Discharge communication is a critical yet underexplored component of patient care, where the goal shifts from diagnosis to education. While recent large language model (LLM) benchmarks emphasize in-visit diagnostic reasoning, they fail to evaluate models’ ability to support patients after the visit. We introduce DischargeSim, a novel benchmark that evaluates LLMs on their ability to act as personalized discharge educators. DischargeSim simulates post-visit, multi-turn conversations between LLM-driven DoctorAgents and PatientAgents with diverse psychosocial profiles (e.g., health literacy, education, emotion). Interactions are structured across six clinically grounded discharge topics and assessed along three axes: (1) dialogue quality via automatic and LLM-as-judge evaluation, (2) personalized document generation including free-text summaries and structured AHRQ checklists, and (3) patient comprehension through a downstream multiple-choice exam. Experiments across 18 LLMs reveal significant gaps in discharge education capability, with performance varying widely across patient profiles. Notably, model size does not always yield better education outcomes, highlighting trade-offs in strategy use and content prioritization. DischargeSim offers a first step toward benchmarking LLMs in post-visit clinical education and promoting equitable, personalized patient support.

Supervised fine-tuning (SFT) on benign data can paradoxically erode a language model’s safety alignment, a phenomenon known as catastrophic forgetting of safety behaviors. Although prior work shows that randomly adding safety examples can reduce harmful output, the principles that make certain examples more effective than others remain poorly understood. This paper investigates the hypothesis that the effectiveness of a safety example is governed by two key factors: its instruction-response behavior (e.g., refusal vs. explanation) and its semantic diversity across harm categories. We systematically evaluate sampling strategies based on these axes and find that structured, diversity-aware sampling significantly improves model safety. Our method reduces harmfulness by up to 41% while adding only 0.05% more data to the fine-tuning set.

Task-oriented dialogue research has mainly focused on a few popular languages like English and Chinese, due to the high dataset creation cost for a new language. To reduce the cost, we apply manual editing to automatically translated data. We create a new multilingual benchmark, X-RiSAWOZ, by translating the Chinese RiSAWOZ to 4 languages: English, French, Hindi, Korean; and a code-mixed English-Hindi language.X-RiSAWOZ has more than 18,000 human-verified dialogue utterances for each language, and unlike most multilingual prior work, is an end-to-end dataset for building fully-functioning agents. The many difficulties we encountered in creating X-RiSAWOZ led us to develop a toolset to accelerate the post-editing of a new language dataset after translation. This toolset improves machine translation with a hybrid entity alignment technique that combines neural with dictionary-based methods, along with many automated and semi-automated validation checks. We establish strong baselines for X-RiSAWOZ by training dialogue agents in the zero- and few-shot settings where limited gold data is available in the target language. Our results suggest that our translation and post-editing methodology and toolset can be used to create new high-quality multilingual dialogue agents cost-effectively. Our dataset, code, and toolkit are released open-source.