# KEPO: Knowledge-Enhanced Preference Optimization for Multimodal Reasoning with Applications to Medical VQA

arXiv: https://arxiv.org/abs/2602.00400 · HTML: https://mlsanity.com/paper/2602.00400/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Reinforcement learning for reasoning, one of 17 directions in LLM reasoning.
- Builds on 22 of its 27 references that are in the map.
- First posted on arXiv 30 Jan 2026.

## Placed in

- LLM reasoning / [Reinforcement learning for reasoning](https://mlsanity.com/lr/reinforcement-learning-for-reasoning/)
- Multimodal LLMs / vision-language models / [Embodied and 3D vision-language models](https://mlsanity.com/mllm/embodied-and-3d-vision-language-models/)
- LLM alignment / RLHF / preference optimisation / [Process reward models for reasoning](https://mlsanity.com/alignment/process-reward-models-for-reasoning/)
- Knowledge distillation / [On-policy and self-distillation for LLMs](https://mlsanity.com/distill/on-policy-and-self-distillation-for-llms/)

## Builds on (most cited first, 22 of 22)

- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Distilling the Knowledge in a Neural Network](https://mlsanity.com/paper/1503.02531/) (2015)
- [DeepSeekMath: Pushing the Limits of Mathematical Reasoning in Open Language Models](https://mlsanity.com/paper/2402.03300/) (2024)
- [DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2501.12948/) (2025)
- [Improved Baselines with Visual Instruction Tuning](https://mlsanity.com/paper/2310.03744/) (2023)
- [Let's Verify Step by Step](https://mlsanity.com/paper/2305.20050/) (2023)
- [DAPO: An Open-Source LLM Reinforcement Learning System at Scale](https://mlsanity.com/paper/2503.14476/) (2025)
- [On-Policy Distillation of Language Models: Learning from Self-Generated Mistakes](https://mlsanity.com/paper/2306.13649/) (2023)
- [Learning to Reason under Off-Policy Guidance](https://mlsanity.com/paper/2504.14945/) (2025)
- [SFT or RL? An Early Investigation into Training R1-Like Reasoning Large Vision-Language Models](https://mlsanity.com/paper/2504.11468/) (2025)
- [OmniMedVQA: A New Large-Scale Comprehensive Evaluation Benchmark for Medical LVLM](https://mlsanity.com/paper/2402.09181/) (2024)
- [MedVLM-R1: Incentivizing Medical Reasoning Capability of Vision-Language Models (VLMs) via Reinforcement Learning](https://mlsanity.com/paper/2502.19634/) (2025)
- [Med-R1: Reinforcement Learning for Generalizable Medical Reasoning in Vision-Language Models](https://mlsanity.com/paper/2503.13939/) (2025)
- [Learning What Reinforcement Learning Can't: Interleaved Online Fine-Tuning for Hardest Questions](https://mlsanity.com/paper/2506.07527/) (2025)
- [BREAD: Branched Rollouts from Expert Anchors Bridge SFT & RL for Reasoning](https://mlsanity.com/paper/2506.17211/) (2025)
- [Blending Supervised and Reinforcement Fine-Tuning with Prefix Sampling](https://mlsanity.com/paper/2507.01679/) (2025)
- [UFT: Unifying Supervised and Reinforcement Fine-Tuning](https://mlsanity.com/paper/2505.16984/) (2025)
- [Scaf-GRPO: Scaffolded Group Relative Policy Optimization for Enhancing LLM Reasoning](https://mlsanity.com/paper/2510.19807/) (2025)
- [StepHint: Multi-level Stepwise Hints Enhance Reinforcement Learning to Reason](https://mlsanity.com/paper/2507.02841/) (2025)
- [VOLD: Reasoning Transfer from LLMs to Vision-Language Models via On-Policy Distillation](https://mlsanity.com/paper/2510.23497/) (2025)
- [Step-wise Adaptive Integration of Supervised Fine-tuning and Reinforcement Learning for Task-Specific LLMs](https://mlsanity.com/paper/2505.13026/) (2025)
- [How Much Backtracking is Enough? Exploring the Interplay of SFT and RL in Enhancing LLM Reasoning](https://mlsanity.com/paper/2505.24273/) (2025)

## Built on by (most cited first, 1 of 1)

- [A Survey of On-Policy Distillation for Large Language Models](https://mlsanity.com/paper/2604.00626/) (2026)

## Abstract (arXiv)

Reinforcement learning (RL) has emerged as a promising paradigm for inducing explicit reasoning behaviors in large language and vision-language models. However, reasoning-oriented RL post-training remains fundamentally challenging due to sparse trajectory-level rewards, leading to ambiguous credit assignment and severe exploration failures that can trap the policy in a ``learning cliff.'' Recent on-policy distillation methods introduce dense teacher supervision to stabilize optimization, but apply it uniformly across all generated trajectories. We argue that such uniform distillation is ill-suited for reasoning-intensive tasks, as low-quality on-policy trajectories often originate from early logical errors, and distillation under flawed contexts injects noisy and misaligned gradients. To address these challenges, we propose Knowledge-Enhanced Preference Optimization (KEPO), a unified post-training framework that integrates: (i) a quality-gated on-policy distillation objective that selectively applies dense teacher guidance only to high-quality trajectories, and (ii) a knowledge-enhanced exploration strategy that leverages hints learned from a teacher model to rejectively sample reward-positive on-policy trajectories for RL, thereby mitigating exploration collapse. Evaluated on a challenging medical visual question answering benchmark under single-source generalization, KEPO demonstrates improved training stability, more coherent reasoning behaviors, and superior out-of-distribution performance over reinforcement learning and on-policy distillation baselines.