explanations and reflection memos. It then shares these outputs with three Peer-Debriefing Agents, each applying a distinct analytical perspective (Theory-Driven, Data-Driven, or Applied) and refining the codes by keeping, renaming, reassigning, merging, or splitting them. These perspectives are drawn from established human QDA practices that generalize across domains and datasets. To evaluate the framework, we test it on three datasets across two domains with three LLMs, measuring semantic similarity to human-annotated codes. Across all settings, perspective-based, peer-debriefing refinement aligns more closely with human codes than a single-LLM baseline, and an ablation further shows the gain is not merely from additional refinement. The three perspectives also produce distinct trade-offs, showing that the choice of perspective is a meaningful and controllable design decision. More broadly, these findings suggest that simulating peer debriefing with explicit perspectives is a promising route to more credible LLM-assisted QDA.