REMEDY: How Far Is Video Generation from Medical Education World Models?

Video generation models are increasingly used as world simulators for storytelling, simulation, and embodied AI. As these models advance, a key question arises: do generated videos obey the physical laws of the real world? Existing evaluations largely rely on automated metrics or coarse human judgments such as preferences or rubric-based checks. While useful for assessing perceptual quality, these methods provide limited insight into when and why generated dynamics violate real-world physical constraints. We introduce Physion-Eval, a large-scale benchmark of expert human reasoning for diagnosing physical realism failures in videos generated by five state-of-the-art models across egocentric and exocentric views, containing 10,990 expert reasoning traces spanning 22 fine-grained physical categories. Each generated video is derived from a corresponding real-world reference video depicting a clear physical process, and annotated with temporally localized glitches, structured failure categories, and natural-language explanations of the violated physical behavior. Using this dataset, we reveal a striking limitation of current video generation models: in physics-critical scenarios, 83.3% of exocentric and 93.5% of egocentric generated videos exhibit at least one human-identifiable physical glitch. We hope Physion-Eval will set a new standard for physical realism evaluation and guide the development of physics-grounded video generation. The benchmark is publicly available at https://huggingface.co/datasets/PhysionLabs/Physion-Eval.

Surgical video data provides the primary training resource for models of intraoperative perception, surgical workflow understanding, and robotic decision-making. However, clinical data acquisition remains constrained by privacy, cost, and class imbalance. Surgical video generation has emerged as a transformative approach to addressing data scarcity and as a foundation for surgical simulation, training, and robotic policy learning. The field has developed rapidly without a clear conceptual framework. This survey organizes the 2024-2026 literature into three categories: unconditional generation, conditional generation, and world modeling generation, revealing a fundamental shift in how the task is defined from synthesizing visually plausible frames to modeling the causal dynamics of surgical scenes. We examine the persistent gap between pixel-level fidelity and clinical plausibility, and identify generalization, physical realism, controllability, and interpretability as bottlenecks. We further summarize experimental results of representative methods on public datasets to provide a quantitative reference for the field. This survey provides a structured overview of the current state and open challenges, offering a reference for researchers working at the intersection of intelligent perception, multi-modal fusion, generative AI, and surgical data science.

Controllable video generation models are increasingly being developed as world models. Accordingly, evaluating them in this role extends beyond the apparent appearance of generated videos to the inherent reactivity of the worlds they depict: the ability to infer from the scene state how the world should react and to generate plausible consequences not explicitly described in the input. Yet existing benchmarks mainly assess visual quality or explicit instruction fulfillment by checking whether requested actions and interaction outcomes are realized, leaving inherent reactivity underexamined. We introduce WorldExam, a hierarchical diagnostic benchmark spanning four levels: Visual Quality, Control Adherence, Spatial Consistency, and World Reactivity. It comprises 1,474 cases across eight dedicated tasks and supports unified evaluation of camera-, action-, and language-driven model paradigms. The World Reactivity level evaluates scene-conditioned reactions and goal-directed behaviors beyond what is explicitly specified in the input. Evaluation of 20 representative models reveals a clear capability split. Camera-driven models excel at camera control, but their interfaces do not support dynamic interaction; action-driven models control subjects more precisely but often leave the world unresponsive; and language-driven models perform better on interaction but follow complex controls less faithfully. No model combines broad task coverage with consistently strong performance, showing that high visual quality and explicit instruction fulfillment do not guarantee inherent reactivity.