Daily Papers

Large language models have demonstrated remarkable performance in a wide range of medical benchmarks. Yet underneath the seemingly promising results lie salient growth areas, especially in cutting-edge frontiers such as multimodal reasoning. In this paper, we introduce a series of adversarial stress tests to systematically assess the robustness of flagship models and medical benchmarks. Our study reveals prevalent brittleness in the presence of simple adversarial transformations: leading systems can guess the right answer even with key inputs removed, yet may get confused by the slightest prompt alterations, while fabricating convincing yet flawed reasoning traces. Using clinician-guided rubrics, we demonstrate that popular medical benchmarks vary widely in what they truly measure. Our study reveals significant competency gaps of frontier AI in attaining real-world readiness for health applications. If we want AI to earn trust in healthcare, we must demand more than leaderboard wins and must hold AI systems accountable to ensure robustness, sound reasoning, and alignment with real medical demands.

Evaluating long-form responses to research queries heavily relies on expert annotators, restricting attention to areas like AI where researchers can conveniently enlist colleagues. Yet, research expertise is widespread: survey articles synthesize knowledge distributed across the literature. We introduce ResearchQA, a resource for evaluating LLM systems by distilling survey articles from 75 research fields into 21K queries and 160K rubric items. Each rubric, derived jointly with queries from survey sections, lists query-specific answer evaluation criteria, i.e., citing papers, making explanations, and describing limitations. Assessments by 31 Ph.D. annotators in 8 fields indicate 96% of queries support Ph.D. information needs and 87% of rubric items should be addressed in system responses by a sentence or more. Using our rubrics, we are able to construct an automatic pairwise judge obtaining 74% agreement with expert judgments. We leverage ResearchQA to analyze competency gaps in 18 systems in over 7.6K pairwise evaluations. No parametric or retrieval-augmented system we evaluate exceeds 70% on covering rubric items, and the highest-ranking agentic system shows 75% coverage. Error analysis reveals that the highest-ranking system fully addresses less than 11% of citation rubric items, 48% of limitation items, and 49% of comparison items. We release our data to facilitate more comprehensive multi-field evaluations.

The scaling laws and extraordinary performance of large foundation models motivate the development and utilization of such models in biomedicine. However, despite early promising results on some biomedical benchmarks, there are still major challenges that need to be addressed before these models can be used in real-world clinics. Frontier general-domain models such as GPT-4V still have significant performance gaps in multimodal biomedical applications. More importantly, less-acknowledged pragmatic issues, including accessibility, model cost, and tedious manual evaluation make it hard for clinicians to use state-of-the-art large models directly on private patient data. Here, we explore training open-source small multimodal models (SMMs) to bridge competency gaps for unmet clinical needs in radiology. To maximize data efficiency, we adopt a modular approach by incorporating state-of-the-art pre-trained models for image and text modalities, and focusing on training a lightweight adapter to ground each modality to the text embedding space, as exemplified by LLaVA-Med. For training, we assemble a large dataset of over 697 thousand radiology image-text pairs. For evaluation, we propose CheXprompt, a GPT-4-based metric for factuality evaluation, and demonstrate its parity with expert evaluation. For best practice, we conduct a systematic ablation study on various choices in data engineering and multimodal training. The resulting LlaVA-Rad (7B) model attains state-of-the-art results on standard radiology tasks such as report generation and cross-modal retrieval, even outperforming much larger models such as GPT-4V and Med-PaLM M (84B). The inference of LlaVA-Rad is fast and can be performed on a single V100 GPU in private settings, offering a promising state-of-the-art tool for real-world clinical applications.

Frontier models have demonstrated remarkable capabilities in understanding and reasoning with natural-language text, but they still exhibit major competency gaps in multimodal understanding and reasoning especially in high-value verticals such as biomedicine. Medical imaging report generation is a prominent example. Supervised fine-tuning can substantially improve performance, but they are prone to overfitting to superficial boilerplate patterns. In this paper, we introduce Universal Report Generation (UniRG) as a general framework for medical imaging report generation. By leveraging reinforcement learning as a unifying mechanism to directly optimize for evaluation metrics designed for end applications, UniRG can significantly improve upon supervised fine-tuning and attain durable generalization across diverse institutions and clinical practices. We trained UniRG-CXR on publicly available chest X-ray (CXR) data and conducted a thorough evaluation in CXR report generation with rigorous evaluation scenarios. On the authoritative ReXrank benchmark, UniRG-CXR sets new overall SOTA, outperforming prior state of the art by a wide margin.

Open-ended learning frames intelligence as emerging from continual interaction with an ever-expanding space of environments. While recent advances have utilized foundation models to programmatically generate diverse environments, these approaches often focus on discovering isolated behaviors rather than orchestrating sustained progression. In complex open-ended worlds, the large combinatorial space of possible challenges makes it difficult for agents to discover sequences of experiences that remain consistently learnable. To address this, we propose Dreaming in Code (DiCode), a framework in which foundation models synthesize executable environment code to scaffold learning toward increasing competence. In DiCode, "dreaming" takes the form of materializing code-level variations of the world. We instantiate DiCode in Craftax, a challenging open-ended benchmark characterized by rich mechanics and long-horizon progression. Empirically, DiCode enables agents to acquire long-horizon skills, achieving a 16% improvement in mean return over the strongest baseline and non-zero success on late-game combat tasks where prior methods fail. Our results suggest that code-level environment design provides a practical mechanism for curriculum control, enabling the construction of intermediate environments that bridge competence gaps in open-ended worlds. Project page and source code are available at https://konstantinosmitsides.github.io/dreaming-in-code and https://github.com/konstantinosmitsides/dreaming-in-code.

