# NurValues: Real-World Nursing Values Evaluation for Large Language Models in Clinical Context

arXiv: https://arxiv.org/abs/2505.08734 · HTML: https://mlsanity.com/paper/2505.08734/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 24 of its 47 references that are in the map.
- First posted on arXiv 13 May 2025.

## Builds on (most cited first, 24 of 24)

- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Self-Consistency Improves Chain of Thought Reasoning in Language Models](https://mlsanity.com/paper/2203.11171/) (2022)
- [A Survey of Large Language Models](https://mlsanity.com/paper/2303.18223/) (2023)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [Aligning AI With Shared Human Values](https://mlsanity.com/paper/2008.02275/) (2020)
- [Med42-v2: A Suite of Clinical LLMs](https://mlsanity.com/paper/2408.06142/) (2024)
- [Utility Engineering: Analyzing and Controlling Emergent Value Systems in AIs](https://mlsanity.com/paper/2502.08640/) (2025)
- [WorldValuesBench: A Large-Scale Benchmark Dataset for Multi-Cultural Value Awareness of Language Models](https://mlsanity.com/paper/2404.16308/) (2024)
- [MedExQA: Medical Question Answering Benchmark with Multiple Explanations](https://mlsanity.com/paper/2406.06331/) (2024)
- [DailyDilemmas: Revealing Value Preferences of LLMs with Quandaries of Daily Life](https://mlsanity.com/paper/2410.02683/) (2024)
- [Values in the Wild: Discovering and Analyzing Values in Real-World Language Model Interactions](https://mlsanity.com/paper/2504.15236/) (2025)
- [Value FULCRA: Mapping Large Language Models to the Multidimensional Spectrum of Basic Human Values](https://mlsanity.com/paper/2311.10766/) (2023)
- [MoralBench: Moral Evaluation of LLMs](https://mlsanity.com/paper/2406.04428/) (2024)
- [MedSafetyBench: Evaluating and Improving the Medical Safety of Large Language Models](https://mlsanity.com/paper/2403.03744/) (2024)
- [Flames: Benchmarking Value Alignment of LLMs in Chinese](https://mlsanity.com/paper/2311.06899/) (2023)
- [MedBench: A Large-Scale Chinese Benchmark for Evaluating Medical Large Language Models](https://mlsanity.com/paper/2312.12806/) (2023)
- [ValueBench: Towards Comprehensively Evaluating Value Orientations and Understanding of Large Language Models](https://mlsanity.com/paper/2406.04214/) (2024)
- [Self-Alignment: Improving Alignment of Cultural Values in LLMs via In-Context Learning](https://mlsanity.com/paper/2408.16482/) (2024)
- [A Chinese Dataset for Evaluating the Safeguards in Large Language Models](https://mlsanity.com/paper/2402.12193/) (2024)
- [ValuesRAG: Enhancing Cultural Alignment Through Retrieval-Augmented Contextual Learning](https://mlsanity.com/paper/2501.01031/) (2025)
- [Edu-Values: Towards Evaluating the Chinese Education Values of Large Language Models](https://mlsanity.com/paper/2409.12739/) (2024)
- [Beyond Single-Sentence Prompts: Upgrading Value Alignment Benchmarks with Dialogues and Stories](https://mlsanity.com/paper/2503.22115/) (2025)

## Abstract (arXiv)

While LLMs have demonstrated medical knowledge and conversational ability, their deployment in clinical practice raises new risks: patients may place greater trust in LLM-generated responses than in nurses' professional judgments, potentially intensifying nurse-patient conflicts. Such risks highlight the urgent need of evaluating whether LLMs align with the core nursing values upheld by human nurses. This work introduces the first benchmark for nursing value alignment, consisting of five core value dimensions distilled from international nursing codes: Altruism, Human Dignity, Integrity, Justice, and Professionalism. We define two-level tasks on the benchmark, considering the two characteristics of emerging nurse-patient conflicts. The Easy-Level dataset consists of 2,200 value-aligned and value-violating instances, which are collected through a five-month longitudinal field study across three hospitals of varying tiers; The Hard-Level dataset is comprised of 2,200 dialogue-based instances that embed contextual cues and subtle misleading signals, which increase adversarial complexity and better reflect the subjectivity and bias of narrators in the context of emerging nurse-patient conflicts. We evaluate a total of 23 SoTA LLMs on their ability to align with nursing values, and find that general LLMs outperform medical ones, and Justice is the hardest value dimension. As the first real-world benchmark for healthcare value alignment, NurValues provides novel insights into how LLMs navigate ethical challenges in clinician-patient interactions.