Doctor-patient consultations require multi-turn, context-aware communication tailored to diverse patient personas. Training or evaluating doctor LLMs in such settings requires realistic patient interaction systems. However, existing simulators often fail to reflect the full range of personas seen in clinical practice. To address this, we introduce PATIENTSIM, a patient simulator that generates realistic and diverse patient personas for clinical scenarios, grounded in medical expertise. PATIENTSIM operates using: 1) clinical profiles, including symptoms and medical history, derived from real-world data in the MIMIC-ED and MIMIC-IV datasets, and 2) personas defined by four axes: personality, language proficiency, medical history recall level, and cognitive confusion level, resulting in 37 unique combinations. We evaluate eight LLMs for factual accuracy and persona consistency. The top-performing open-source model, Llama 3.3 70B, is validated by four clinicians to confirm the robustness of our framework. As an open-source, customizable platform, PATIENTSIM provides a reproducible and scalable solution that can be customized for specific training needs. Offering a privacy-compliant environment, it serves as a robust testbed for evaluating medical dialogue systems across diverse patient presentations and shows promise as an educational tool for healthcare.

Doctor-patient consultations require multi-turn, context-aware communication tailored to diverse patient personas. Training or evaluating doctor LLMs in such settings requires realistic patient interaction systems. However, existing simulators often fail to reflect the full range of personas seen in clinical practice. To address this, we introduce PatientSim, a patient simulator that generates realistic and diverse patient personas for clinical scenarios, grounded in medical expertise. PatientSim operates using: 1) clinical profiles, including symptoms and medical history, derived from real-world data in the MIMIC-ED and MIMIC-IV datasets, and 2) personas defined by four axes: personality, language proficiency, medical history recall level, and cognitive confusion level, resulting in 37 unique combinations. We evaluate eight LLMs for factual accuracy and persona consistency. The top-performing open-source model, Llama 3.3 70B, is validated by four clinicians to confirm the robustness of our framework. As an open-source, customizable platform, PatientSim provides a reproducible and scalable solution that can be customized for specific training needs. Offering a privacy-compliant environment, it serves as a robust testbed for evaluating medical dialogue systems across diverse patient presentations and shows promise as an educational tool for healthcare. The code is available at https://github.com/dek924/PatientSim.

In reading garden-path sentences, people must resolve competing interpretations, though initial misinterpretations can linger despite reanalysis. This study examines the role of inhibitory control (IC) in managing these misinterpretations among Chinese-English bilinguals. Using self-paced reading tasks, we investigated how IC influences recovery from garden-path sentences in Chinese (L1) and its interaction with language proficiency during English (L2) processing. Results indicate that IC does not affect garden-path recovery in Chinese, suggesting reliance on semantic context may reduce the need for IC. In contrast, findings for English L2 learners reveal a complex relationship between language proficiency and IC: Participants with low L2 proficiency but high IC showed lingering misinterpretations, while those with high proficiency exhibited none. These results support and extend the Model of Cognitive Control (Ness et al., 2023). Moreover, our comparison of three Stroop task versions identifies L1 colour-word Stroop task as the preferred measure of IC in bilingual research.

Spoken language assessment (SLA) systems restrict themselves to evaluating the pronunciation and oral fluency of a speaker by analysing the read and spontaneous spoken utterances respectively. The assessment of language grammar or vocabulary is relegated to written language assessment (WLA) systems. Most WLA systems present a set of sentences from a curated finite-size database of sentences thereby making it possible to anticipate the test questions and train oneself. In this paper, we propose a novel end-to-end SLA system to assess language grammar from spoken utterances thus making WLA systems redundant; additionally, we make the assessment largely unteachable by employing a large language model (LLM) to bring in variations in the test. We further demonstrate that a hybrid automatic speech recognition (ASR) with a custom-built language model outperforms the state-of-the-art ASR engine for spoken grammar assessment.

Large Language Models have demonstrated impressive reasoning capabilities across multiple languages. However, the relationship between capabilities in different languages is less explored. In this work, we decompose the process of reasoning tasks into two separated parts: knowledge retrieval and knowledge-free reasoning, and analyze the cross-lingual transferability of them. With adapted and constructed knowledge-free reasoning datasets, we show that the knowledge-free reasoning capability can be nearly perfectly transferred across various source-target language directions despite the secondary impact of resource in some specific target languages, while cross-lingual knowledge retrieval significantly hinders the transfer. Moreover, by analyzing the hidden states and feed-forward network neuron activation during the reasoning tasks, we show that higher similarity of hidden representations and larger overlap of activated neurons could explain the better cross-lingual transferability of knowledge-free reasoning than knowledge retrieval. Thus, we hypothesize that knowledge-free reasoning embeds in some language-shared mechanism, while knowledge is stored separately in different languages.

