SIC-Agents: Benchmarking and Building an Adaptive Simulator for Pediatric Serious Illness Communication Training

Pediatric serious illness communication (SIC) is critically important, yet scalable communication training for clinicians remains limited. Compared with other dialogue simulation settings, pediatric SIC poses additional challenges, including multi-party interactions, response to parental distress and strong dependence on feedback dynamics. Existing LLM-based simulators optimize generic dialogue quality rather than curriculum-contingent behavior required for effective SIC training. In collaboration with educators and pediatric clinicians, we introduce the first benchmark suite and simulation framework tailored to pediatric SIC training. Our benchmarks, PitfallBench and DialogueBench, evaluate simulators both at the turn-level and across full dialogues. We further propose SIC-Agents, a self-improving framework that generates a clinician-editable skill document to guide simulator behavior. Our experiments show that SIC-Agents outperforms static expert prompting. To support future research, we release our benchmarks for parent simulation in pediatric SIC at https://github.com/Beikewzh/sic-benchmarks

Enhanced Real-Time 6-DOF Extended Reality Catheter Tracking for Evaluating Potential Improvement in Efficiency, Precision, and Depth Perception for Cardiac Interventions

Despite advances in 3D ultrasound, most percutaneous cardiac interventions still rely on 2D visualization, limiting depth perception and spatial understanding. To address this challenge, we developed an Extended Reality (XR)-based platform that enables real-time six-degree-of-freedom (6-DOF) catheter tracking and visualization within a patient-specific 3D heart model. The system combines a custom machine-vision algorithm for 5-DOF catheter tracking with a 3D-printed electromechanical encoder that measures catheter roll, providing complete 6-DOF motion reconstruction. In a proof-of-concept study, 20 novice medical students navigated an intracardiac echocardiography (ICE) catheter to six anatomical targets using either immersive 3D visualization or a conventional 2D cathlab-style view. Participants in the 3D condition completed the task in 54.6 seconds and traveled 1,939 mm on average, compared with 267.5 seconds and 7,854 mm in the 2D condition. Therefore, the XR-based 3D system was more than 5x faster and required ~5x less catheter travel. The 3D mode also improved targeting precision and reduced performance variability. Participants consistently rated immersive visualization higher for accuracy, speed, usability, and clinical value. Kinematic analysis showed smoother depth-axis navigation in 3D, whereas 2D users relied on repeated corrective movements. These findings demonstrate that XR-based visualization can substantially improve procedural training efficiency, precision, and motor control.

LoRA-Based Cascaded Multimodal Fusion for Action Recognition in Medical Training Environments

This paper presents a cascaded Low-Rank Adaptation (LoRA)-based multimodal fusion framework for action and activity recognition in healthcare-oriented training environments. The proposed architecture combines parameter-efficient modality-specific adaptation with sequential fusion, enabling modalities to be integrated in stages without retraining previously learned components. Rather than assuming a fixed fusion structure, the framework first integrates more closely related modalities and then incorporates additional heterogeneous modalities, supporting scalable adaptation across datasets with different modality sets.We evaluate the framework on two healthcare-oriented training environment datasets: NurViD and the Nurse Training dataset. Across these datasets, preliminary results suggest that the proposed cascaded fusion strategy improves over individual modality models and provides competitive performance relative to previously reported dataset-specific baselines. Overall, these findings indicate that cascaded LoRA-based fusion is a promising parameter-efficient approach for integrating heterogeneous modalities in medical training action and activity recognition tasks. github: https://github.com/anonymous0-ai/LoRA-Based-Cascaded-Multimodal-Fusion-.git.