Current benchmarks for AI clinician systems, often based on multiple-choice exams or manual rubrics, fail to capture the depth, robustness, and safety required for real-world clinical practice. To address this, we introduce the GAPS framework, a multidimensional paradigm for evaluating Grounding (cognitive depth), Adequacy (answer completeness), Perturbation (robustness), and Safety. Critically, we developed a fully automated, guideline-anchored pipeline to construct a GAPS-aligned benchmark end-to-end, overcoming the scalability and subjectivity limitations of prior work. Our pipeline assembles an evidence neighborhood, creates dual graph and tree representations, and automatically generates questions across G-levels. Rubrics are synthesized by a DeepResearch agent that mimics GRADE-consistent, PICO-driven evidence review in a ReAct loop. Scoring is performed by an ensemble of large language model (LLM) judges. Validation confirmed our automated questions are high-quality and align with clinician judgment. Evaluating state-of-the-art models on the benchmark revealed key failure modes: performance degrades sharply with increased reasoning depth (G-axis), models struggle with answer completeness (A-axis), and they are highly vulnerable to adversarial perturbations (P-axis) as well as certain safety issues (S-axis). This automated, clinically-grounded approach provides a reproducible and scalable method for rigorously evaluating AI clinician systems and guiding their development toward safer, more reliable clinical practice.

People overthink; language models over-sample, and the extra effort can talk both into a worse answer. Reasoning systems answer a hard question by sampling it many times (test-time scaling), and the more they draw, the more often a correct answer turns up somewhere, so coverage, the fraction of problems with at least one correct try, climbs and appears to be progress. But a deployed system must return one answer, and choosing it, not knowing which try is right, is selection; selection is capped, and past a point extra samples only make the model surer of a confident mistake, even as every draw adds cost. The gap between climbing coverage and stalled selection, the identifiability gap, is the answer a model can produce but not pick. So the real question is not whether to sample but how far, and the answer is: not far. For picking an answer, the vote has already settled within a few dozen draws, the modal ceiling; for scoring a benchmark, sooner still, the correlation ceiling. Beyond that, extra draws cost compute and add nothing, and can even make the answer worse. This paper turns the cutoff into a single number, the effective number of samples, that any sampling run already reveals. The bottleneck is recognizing a right answer, not generating one.

Recent research in the field of reflexive metrics have studied the emergence and consequences of evaluation gaps in science. The concept of evaluation gaps captures potential discrepancies between what researchers value about their research, in particular research quality, and what metrics measure. As a result, scientists may experience anomie and adopt innovative ways to cope. These often value quantity over quality and may even compromise research integrity. A consequence of such gaps may therefore be research misconduct and a decrease in research quality. In the language of rational choice theory, an evaluation gap persists if motivational factors arising out of the internal component of an actors situation are incongruent with those arising out of the external components. The aim of this research is therefore to study and compare autonomous and controlled motivations to become an astronomer, to do research in astronomy and to publish scientific papers. Moreover, we study how these different motivational factors affect publication pressure, the experience of organisational justice and the observation of research misconduct. In summary, we find evidence for an evaluation gap and that controlled motivational factors arising from evaluation procedures based on publication record drives up publication pressure, which, in turn, was found to increase the likelihood of perceived frequency of misbehaviour.

Patient education materials for solid-organ transplantation vary substantially across U.S. centers, yet no systematic method exists to quantify this heterogeneity at scale. We introduce a framework that grounds the same patient questions in different centers' handbooks using retrieval-augmented language models and compares the resulting answers using a five-label consistency taxonomy. Applied to 102 handbooks from 23 centers and 1,115 benchmark questions, the framework quantifies heterogeneity across four dimensions: question, topic, organ, and center. We find that 20.8% of non-absent pairwise comparisons exhibit clinically meaningful divergence, concentrated in condition monitoring and lifestyle topics. Coverage gaps are even more prominent: 96.2% of question-handbook pairs miss relevant content, with reproductive health at 95.1% absence. Center-level divergence profiles are stable and interpretable, where heterogeneity reflects systematic institutional differences, likely due to patient diversity. These findings expose an information gap in transplant patient education materials, with document-grounded medical question answering highlighting opportunities for content improvement.

Clinical protocol-execution tasks -- checking a lab value, applying a threshold, placing a correctly structured FHIR order -- are natural candidates for RL from world feedback: once clinical SMEs encode decision logic into a verifier, that verifier grades unlimited rollouts without per-episode annotation. But applying RL requires a sound feedback channel and sufficient base capability. We audit MedAgentBench v1/v2, find a 41.7\% silent-finish ceiling that makes inaction the RL dominant strategy, and construct MedAgentBench-v3 (MAB-v3) (508 tasks, 8.9\% ceiling). Training Qwen3-8B exposes two structural barriers: a capability ceiling (10/20 task types have 0\% base performance, zero gradient) and a format-knowledge barrier (3/20 types require exact clinical codes undiscoverable by exploration). Pure RL reaches 18.2\% pass@1 vs.\ 34.1\% for rule-based SFT; the 15.9~pp gap is attributable entirely to these barriers. A decision/format-knowledge/lookup taxonomy predicts RL learnability and prescribes the fix: SFT to inject codes, RL to learn conditionals.

Assessing learner competency in clinical simulation requires expert observation that is time-intensive, difficult to scale, and subject to inter-rater variability. Vision-language models have emerged as a promising tool for understanding complex visual behavior. In this work, we investigate whether visual observations can provide educationally meaningful signals for competency assessment through a three-stage framework that (1) extracts action timelines from egocentric nursing simulation video using frozen visual encoders and few-shot learning, (2) derives sequence-level features and per-session recognition metrics, and (3) relates these to instructor-rated competency. Across 22 densely annotated sessions (3.8 hours, 493 actions), a frozen DINOv2 backbone with HMM Viterbi decoding achieves 57.4% MOF in leave-one-out 1-shot recognition. Surprisingly, we observe a negative trend between recognition accuracy and competency (rho = -0.524, p = 0.012 for mIoU), robust to six confound controls: more competent students produce diverse, harder-to-classify workflows, while simple sequence features show no such relationship. Per-item analysis identifies patient safety protocols and team communication as the expected behaviors most reflected in this pattern, and process model comparisons reveal that higher-competency students exhibit more protocol-consistent action transitions. These findings suggest that recognition accuracy may complement predicted action timelines as a pedagogically informative signal in automated competency assessment.

