How sensitive do we want AI to be? Socio-communicative competencies of large language models in healthcare

Background. Effective clinical practice relies heavily on the socio-communicative skills of medical professionals. Large language models (LLMs) have been proposed for tasks such as triaging patients, report drafting or translating medical jargon to support informed decision-making. These applications require both factual and social competence. This study evaluates dialogues between LLMs and participants to assess the current state of socio-communicative competencies displayed in LLM-generated texts. Methods. We extracted a subset of extended dialogues from the HELP-Med dataset, comprising 1800 conversation transcripts of interactions between human participants seeking medical information and three different LLMs, GPT 4o, Llama 3 and Command R+. Two experts coded the transcripts for demonstrations of socio-communicative behaviours (non-hostility, sensitivity, structuring, non-intrusiveness) using the IC-MD instrument, originally designed to evaluate interactional competencies in medical student admissions. Results. The LLMs in our study showed strength in non-hostility, mixed results in sensitivity and non-intrusiveness and performed poorly in structuring. Conclusion. Current LLMs lack the consistent and reliable socio-communicative skills needed for safe and effective use as healthcare advisors. While existing frameworks for assessing interactional competencies may support the development of more socially responsive LLMs, they will require adaptation to account for the differences in desirable behaviour between humans and LLMs.