arXiv:2509.05818v2 Announce Type: replace Abstract: Patients must possess the knowledge necessary to actively participate in their care. We present NoteAid-Chatbot, a conversational AI that promotes patient understanding via a novel 'learning as conversation' framework, built on a multi-agent large language model (LLM) and reinforcement learning (RL) setup without human-labeled data. NoteAid-Chatbot was built on a lightweight LLaMA 3.2 3B model trained in two stages: initial supervised fine-tuning on conversational data synthetically generated using medical conversation strategies, followed by RL with rewards derived from patient understanding assessments in simulated hospital discharge scenarios. Our evaluation, which includes comprehensive human-aligned assessments and case studies, demonstrates that NoteAid-Chatbot exhibits key emergent behaviors critical for patient education, such as clarity, relevance, and structured dialogue, even though it received no explicit supervision for these attributes. Our results show that even simple Proximal Policy Optimization (PPO)-based reward modeling can successfully train lightweight, domain-specific chatbots to handle multi-turn interactions, incorporate diverse educational strategies, and meet nuanced communication objectives. Our Turing test demonstrates that NoteAid-Chatbot surpasses non-expert human. Although our current focus is on healthcare, the framework we present illustrates the feasibility and promise of applying low-cost, PPO-based RL to realistic, open-ended conversational domains, broadening the applicability of RL-based alignment methods.

arXiv:2410.04108v3 Announce Type: replace-cross Abstract: Reinforcement learning with general utilities (RLGU) offers a unifying framework to capture several problems beyond standard expected returns, including imitation learning, pure exploration, and safe RL. Despite recent fundamental advances in the theoretical analysis of policy gradient (PG) methods for standard RL and recent efforts in RLGU, the understanding of these PG algorithms and their scope of application in RLGU still remain limited. In this work, we establish global optimality guarantees of PG methods for RLGU in which the objective is a general concave utility function of the state-action occupancy measure. In the tabular setting, we provide global optimality results using a new proof technique building on recent theoretical developments on the convergence of PG methods for standard RL using gradient domination. Our proof technique opens avenues for analyzing policy parameterizations beyond the direct policy parameterization for RLGU. In addition, we provide global optimality results for large state-action space settings beyond prior work which has mostly focused on the tabular setting. In this large scale setting, we adapt PG methods by approximating occupancy measures within a function approximation class using maximum likelihood estimation. Our sample complexity only scales with the dimension induced by our approximation class instead of the size of the state-action space.