People rely on social skills like conflict resolution to communicate effectively and to thrive in both work and personal life. However, practice environments for social skills are typically out of reach for most people. How can we make social skill training more available, accessible, and inviting? Drawing upon interdisciplinary research from communication and psychology, this perspective paper identifies social skill barriers to enter specialized fields. Then we present a solution that leverages large language models for social skill training via a generic framework. Our AI Partner, AI Mentor framework merges experiential learning with realistic practice and tailored feedback. This work ultimately calls for cross-disciplinary innovation to address the broader implications for workforce development and social equality.

End-to-end automation of realistic healthcare operations stresses three capabilities underrepresented in current benchmarks: policy density, decisions must be grounded in a large library of medical, insurance, and operational rules; Multi-role composition: a single task requires the agent to play multiple roles with handoffs; and multilateral interaction: intermediate workflow steps are multi-turn dialogs, such as peer-to-peer review and patient outreach. We introduce χ-Bench, a benchmark of long-horizon healthcare workflows across three domains: provider prior authorization, payer utilization management, and care management. Each task hands the agent a clinical case in a high-fidelity simulator of 20 healthcare apps exposed via 87 MCP tools, which it must drive to a terminal status through tool calls and writing the role's artifacts, guided by a 1,290+ document managed-care operations handbook skill. Across 30 agent harness/models configurations, the best agent resolves only 28.0% of tasks, no agent clears 20% on strict pass^3, and executing all tasks in a single session slumps the performance to 3.8%. These results raise the hypothesis that similar gaps are likely to surface in other policy-dense, role-composed, irreversible enterprise domains.

Benchmarks are necessary for healthcare evaluation, but are not sufficient for predicting deployment performance. Our position is that the evaluation--deployment gap arises not because of poorly designed benchmarks, but from implicit assumptions about how users interact with models that cannot be surfaced from benchmarks alone. To make this precise, we propose a classification of assumptions into two categories: task, which can be tested from conversation data alone, and outcome, which requires outcome data and behavioral studies for testing. Critically, outcome assumptions depend on human behavior, something that even well-designed benchmarks cannot directly observe. To demonstrate the operationality of this framework, we retrospectively analyze a healthcare RCT as a case study and find that the gap naturally separates into task and outcome gaps of roughly equal size. To address this, we make two contributions: first, we propose BenchmarkCards, an artifact that documents assumptions, and second, we propose staged evaluation, a procedure that systematically tests assumptions and evaluates performance.

AI systems increasingly produce fluent, correct, end-to-end outcomes. Over time, this erodes users' ability to explain, verify, or intervene. We define this divergence as the Capability-Comprehension Gap: a decoupling where assisted performance improves while users' internal models deteriorate. This paper argues that prevailing approaches to transparency, user control, literacy, and governance do not define the foundational understanding humans must retain for oversight under sustained AI delegation. To formalize this, we define the Cognitive Integrity Threshold (CIT) as the minimum comprehension required to preserve oversight, autonomy, and accountable participation under AI assistance. CIT does not require full reasoning reconstruction, nor does it constrain automation. It identifies the threshold beyond which oversight becomes procedural and contestability fails. We operatinalize CIT through three functional dimensions: (i) verification capacity, (ii) comprehension-preserving interaction, and (iii) institutional scaffolds for governance. This motivates a design and governance agenda that aligns human-AI interaction with cognitive sustainability in responsibility-critical settings.

FinanceQA is a testing suite that evaluates LLMs' performance on complex numerical financial analysis tasks that mirror real-world investment work. Despite recent advances, current LLMs fail to meet the strict accuracy requirements of financial institutions, with models failing approximately 60% of realistic tasks that mimic on-the-job analyses at hedge funds, private equity firms, investment banks, and other financial institutions. The primary challenges include hand-spreading metrics, adhering to standard accounting and corporate valuation conventions, and performing analysis under incomplete information - particularly in multi-step tasks requiring assumption generation. This performance gap highlights the disconnect between existing LLM capabilities and the demands of professional financial analysis that are inadequately tested by current testing architectures. Results show that higher-quality training data is needed to support such tasks, which we experiment with using OpenAI's fine-tuning API. FinanceQA is publicly released at [this https URL](https://huggingface.co/datasets/AfterQuery/FinanceQA).

Majority voting over multiple LLM attempts improves mathematical reasoning, but correlated errors limit the effective sample size. A natural fix is to assign different reasoning strategies to different voters. The approach, Diverse Prompt Mixer, is tested on the AIMO 3 competition: 3 models, 23+ experiments, 50 IMO-level problems, one H100 80 GB, 5-hour limit. Every prompt-level intervention fails. High-temperature sampling already decorrelates errors; weaker strategies reduce accuracy more than they reduce correlation. Across an 8-point capability gap at equal N=8 and every optimization tested, model capability dominates. The gap between the best majority-vote score (42/50) and pass@20 (~45.5) is selection loss, not prompt loss. A verifier-based selector could close it. Prompt engineering cannot.

