EmoPatient: An Emotion-Directed Patient Simulator for Realistic Palliative Care Communication Training

Effective communication during palliative care discussions is a critical clinical skill, yet training clinicians to manage complex patient emotions remains challenging. Large language model (LLM)-based patient simulators provide a scalable approach for communication training, but most existing systems treat patient emotion as static and fail to capture the dynamic emotional shifts observed in clinical interactions. We present EmoPatient, an emotion-directed patient simulator designed to generate evolving emotional responses during palliative care discussions. The system introduces an Emotion Director agent that estimates the patient's emotional state and generates turn-level control signals for emotional intensity, regulatory stability, and interactional guidance. We evaluate EmoPatient through controlled multi-turn physician-patient dialogue simulations and compare it with baseline simulators. Results show improvements across four theory-informed emotional realism metrics and robustness across conversational personality variants, suggesting that modeling emotional dynamics can improve the realism of LLM-based patient simulators for palliative care communication training.