Laurah Turner

Tri Nguyen, Lohith Srikanth Pentapalli, Magnus Sieverding et al.

Jailbreaking in Large Language Models (LLMs) threatens their safe use in sensitive domains like education by allowing users to bypass ethical safeguards. This study focuses on detecting jailbreaks in 2-Sigma, a clinical education platform that simulates patient interactions using LLMs. We annotated over 2,300 prompts across 158 conversations using four linguistic variables shown to correlate strongly with jailbreak behavior. The extracted features were used to train several predictive models, including Decision Trees, Fuzzy Logic-based classifiers, Boosting methods, and Logistic Regression. Results show that feature-based predictive models consistently outperformed Prompt Engineering, with the Fuzzy Decision Tree achieving the best overall performance. Our findings demonstrate that linguistic-feature-based models are effective and explainable alternatives for jailbreak detection. We suggest future work explore hybrid frameworks that integrate prompt-based flexibility with rule-based robustness for real-time, spectrum-based jailbreak monitoring in educational LLMs.

Weibing Zheng, Laurah Turner, Jess Kropczynski et al.

As Artificial Intelligence (AI) and Agentic AI become increasingly integrated across sectors such as education and healthcare, it is critical to ensure that Multi-Agent Education System (MAES) is explainable from the early stages of requirements engineering (RE) within the AI software development lifecycle. Explainability is essential to build trust, promote transparency, and enable effective human-AI collaboration. Although personas are well-established in human-computer interaction to represent users and capture their needs and behaviors, their role in RE for explainable MAES remains underexplored. This paper proposes a human-first, persona-driven, explainable MAES RE framework and demonstrates the framework through a MAES for clinical reasoning training. The framework integrates personas and user stories throughout the RE process to capture the needs, goals, and interactions of various stakeholders, including medical educators, medical students, AI patient agent, and clinical agents (physical exam agent, diagnostic agent, clinical intervention agent, supervisor agent, evaluation agent). The goals, underlying models, and knowledge base shape agent interactions and inform explainability requirements that guided the clinical reasoning training of medical students. A post-usage survey found that more than 78\% of medical students reported that MAES improved their clinical reasoning skills. These findings demonstrate that RE based on persona effectively connects technical requirements with non-technical medical students from a human-centered approach, ensuring that explainable MAES are trustworthy, interpretable, and aligned with authentic clinical scenarios from the early stages of the AI system engineering. The partial MAES for the clinical scenario simulator is~\href{https://github.com/2sigmaEdTech/MAS/}{open sourced here}.

Weibing Zheng, Laurah Turner, Jess Kropczynski et al.

Clinical communication skills are critical in medical education, and practicing and assessing clinical communication skills on a scale is challenging. Although LLM-powered clinical scenario simulations have shown promise in enhancing medical students' clinical practice, providing automated and scalable clinical evaluation that follows nuanced physician judgment is difficult. This paper combines fuzzy logic and Large Language Model (LLM) and proposes LLM-as-a-Fuzzy-Judge to address the challenge of aligning the automated evaluation of medical students' clinical skills with subjective physicians' preferences. LLM-as-a-Fuzzy-Judge is an approach that LLM is fine-tuned to evaluate medical students' utterances within student-AI patient conversation scripts based on human annotations from four fuzzy sets, including Professionalism, Medical Relevance, Ethical Behavior, and Contextual Distraction. The methodology of this paper started from data collection from the LLM-powered medical education system, data annotation based on multidimensional fuzzy sets, followed by prompt engineering and the supervised fine-tuning (SFT) of the pre-trained LLMs using these human annotations. The results show that the LLM-as-a-Fuzzy-Judge achieves over 80\% accuracy, with major criteria items over 90\%, effectively leveraging fuzzy logic and LLM as a solution to deliver interpretable, human-aligned assessment. This work suggests the viability of leveraging fuzzy logic and LLM to align with human preferences, advances automated evaluation in medical education, and supports more robust assessment and judgment practices. The GitHub repository of this work is available at https://github.com/2sigmaEdTech/LLMAsAJudge

Weibing Zheng, Laurah Turner, Jess Kropczynski et al.

Assisting medical students with clinical reasoning (CR) during clinical scenario training remains a persistent challenge in medical education. This paper presents the design and architecture of the Fuzzy Supervisor Agent (FSA), a novel component for the Multi-Agent Educational Clinical Scenario Simulation (MAECSS) platform. The FSA leverages a Fuzzy Inference System (FIS) to continuously interpret student interactions with specialized clinical agents (e.g., patient, physical exam, diagnostic, intervention) using pre-defined fuzzy rule bases for professionalism, medical relevance, ethical behavior, and contextual distraction. By analyzing student decision-making processes in real-time, the FSA is designed to deliver adaptive, context-aware feedback and provides assistance precisely when students encounter difficulties. This work focuses on the technical framework and rationale of the FSA, highlighting its potential to provide scalable, flexible, and human-like supervision in simulation-based medical education. Future work will include empirical evaluation and integration into broader educational settings. More detailed design and implementation is~\href{https://github.com/2sigmaEdTech/MAS/}{open sourced here}.