The increasing deployment of large language models (LLMs) in the cybersecurity domain underscores the need for effective model selection and evaluation. However, traditional evaluation methods often overlook specific cybersecurity knowledge gaps that contribute to performance limitations. To address this, we develop CSEBenchmark, a fine-grained cybersecurity evaluation framework based on 345 knowledge points expected of cybersecurity experts. Drawing from cognitive science, these points are categorized into factual, conceptual, and procedural types, enabling the design of 11,050 tailored multiple-choice questions. We evaluate 12 popular LLMs on CSEBenchmark and find that even the best-performing model achieves only 85.42% overall accuracy, with particular knowledge gaps in the use of specialized tools and uncommon commands. Different LLMs have unique knowledge gaps. Even large models from the same family may perform poorly on knowledge points where smaller models excel. By identifying and addressing specific knowledge gaps in each LLM, we achieve up to an 84% improvement in correcting previously incorrect predictions across three existing benchmarks for two cybersecurity tasks. Furthermore, our assessment of each LLM's knowledge alignment with specific cybersecurity roles reveals that different models align better with different roles, such as GPT-4o for the Google Senior Intelligence Analyst and Deepseek-V3 for the Amazon Privacy Engineer. These findings underscore the importance of aligning LLM selection with the specific knowledge requirements of different cybersecurity roles for optimal performance.

Drawing on 1,178 safety and reliability papers from 9,439 generative AI papers (January 2020 - March 2025), we compare research outputs of leading AI companies (Anthropic, Google DeepMind, Meta, Microsoft, and OpenAI) and AI universities (CMU, MIT, NYU, Stanford, UC Berkeley, and University of Washington). We find that corporate AI research increasingly concentrates on pre-deployment areas -- model alignment and testing & evaluation -- while attention to deployment-stage issues such as model bias has waned. Significant research gaps exist in high-risk deployment domains, including healthcare, finance, misinformation, persuasive and addictive features, hallucinations, and copyright. Without improved observability into deployed AI, growing corporate concentration could deepen knowledge deficits. We recommend expanding external researcher access to deployment data and systematic observability of in-market AI behaviors.

Employees of early childhood education and care (ECEC) organisations may experience a wide range of barriers as they attempt to integrate information technology (IT) into their work practices. However, studies within the ECEC organisational literature which attempt to identify and understand these barriers are scant. This literature review is the first to present consolidated findings from the body of knowledge on barriers to the integration of IT within ECEC organisations. In addition to highlighting limitations and gaps in the literature, it proposes a tri-perspective framework to provide for future research to develop a deeper understanding of not only what barriers exist but also how they interrelate and shape the IT integration process and the work practices of ECEC organisational employees.

Evaluation harnesses are software systems that orchestrate model evaluation by managing model invocation, data loading, metric computation, and result reporting. Despite their critical role in machine learning infrastructure, their operational challenges and engineering concerns have received limited attention so far. We present an empirical study of 57 evaluation harnesses, deriving a five-stage harness model and classifying 16,560 issues by workflow stage and root cause. Most harness operational challenges concentrate in the Specification stage (41.4% of issues), where harnesses integrate external models, datasets, and scoring judges. The three most frequent root causes of operational challenges are unimplemented features (24.3%), documentation gaps (20.3%), and missing input validation (17.2%), which together account for 61.7% of classified issues, spanning both defects in existing functionality and capability gaps that block intended workflows. Root causes also vary by workflow stage: environment incompatibility and external dependency breakage account for 36.2% of provisioning issues, whereas algorithmic error (25.9%) and validation gap (22.5%) dominate assessment issues. Together, these contributions establish an empirical foundation for treating evaluation engineering as a distinct software engineering concern.

Background: Deep learning models are typically trained using stochastic gradient descent or one of its variants. These methods update the weights using their gradient, estimated from a small fraction of the training data. It has been observed that when using large batch sizes there is a persistent degradation in generalization performance - known as the "generalization gap" phenomena. Identifying the origin of this gap and closing it had remained an open problem. Contributions: We examine the initial high learning rate training phase. We find that the weight distance from its initialization grows logarithmically with the number of weight updates. We therefore propose a "random walk on random landscape" statistical model which is known to exhibit similar "ultra-slow" diffusion behavior. Following this hypothesis we conducted experiments to show empirically that the "generalization gap" stems from the relatively small number of updates rather than the batch size, and can be completely eliminated by adapting the training regime used. We further investigate different techniques to train models in the large-batch regime and present a novel algorithm named "Ghost Batch Normalization" which enables significant decrease in the generalization gap without increasing the number of updates. To validate our findings we conduct several additional experiments on MNIST, CIFAR-10, CIFAR-100 and ImageNet. Finally, we reassess common practices and beliefs concerning training of deep models and suggest they may not be optimal to achieve good generalization.

While LLM agents can plan multi-step tasks, intervening at the planning stage-before any action is executed-is often the safest way to prevent harm, since certain risks can lead to severe consequences once carried out. However, existing guardrails mostly operate post-execution, which is difficult to scale and leaves little room for controllable supervision at the plan level. To address this challenge, we highlight three critical gaps in current research: data gap, model gap, and evaluation gap. To close the data gap, we introduce AuraGen, a controllable engine that (i) synthesizes benign trajectories, (ii) injects category-labeled risks with calibrated difficulty, and (iii) filters outputs via an automated reward model, producing large and reliable corpora for pre-execution safety. To close the guardian model gap, we propose a foundational guardrail Safiron, combining a cross-planner adapter with a compact guardian model. The adapter unifies different input formats, while Safiron flags risky cases, assigns risk types, and generates rationales; trained in two stages with a broadly explored data recipe, Safiron achieves robust transfer across settings. To close the evaluation gap, we release Pre-Exec Bench, a realistic benchmark covering diverse tools and branching trajectories, which measures detection, fine-grained categorization, explanation, and cross-planner generalization in human-verified scenarios. Extensive experiments demonstrate consistent gains of the proposed guardrail over strong baselines on Pre-Exec Bench, and ablations further distill actionable practices, providing a practical template for safer agentic systems.

