Training medical personnel using standardized patients (SPs) remains a complex challenge, requiring extensive domain expertise and role-specific practice. Most research on Large Language Model (LLM)-based simulated patients focuses on improving data retrieval accuracy or adjusting prompts through human feedback. However, this focus has overlooked the critical need for patient agents to learn a standardized presentation pattern that transforms data into human-like patient responses through unsupervised simulations. To address this gap, we propose EvoPatient, a novel simulated patient framework in which a patient agent and doctor agents simulate the diagnostic process through multi-turn dialogues, simultaneously gathering experience to improve the quality of both questions and answers, ultimately enabling human doctor training. Extensive experiments on various cases demonstrate that, by providing only overall SP requirements, our framework improves over existing reasoning methods by more than 10% in requirement alignment and better human preference, while achieving an optimal balance of resource consumption after evolving over 200 cases for 10 hours, with excellent generalizability. Our system will be available at https://github.com/ZJUMAI/EvoPatient

In this work, we investigate an important task named instruction-following text embedding, which generates dynamic text embeddings that adapt to user instructions, highlighting specific attributes of text. Despite recent advancements, existing approaches suffer from significant computational overhead, as they require re-encoding the entire corpus for each new instruction. To address this challenge, we propose GSTransform, a novel instruction-following text embedding framework based on Guided Space Transformation. Our key observation is that instruction-relevant information is inherently encoded in generic embeddings but remains underutilized. Instead of repeatedly encoding the corpus for each instruction, GSTransform is a lightweight transformation mechanism that adapts pre-computed embeddings in real time to align with user instructions, guided by a small amount of text data with instruction-focused label annotation. We conduct extensive experiments on three instruction-awareness downstream tasks across nine real-world datasets, demonstrating that GSTransform improves instruction-following text embedding quality over state-of-the-art methods while achieving dramatic speedups of 6~300× in real-time processing on large-scale datasets. The source code is available at https://github.com/YingchaojieFeng/GSTransform.