Patients With Personality: Realistic Patient Simulation through Controlled Diversity and Selective Disclosure

[Submitted on 13 May 2026 (v1), last revised 11 Aug 2026 (this version, v2)]

Authors:Moritz Schlager, Friederike Jungmann, Samuel Schmidgall, Philipp Raffler, Franziska Hartl, Eva Wende, Paula Roßmüller, Conrad Ketzer, Avinatan Hassidim, Dale R. Webster, Yossi Matias, Yun Liu, Daniel Rueckert, Mike Schaekermann, Paul Hager

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Abstract:Simulating realistic patient interactions is a key requirement to testing clinical applications of LLMs at scale without time-consuming and expensive user studies. However, existing approaches often lack realism and controllability, often oversharing information unprompted, and failing to capture the wide variability of patient behavior. Here, we introduce PatientsWithPersonality (PWP), a patient simulation framework that generates realistic yet diverse virtual patient responses through explicit personality parametrization over a latent patient state. Grounded in HEXACO, a six-dimensional personality space used to quantify and parameterize human behavioral traits, our approach enables fine-grained control over conversational style, cooperativeness, and information disclosure within a unified framework. In a clinician evaluation, PWP is judged nearly as realistic as recorded human actors and clearly ahead of prior simulators, while being flagged as “too informative” far less often. Conditioning on HEXACO axes yields personas whose configured traits are recoverable by both clinicians and an autorater, span a substantially wider behavioral footprint than the closest baseline, and prevent oversharing. Altogether, our framework paves the way for more accurate and informative LLM benchmarking through our realistic and steerable patient simulator.

Submission history

From: Moritz Schlager [view email]
[v1] Wed, 13 May 2026 15:26:15 UTC (684 KB)
[v2] Tue, 11 Aug 2026 12:48:31 UTC (690 KB)