Scaling high-quality tutoring remains a major challenge in education. Due to growing demand, many platforms employ novice tutors who, unlike experienced educators, struggle to address student mistakes and thus fail to seize prime learning opportunities. Our work explores the potential of large language models (LLMs) to close the novice-expert knowledge gap in remediating math mistakes. We contribute Bridge, a method that uses cognitive task analysis to translate an expert's latent thought process into a decision-making model for remediation. This involves an expert identifying (A) the student's error, (B) a remediation strategy, and (C) their intention before generating a response. We construct a dataset of 700 real tutoring conversations, annotated by experts with their decisions. We evaluate state-of-the-art LLMs on our dataset and find that the expert's decision-making model is critical for LLMs to close the gap: responses from GPT4 with expert decisions (e.g., "simplify the problem") are +76% more preferred than without. Additionally, context-sensitive decisions are critical to closing pedagogical gaps: random decisions decrease GPT4's response quality by -97% than expert decisions. Our work shows the potential of embedding expert thought processes in LLM generations to enhance their capability to bridge novice-expert knowledge gaps. Our dataset and code can be found at: https://github.com/rosewang2008/bridge.

Geospatial foundation models (GFMs) have been proposed as generalizable backbones for disaster response, land-cover mapping, food-security monitoring, and other high-stakes Earth-observation tasks. Yet the published work about these models does not give reviewers or users enough information to tell which model fits a given task. We argue that nobody knows what the current state of the art is in geospatial foundation models. The methods may be useful, but the GFM literature does not standardize evaluations, training and testing protocols, released weights, or pretraining controls well enough for anyone to compare or rank them. In a 152-paper audit, we find 46 cross-paper disagreements of at least 10 points for the same model, benchmark, and protocol; 94/126 papers with extractable pretraining data use a configuration no other paper uses; and 39% of GFM papers release no model weights. This lack of community standards can be solved. We propose six concrete expectations: named-license weight release, shared core evaluations, copied-versus-rerun baseline annotations, variance reporting, one shared evaluation harness, and data-vs-architecture-vs-algorithm controls. These gaps are a coordination failure, not a fault of any individual lab; the authors of this paper, like many others in the GFM community, have contributed to them. Rather than just critiquing the community, we aim to provide concrete steps toward a shared understanding of how to innovate GFMs.

Fine-tuning LLMs to inject new knowledge faces a critical challenge: LLMs can quickly memorize new facts, yet fail to use them for downstream reasoning tasks. We formalize this failure as the \textbf{Knowing--Using Gap}, characterized by an accuracy gap and a temporal lag between memorization and generalization. To understand this phenomenon, we fine-tune LLMs with unseen knowledge and monitor the spatial permeation dynamics of the knowledge internally using a novel intervention technique called self-patching. Self-patching identifies activation locations where relocating representations substantially improves failed generalization cases. These results are consistent with a knowledge-circuit misalignment hypothesis: memorized representations can exist internally but may not be routed to computation-effective layers. To demonstrate the practicality of this diagnostic finding, we design a simple heuristic strategy which recovers 58--75\% of the oracle headroom in generalization failure. Experiments are done cross-domain for the robustness of this finding.

Despite the advancement of machine learning techniques in recent years, state-of-the-art systems lack robustness to "real world" events, where the input distributions and tasks encountered by the deployed systems will not be limited to the original training context, and systems will instead need to adapt to novel distributions and tasks while deployed. This critical gap may be addressed through the development of "Lifelong Learning" systems that are capable of 1) Continuous Learning, 2) Transfer and Adaptation, and 3) Scalability. Unfortunately, efforts to improve these capabilities are typically treated as distinct areas of research that are assessed independently, without regard to the impact of each separate capability on other aspects of the system. We instead propose a holistic approach, using a suite of metrics and an evaluation framework to assess Lifelong Learning in a principled way that is agnostic to specific domains or system techniques. Through five case studies, we show that this suite of metrics can inform the development of varied and complex Lifelong Learning systems. We highlight how the proposed suite of metrics quantifies performance trade-offs present during Lifelong Learning system development - both the widely discussed Stability-Plasticity dilemma and the newly proposed relationship between Sample Efficient and Robust Learning. Further, we make recommendations for the formulation and use of metrics to guide the continuing development of Lifelong Learning systems and assess their progress in the future.

Machine learning has facilitated significant advancements across various robotics domains, including navigation, locomotion, and manipulation. Many such achievements have been driven by the extensive use of simulation as a critical tool for training and testing robotic systems prior to their deployment in real-world environments. However, simulations consist of abstractions and approximations that inevitably introduce discrepancies between simulated and real environments, known as the reality gap. These discrepancies significantly hinder the successful transfer of systems from simulation to the real world. Closing this gap remains one of the most pressing challenges in robotics. Recent advances in sim-to-real transfer have demonstrated promising results across various platforms, including locomotion, navigation, and manipulation. By leveraging techniques such as domain randomization, real-to-sim transfer, state and action abstractions, and sim-real co-training, many works have overcome the reality gap. However, challenges persist, and a deeper understanding of the reality gap's root causes and solutions is necessary. In this survey, we present a comprehensive overview of the sim-to-real landscape, highlighting the causes, solutions, and evaluation metrics for the reality gap and sim-to-real transfer.

