Quality Action Assurance: Multimodal Verification of Examiner Claims in VR OSCEs

The clinical and communication skills of medical students are commonly assessed through Objective Structured Clinical Examinations (OSCEs), which consist of brief scenario-driven simulations of doctor-patient interactions. However, training is often limited by the low availability of human standardized patients, motivating the development of realistic virtual patients (VPs). To address this gap, we introduce a French OSCE dialogue dataset comprising 240 student-patient training interactions. We build upon it a controllable LLM-based pipeline to generate synthetic OSCE dialogues. The pipeline integrates modular components, such as retrieval-based grounding and a reflection loop, to ensure patient fidelity, coherence, and realism. Additionally, we propose a multi-level evaluation framework assessing patient simulation quality, student performance, and linguistic quality, using an LLM-as-a-Judge approach. Experiments suggest that controllability modules generally improve patient fidelity and student evaluation consistency. Finally, we implement an interactive prototype in which students can practice with a VP and receive automatic feedback.

Automated action quality assessment (AQA) in Olympic sports remains a challenging task due to the complexity of human motion and the subjectivity inherent in expert judging. This work evaluates the capability of open-source Vision-Language Models (VLMs) to perform zero-shot action quality assessment on Olympic diving videos using the AQA-7 benchmark dataset. In this regard, a regression-based framework is pro-posed to leverage both the semantic reasoning and phase-level sub-scores generated by the VLMs, combining TF-IDF vectorization, dimensionality reduction, and ensemble learning to predict final competition scores. Experimental results show that standalone VLMs achieve moderate Spearman correlations below 0.32, while the proposed ensemble regression framework substantially improves performance in the reported evaluation, reaching a Spearman correlation of 0.67 with a four-model configuration. Textual reasoning features con-sistently outperformed raw numerical sub-scores, highlighting the richness of VLM-generated explanations for action quality analysis. These findings suggest that VLMs hold strong potential as assistive tools for explainable and semi-automated sports performance evaluation. The code is publicly available on GitHub https://github.com/hvelesaca/olympic diving judge vlm

Multimodal large language models (MLLMs) are increasingly explored as interfaces for scientific image analysis, where a visual question-answering (VQA) response may be paired with a spatial output that guides a downstream stage. A supervisor reads the language answer, while a downstream workflow such as segmentation or region review consumes the point-set output. We call this transition from inspecting the answer to relying on its point action the language-to-action hand-off. A silent failure occurs when the answer is correct while the paired action misses annotated objects needed downstream, so answer-based oversight clears a region whose action is unreliable. We introduce Spatial Action Review, a visual analytics dashboard for auditing this failure mode in electron microscopy (EM) mitochondria analysis. It links paired answer-action records through an answer-action ledger, a task-by-dataset risk map, and an image-region audit view, connecting aggregate patterns to image evidence while an adjustable action-reliability gate supports re-audit. The review ends in a human-AI hand-off, where a supervisor records whether the action is accepted, escalated, held under a stricter gate, or flagged for model revision. Across 541 image regions from an EM-adapted Qwen3-VL case-study run, point actions fail the gate in 54.4% of records with a correct VQA response, and 27.4% of all records are silent failures. A correct answer is associated with only a 5.8-percentage-point higher probability of a reliable action, with a bootstrap interval spanning zero; the point-biserial correlation between answer correctness and object coverage is 0.061. This weak coupling persists across five model conditions on 753 matched image regions. Spatial Action Review makes answer-action mismatches visible and ties them to image evidence and a recorded decision before MLLM outputs enter autonomous scientific workflows.