Medical history taking is a dialogue-based clinical reasoning task in which learners must gather, organise, and integrate patient information while the consultation unfolds. Generative AI-powered virtual patients (GenAI VPs) make repeated history taking practice scalable and preserve full turn by turn dialogue. However, these logs are educationally difficult to use directly. Complete transcripts are too detailed for routine teacher review, whereas final scores obscure whether learners followed up patient cues, checked uncertainty, or used summaries to guide later questioning. This study examined whether coded GenAI VP dialogues can provide teacher-interpretable process evidence of clinical reasoning. We analysed 1{,}030 GenAI VP dialogues from 210 second-year medical learners across five weeks chest-pain cases. Each consultation was teacher-scored using a rubric assessing the full history taking dialogue, and consultations were classified within each week as high- or low-rated using the weekly median score. To explain how rated performance was reflected in the dialogue process, we applied three analytic layers to the same coded dialogue data: behavioural prevalence, local co-occurrence using Epistemic Network Analysis, and sequential transition using Transition Network Analysis. High-rated consultations involved more history taking activity, but differences were not simply about volume. High rated consultations more often connected information gathering and symptom exploration with communication, checking, organisation, and synthesis. Summarising and organising moves more often led to verification or mechanism-oriented follow-up. These findings show how layered analysis of GenAI VP dialogue logs can reveal process patterns associated with high rated history taking and support process-focused feedback in medical education.
A central goal of biomedicine is to understand, predict and ultimately control the dynamic mechanisms by which biological systems respond to perturbations, disease progression and therapeutic intervention. Although foundation models and large language models have accelerated biomedical data interpretation, most current systems remain focused on static pattern recognition rather than prospective simulation of biological futures. Here we propose biomedical world models as a paradigm for AI-driven discovery. These models learn latent representations of molecular, cellular, tissue and clinical states, together with intervention-conditioned dynamics that allow future trajectories to be simulated before actions are taken. We discuss how biomedical world models could function as data engines, environment simulators and scientific planning substrates across applications including virtual cells, organoids, virtual patients and surgical simulation. We outline the data infrastructure, evaluation benchmarks, safety constraints and governance frameworks required. Biomedical world models may provide a foundation for simulation-guided, closed-loop and experimentally actionable biomedical discovery.