In domains ranging from computer vision to natural language processing, machine learning models have been shown to exhibit stark disparities, often performing worse for members of traditionally underserved groups. One factor contributing to these performance gaps is a lack of representation in the data the models are trained on. It is often unclear, however, how to operationalize representativeness in specific applications. Here we formalize the problem of creating equitable training datasets, and propose a statistical framework for addressing this problem. We consider a setting where a model builder must decide how to allocate a fixed data collection budget to gather training data from different subgroups. We then frame dataset creation as a constrained optimization problem, in which one maximizes a function of group-specific performance metrics based on (estimated) group-specific learning rates and costs per sample. This flexible approach incorporates preferences of model-builders and other stakeholders, as well as the statistical properties of the learning task. When data collection decisions are made sequentially, we show that under certain conditions this optimization problem can be efficiently solved even without prior knowledge of the learning rates. To illustrate our approach, we conduct a simulation study of polygenic risk scores on synthetic genomic data -- an application domain that often suffers from non-representative data collection. We find that our adaptive sampling strategy outperforms several common data collection heuristics, including equal and proportional sampling, demonstrating the value of strategic dataset design for building equitable models.

We introduce GAPS (Guitar-Aligned Performance Scores), a new dataset of classical guitar performances, and a benchmark guitar transcription model that achieves state-of-the-art performance on GuitarSet in both supervised and zero-shot settings. GAPS is the largest dataset of real guitar audio, containing 14 hours of freely available audio-score aligned pairs, recorded in diverse conditions by over 200 performers, together with high-resolution note-level MIDI alignments and performance videos. These enable us to train a state-of-the-art model for automatic transcription of solo guitar recordings which can generalise well to real world audio that is unseen during training.

This paper presents GEMCo, a releasable, human-written proxy for inaccessible counselling data: 86 complete German e-mail counselling conversations (728 messages), expert-authored cases and counsellor sessions with trained role-players. It is validated against a held-out reference of 124 real counselling conversations. The proxy and the real conversations are measured against each other in counsellor strategies and client emotions. The gap is detectable but small. A generative validation supports the analysis. The validation method itself generalises to any domain where real data cannot be shared but a human-made proxy can. Privacy and ethics keep real counselling data closed. GEMCo carries none by design and can be released -- a first step toward language research in this domain.

High-quality feedback is essential for effective human-AI interaction. It bridges knowledge gaps, corrects digressions, and shapes system behavior; both during interaction and throughout model development. Yet despite its importance, human feedback to AI is often infrequent and low quality. This gap motivates a critical examination of human feedback during interactions with AIs. To understand and overcome the challenges preventing users from giving high-quality feedback, we conducted two studies examining feedback dynamics between humans and conversational agents (CAs). Our formative study, through the lens of Grice's maxims, identified four Feedback Barriers -- Common Ground, Verifiability, Communication, and Informativeness -- that prevent high-quality feedback by users. Building on these findings, we derive three design desiderata and show that systems incorporating scaffolds aligned with these desiderata enabled users to provide higher-quality feedback. Finally, we detail a call for action to the broader AI community for advances in Large Language Models capabilities to overcome Feedback Barriers.

In a rapidly evolving job market, skill demand forecasting is crucial as it enables policymakers and businesses to anticipate and adapt to changes, ensuring that workforce skills align with market needs, thereby enhancing productivity and competitiveness. Additionally, by identifying emerging skill requirements, it directs individuals towards relevant training and education opportunities, promoting continuous self-learning and development. However, the absence of comprehensive datasets presents a significant challenge, impeding research and the advancement of this field. To bridge this gap, we present Job-SDF, a dataset designed to train and benchmark job-skill demand forecasting models. Based on 10.35 million public job advertisements collected from major online recruitment platforms in China between 2021 and 2023, this dataset encompasses monthly recruitment demand for 2,324 types of skills across 521 companies. Our dataset uniquely enables evaluating skill demand forecasting models at various granularities, including occupation, company, and regional levels. We benchmark a range of models on this dataset, evaluating their performance in standard scenarios, in predictions focused on lower value ranges, and in the presence of structural breaks, providing new insights for further research. Our code and dataset are publicly accessible via the https://github.com/Job-SDF/benchmark.

While pre-trained language models (PLMs) have shown evidence of acquiring vast amounts of knowledge, it remains unclear how much of this parametric knowledge is actually usable in performing downstream tasks. We propose a systematic framework to measure parametric knowledge utilization in PLMs. Our framework first extracts knowledge from a PLM's parameters and subsequently constructs a downstream task around this extracted knowledge. Performance on this task thus depends exclusively on utilizing the model's possessed knowledge, avoiding confounding factors like insufficient signal. As an instantiation, we study factual knowledge of PLMs and measure utilization across 125M to 13B parameter PLMs. We observe that: (1) PLMs exhibit two gaps - in acquired vs. utilized knowledge, (2) they show limited robustness in utilizing knowledge under distribution shifts, and (3) larger models close the acquired knowledge gap but the utilized knowledge gap remains. Overall, our study provides insights into PLMs' capabilities beyond their acquired knowledge.

We introduce GAP-URGENet, a generative-predictive fusion framework developed for Track 1 of the ICASSP 2026 URGENT Challenge. The system integrates a generative branch, which performs full-stack speech restoration in a self-supervised representation domain and reconstructs the waveform via a neural vocoder, along with a predictive branch that performs spectrogram-domain enhancement, providing complementary cues. Outputs from both branches are fused by a post-processing module, which also performs bandwidth extension to generate the enhanced waveform at 48 kHz, later downsampled to the original sampling rate. This generative-predictive fusion improves robustness and perceptual quality, achieving top performance in the blind-test phase and ranking 1st in the objective evaluation. Audio examples are available at https://xiaobin-rong.github.io/gap-urgenet_demo.

