@inproceedings{runyon-etal-2026-evaluating,
    title = "Evaluating {LLM} Workflows for Generating Clinical Communication Assessment Items: A Comparative Study with Subject-Matter Experts",
    author = "Runyon, Christopher  and
      Baldwin, Peter  and
      Micir, Ian  and
      Frome, Kevin  and
      Mann, Stephanie  and
      Rezayi, Saed  and
      Evanini, Keelan  and
      Yaneva, Victoria",
    editor = "Kochmar, Ekaterina  and
      Alhafni, Bashar  and
      Bann{\`o}, Stefano  and
      Bexte, Marie  and
      Burstein, Jill  and
      Horbach, Andrea  and
      Laarmann-Quante, Ronja  and
      Tack, Anais  and
      Yaneva, Victoria  and
      Yuan, Zheng",
    booktitle = "Proceedings of the 21st Workshop on Innovative Use of {NLP} for Building Educational Applications ({BEA} 2026)",
    month = jul,
    year = "2026",
    address = "San Diego, California, USA",
    publisher = "Association for Computational Linguistics",
    url = "https://preview.aclanthology.org/ingest-acl-workshops/2026.bea-1.12/",
    pages = "153--173",
    ISBN = "979-8-89176-409-5",
    abstract = "Generative AI is increasingly used to accelerate assessment content development, yet its effectiveness for generating content used in complex assessment tasks for knowledge-rich domains such as medical education is unclear. This study evaluates automated LLM-supported workflows for generating patient-centered communication assessment items that allow students to practice their communication skills. We compared two content generation approaches{---}constrained linear and exploratory branching{---}each implemented with and without anchoring in vetted multiple-choice questions (MCQs). Ten subject-matter experts (SMEs) evaluated 80 communication items across six quality dimensions using structured rubrics. The constrained linear approach yielded better ratings than exploratory branching approaches, particularly for medical accuracy and alignment with learning objectives and patient-centered behaviors. MCQ anchoring did not improve medical accuracy. Only a minority of items met all criteria without requiring revision, and no items were unanimously approved by all SMEs. These findings underscore the importance of workflow design in LLM-supported assessment content generation, the continued need for human oversight, and the current limitations of automated content generation in medical education."
}