This study explores F0 entrainment in second language (L2) English speech imitation during an Alternating Reading Task (ART). Participants with Italian, French, and Slovak native languages imitated English utterances, and their F0 entrainment was quantified using the Dynamic Time Warping (DTW) distance between the parameterized F0 contours of the imitated utterances and those of the model utterances. Results indicate a nuanced relationship between L2 English proficiency and entrainment: speakers with higher proficiency generally exhibit less entrainment in pitch variation and declination. However, within dyads, the more proficient speakers demonstrate a greater ability to mimic pitch range, leading to increased entrainment. This suggests that proficiency influences entrainment differently at individual and dyadic levels, highlighting the complex interplay between language skill and prosodic adaptation.

Language tests measure a person's ability to use a language in terms of listening, speaking, reading, or writing. Such tests play an integral role in academic, professional, and immigration domains, with entities such as educational institutions, professional accreditation bodies, and governments using them to assess candidate language proficiency. Recent advances in Artificial Intelligence (AI) and the discipline of Natural Language Processing have prompted language test providers to explore AI's potential applicability within language testing, leading to transformative activity patterns surrounding language instruction and learning. However, with concerns over AI's trustworthiness, it is imperative to understand the implications of integrating AI into language testing. This knowledge will enable stakeholders to make well-informed decisions, thus safeguarding community well-being and testing integrity. To understand the concerns and effects of AI usage in language tests, we conducted interviews and surveys with English test-takers. To the best of our knowledge, this is the first empirical study aimed at identifying the implications of AI adoption in language tests from a test-taker perspective. Our study reveals test-taker perceptions and behavioral patterns. Specifically, we identify that AI integration may enhance perceptions of fairness, consistency, and availability. Conversely, it might incite mistrust regarding reliability and interactivity aspects, subsequently influencing the behaviors and well-being of test-takers. These insights provide a better understanding of potential societal implications and assist stakeholders in making informed decisions concerning AI usage in language testing.

Researchers have traditionally recruited native speakers to provide annotations for widely used benchmark datasets. However, there are languages for which recruiting native speakers can be difficult, and it would help to find learners of those languages to annotate the data. In this paper, we investigate whether language learners can contribute annotations to benchmark datasets. In a carefully controlled annotation experiment, we recruit 36 language learners, provide two types of additional resources (dictionaries and machine-translated sentences), and perform mini-tests to measure their language proficiency. We target three languages, English, Korean, and Indonesian, and the four NLP tasks of sentiment analysis, natural language inference, named entity recognition, and machine reading comprehension. We find that language learners, especially those with intermediate or advanced levels of language proficiency, are able to provide fairly accurate labels with the help of additional resources. Moreover, we show that data annotation improves learners' language proficiency in terms of vocabulary and grammar. One implication of our findings is that broadening the annotation task to include language learners can open up the opportunity to build benchmark datasets for languages for which it is difficult to recruit native speakers.

This paper reports on progress towards building an online language learning tool to provide learners with conversational experience by using dialog systems as conversation practice partners. Our system can adapt to users' language proficiency on the fly. We also provide automatic grammar error feedback to help users learn from their mistakes. According to our first adopters, our system is entertaining and useful. Furthermore, we will provide the learning technology community a large-scale conversation dataset on language learning and grammar correction. Our next step is to make our system more adaptive to user profile information by using reinforcement learning algorithms.

Conversational practice, while crucial for all language learners, can be challenging to get enough of and very expensive. Chatbots are computer programs developed to engage in conversations with humans. They are designed as software avatars with limited, but growing conversational capability. The most natural and potentially powerful application of chatbots is in line with their fundamental nature - language practice. However, their role and outcomes within (in)formal language learning are currently tangential at best. Existing research in the area has generally focused on chatbots' comprehensibility and the motivation they inspire in their users. In this paper, we provide an overview of the chatbots for learning languages, critically analyze existing approaches, and discuss the major challenges for future work.