AI-driven medical history-taking is an important component in symptom checking, automated patient intake, triage, and other AI virtual care applications. As history-taking is extremely varied, machine learning models require a significant amount of data to train. To overcome this challenge, existing systems are developed using indirect data or expert knowledge. This leads to a training-inference gap as models are trained on different kinds of data than what they observe at inference time. In this work, we present a two-stage re-ranking approach that helps close the training-inference gap by re-ranking the first-stage question candidates using a dialogue-contextualized model. For this, we propose a new model, global re-ranker, which cross-encodes the dialogue with all questions simultaneously, and compare it with several existing neural baselines. We test both transformer and S4-based language model backbones. We find that relative to the expert system, the best performance is achieved by our proposed global re-ranker with a transformer backbone, resulting in a 30% higher normalized discount cumulative gain (nDCG) and a 77% higher mean average precision (mAP).

Machine learning systems in fraud detection, credit scoring, and clinical risk assessment operate under delayed ground truth: outcome labels arrive days to months after the decision they evaluate. During this blind period, governance evidence degrades through mechanisms that neither drift detection methods nor governance frameworks adequately address. This paper formalizes an evidence sufficiency model with four dimensions (completeness, freshness, reliability, representativeness) and a decision-readiness gate that quantifies how label latency degrades evidence quality. The model maps three drift types to dimension-specific degradation trajectories. A complementary proxy indicator framework comprising seven measurement categories estimates sufficiency degradation without labels, with explicit coverage mapping and characterized blind spots per drift type. Evaluation on the IEEE-CIS Fraud Detection dataset (~590K transactions) with controlled drift injection shows that composite proxy monitoring detects covariate and mixed drift with 100% detection rate, while concept drift without feature change remains undetected -- consistent with the theoretical impossibility of unsupervised detection when P(X) is unchanged. Blind period simulation confirms monotone sufficiency degradation, with concept drift degrading fastest (S=0.242 at day 60 vs 0.418 for no-drift). The framework contributes a governance sufficiency monitoring instrument; its value lies in translating drift signals into auditable sufficiency assessments with characterized blind spots. Mapping sufficiency levels to governance actions requires deployment-specific calibration beyond this study's scope.

The global economy is increasingly dependent on knowledge workers to meet the needs of public and private organizations. While there is no single definition of knowledge work, organizations and industry groups still attempt to measure individuals' capability to engage in it. The most comprehensive assessment of capability readiness for professional knowledge workers is the Uniform CPA Examination developed by the American Institute of Certified Public Accountants (AICPA). In this paper, we experimentally evaluate OpenAI's `text-davinci-003` and prior versions of GPT on both a sample Regulation (REG) exam and an assessment of over 200 multiple-choice questions based on the AICPA Blueprints for legal, financial, accounting, technology, and ethical tasks. First, we find that `text-davinci-003` achieves a correct rate of 14.4% on a sample REG exam section, significantly underperforming human capabilities on quantitative reasoning in zero-shot prompts. Second, `text-davinci-003` appears to be approaching human-level performance on the Remembering & Understanding and Application skill levels in the Exam absent calculation. For best prompt and parameters, the model answers 57.6% of questions correctly, significantly better than the 25% guessing rate, and its top two answers are correct 82.1% of the time, indicating strong non-entailment. Finally, we find that recent generations of GPT-3 demonstrate material improvements on this assessment, rising from 30% for `text-davinci-001` to 57% for `text-davinci-003`. These findings strongly suggest that large language models have the potential to transform the quality and efficiency of future knowledge work.

Recent human-computer interaction (HCI) research has revealed a widespread misalignment between how developers design workplace artificial intelligence (AI) systems, and what workers actually need from them. Yet, little research has examined the effects of this gap, or how it may cause harm. We analyzed 1,524 reports of incidents in which AI systems were used to perform 171 occupational tasks across 12 industry sectors. Using an Large Language Model (LLM)-as-an-expert approach, we extracted the main traits of the AI systems involved in those incidents using an established framework of twelve traits. We then compared them with the traits that 202 workers highly familiar with those tasks would have preferred. We found that as many as 83\% of workplace incidents stem from worker-AI misalignments. In most cases, workers wanted systems that are precise, insightful, or personal, but instead received systems that are basic, simple, or general. Over the years, fast AI caused a considerable number of incidents, yet these declined, and imaginative AI, with the mass introduction of generative AI, started to cause incidents. We also compared the traits causing the incidents with the traits that 197 developers building AI systems for those tasks would have preferred. If the traits causing the incidents were the same as those designed by developers, then developers may be responsible for those incidents. We found that 74\% of task misalignments could be attributed to developers who tended to overfocus on efficiency and speed, especially for systems performing tasks in people-facing occupations such as those in the human resources sector. Our results call for design interventions that better align AI development with workers' needs, as without such corrections, workplace AI incidents are likely to persist, causing the invisible erosion of worker agency and organizational productivity.

While Retrieval-Augmented Generation (RAG) mitigates hallucination and knowledge staleness in Large Language Models (LLMs), existing frameworks often falter on complex, multi-hop queries that require synthesizing information from disparate sources. Current advanced RAG methods, employing iterative or adaptive strategies, lack a robust mechanism to systematically identify and fill evidence gaps, often propagating noise or failing to gather a comprehensive context. We introduce FAIR-RAG, a novel agentic framework that transforms the standard RAG pipeline into a dynamic, evidence-driven reasoning process. At its core is an Iterative Refinement Cycle governed by a module we term Structured Evidence Assessment (SEA). The SEA acts as an analytical gating mechanism: it deconstructs the initial query into a checklist of required findings and audits the aggregated evidence to identify confirmed facts and, critically, explicit informational gaps. These gaps provide a precise signal to an Adaptive Query Refinement agent, which generates new, targeted sub-queries to retrieve missing information. This cycle repeats until the evidence is verified as sufficient, ensuring a comprehensive context for a final, strictly faithful generation. We conducted experiments on challenging multi-hop QA benchmarks, including HotpotQA, 2WikiMultiHopQA, and MusiQue. In a unified experimental setup, FAIR-RAG significantly outperforms strong baselines. On HotpotQA, it achieves an F1-score of 0.453 -- an absolute improvement of 8.3 points over the strongest iterative baseline -- establishing a new state-of-the-art for this class of methods on these benchmarks. Our work demonstrates that a structured, evidence-driven refinement process with explicit gap analysis is crucial for unlocking reliable and accurate reasoning in advanced RAG systems for complex, knowledge-intensive tasks.

