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Oct 16

SCRIBE: Structured Mid-Level Supervision for Tool-Using Language Models

Training reliable tool-augmented agents remains a significant challenge, largely due to the difficulty of credit assignment in multi-step reasoning. While process-level reward models offer a promising direction, existing LLM-based judges often produce noisy and inconsistent signals because they lack fine-grained, task-specific rubrics to distinguish high-level planning from low-level execution. In this work, we introduce SCRIBE (Skill-Conditioned Reward with Intermediate Behavioral Evaluation), a reinforcement learning framework that intervenes at a novel mid-level abstraction. SCRIBE grounds reward modeling in a curated library of skill prototypes, transforming open-ended LLM evaluation into a constrained verification problem. By routing each subgoal to a corresponding prototype, the reward model is equipped with precise, structured rubrics that substantially reduce reward variance. Experimental results show that SCRIBE achieves state-of-the-art performance across a range of reasoning and tool-use benchmarks. In particular, it improves the AIME25 accuracy of a Qwen3-4B model from 43.3% to 63.3%, and significantly increases success rates in complex multi-turn tool interactions. Further analysis of training dynamics reveals a co-evolution across abstraction levels, where mastery of mid-level skills consistently precedes the emergence of effective high-level planning behaviors. Finally, we demonstrate that SCRIBE is additive to low-level tool optimizations, providing a scalable and complementary pathway toward more autonomous and reliable tool-using agents.

  • 2 authors
·
Jan 6

From Black Box to Glass Box: Cross-Model ASR Disagreement to Prioto Review in Ambient AI Scribe Documentation

Ambient AI "scribe" systems promise to reduce clinical documentation burden, but automatic speech recognition (ASR) errors can remain unnoticed without careful review, and high-quality human reference transcripts are often unavailable for calibrating uncertainty. We investigate whether cross-model disagreement among heterogeneous ASR systems can act as a reference-free uncertainty signal to prioritize human verification in medical transcription workflows. Using 50 publicly available medical education audio clips (8 h 14 min), we transcribed each clip with eight ASR systems spanning commercial APIs and open-source engines. We aligned multi-model outputs, built consensus pseudo-references, and quantified token-level agreement using a majority-strength metric; we further characterized disagreements by type (content vs. punctuation/formatting) and assessed per-model agreement via leave-one-model-out (jackknife) consensus scoring. Inter-model reliability was low (ICC[2,1] = 0.131), indicating heterogeneous failure modes across systems. Across 76,398 evaluated token positions, 72.1% showed near-unanimous agreement (7-8 models), while 2.5% fell into high-risk bands (0-3 models), with high-risk mass varying from 0.7% to 11.4% across accent groups. Low-agreement regions were enriched for content disagreements, with the content fraction increasing from 53.9% to 73.9% across quintiles of high-risk mass. These results suggest that cross-model disagreement provides a sparse, localizable signal that can surface potentially unreliable transcript spans without human-verified references, enabling targeted review; clinical accuracy of flagged regions remains to be established.

  • 3 authors
·
Mar 1

One note in three: a verified census of three deployed AI scribes, and the instrument that counted it

Ambient AI scribes draft clinical notes under the reassurance that a clinician signs every note. We audited three commercial AI scribes on the same 142 consultations: 565 notes from recorded UK primary-care and US ambulatory encounters plus authored scenarios. Twelve discovery passes proposed 13,678 candidate errors; the 5,898 clearing an importance filter went to an adversarial panel of two models from different families, each told to refute what it could, and 618 survived. One note in three (31.3% [27.0, 35.6]) carries a verified failure, concentrated in allergy and medication information, invented patient identity, and history written up as examination on telephone consultations that can contain none. No product was given a patient record; setting aside the two classes a record would have prefilled, invented identity and dates, the rate is 24.8% [20.8, 29.0]. One failure mode did not fit our scheme, drawn from published scribe-error taxonomies: a treatment the clinician retracts, recorded as delivered care. Two clinicians adjudicated blind, disjoint samples: a physician author upheld 20 of 21 findings (95.2% [77.3, 99.2]) and an independent clinician, not an author, 12 of 12 ([75.8, 100]); both judged every sampled refusal genuine. A failure rate depends on the instrument as much as the scribes. With model, evidence and settings fixed, the review instruction alone moves the share of candidates verified from 9.3% to 79.0%, and the reviewing family moves it too: alone at that instruction the gentler flags 54.8% of notes against 27.8%. Between 28% and 97% of sampled notes carry a failure depending on the standard. Published audits disagree among themselves by a margin instrument differences alone can produce: omission is 54-86% of their errors against our 23.1%. We release all 618 findings with transcript-side evidence, every prompt and model version, and the re-runnable pipeline.

  • 4 authors
·
Aug 30