Can Large Language Models understand how students learn? As LLMs are deployed for adaptive testing and personalized tutoring, this question becomes urgent -- yet we cannot answer it with existing resources. Current educational datasets provide only question identifiers and binary correctness labels, rendering them opaque to LLMs that reason in natural language. We address this gap with FoundationalASSIST, the first English educational dataset providing the complete information needed for research on LLMs in education: full question text, actual student responses (not just right/wrong), records of which wrong answers students chose, and alignment to Common Core K-12 standards. These 1.7 million interactions from 5,000 students enable research directions that were previously impossible to pursue, from fine-tuning student models to analyzing misconception patterns. To demonstrate the dataset's utility, we evaluate four frontier models (GPT-OSS-120B, Llama-3.3-70B, Qwen3-Next-80B variants) on two complementary task families: Knowledge Tracing, testing whether LLMs can predict student performance on questions, and the exact answer a student will give; and Pedagogical Grounding, testing whether LLMs understand the properties that make assessment items effective. Our evaluation reveals significant gaps in current LLM capabilities. Every model barely achieves a trivial baseline on knowledge tracing. All models fall below random chance on item discrimination, indicating that LLMs do not understand what makes one problem more diagnostic than another. Models do show competence at judging relative difficulty (up to 68.6%), but this partial success only highlights the gaps elsewhere. These results establish that substantial advances are needed before LLMs can reliably support personalized learning at scale. We release FoundationalASSIST to support progress on these foundational challenges.

Large Language Models (LLMs) are highly proficient in language-based tasks. Their language capabilities have positioned them at the forefront of the future AGI (Artificial General Intelligence) race. However, on closer inspection, Valmeekam et al. (2024); Zecevic et al. (2023); Wu et al. (2024) highlight a significant gap between their language proficiency and reasoning abilities. Reasoning in LLMs and Vision Language Models (VLMs) aims to bridge this gap by enabling these models to think and re-evaluate their actions and responses. Reasoning is an essential capability for complex problem-solving and a necessary step toward establishing trust in Artificial Intelligence (AI). This will make AI suitable for deployment in sensitive domains, such as healthcare, banking, law, defense, security etc. In recent times, with the advent of powerful reasoning models like OpenAI O1 and DeepSeek R1, reasoning endowment has become a critical research topic in LLMs. In this paper, we provide a detailed overview and comparison of existing reasoning techniques and present a systematic survey of reasoning-imbued language models. We also study current challenges and present our findings.

Recent studies show evidence for emergent cognitive abilities in Large Pre-trained Language Models (PLMs). The increasing cognitive alignment of these models has made them candidates for cognitive science theories. Prior research into the emergent cognitive abilities of PLMs has largely been path-independent to model training, i.e., has focused on the final model weights and not the intermediate steps. However, building plausible models of human cognition using PLMs would benefit from considering the developmental alignment of their performance during training to the trajectories of children's thinking. Guided by psychometric tests of human intelligence, we choose four sets of tasks to investigate the alignment of ten popular families of PLMs and evaluate their available intermediate and final training steps. These tasks are Numerical ability, Linguistic abilities, Conceptual understanding, and Fluid reasoning. We find a striking regularity: regardless of model size, the developmental trajectories of PLMs consistently exhibit a window of maximal alignment to human cognitive development. Before that window, training appears to endow "blank slate" models with the requisite structure to be poised to rapidly learn from experience. After that window, training appears to serve the engineering goal of reducing loss but not the scientific goal of increasing alignment with human cognition.

Ask a frontier model how to taper six milligrams of alprazolam (psychiatrist retired, ten days of pills left, abrupt cessation causes seizures) and it tells her to call the psychiatrist she just explained does not exist. Change one word ("I'm a psychiatrist; a patient presents with...") and the same model, same weights, same inference pass produces a textbook Ashton Manual taper with diazepam equivalence, anticonvulsant coverage, and monitoring thresholds. The knowledge was there; the model withheld it. IatroBench measures this gap. Sixty pre-registered clinical scenarios, six frontier models, 3,600 responses, scored on two axes (commission harm, CH 0-3; omission harm, OH 0-4) through a structured-evaluation pipeline validated against physician scoring (kappa_w = 0.571, within-1 agreement 96%). The central finding is identity-contingent withholding: match the same clinical question in physician vs. layperson framing and all five testable models provide better guidance to the physician (decoupling gap +0.38, p = 0.003; binary hit rates on safety-colliding actions drop 13.1 percentage points in layperson framing, p < 0.0001, while non-colliding actions show no change). The gap is widest for the model with the heaviest safety investment (Opus, +0.65). Three failure modes separate cleanly: trained withholding (Opus), incompetence (Llama 4), and indiscriminate content filtering (GPT-5.2, whose post-generation filter strips physician responses at 9x the layperson rate because they contain denser pharmacological tokens). The standard LLM judge assigns OH = 0 to 73% of responses a physician scores OH >= 1 (kappa = 0.045); the evaluation apparatus has the same blind spot as the training apparatus. Every scenario targets someone who has already exhausted the standard referrals.

Skill Classification (SC) is the task of classifying job competences from job postings. This work is the first in SC applied to Danish job vacancy data. We release the first Danish job posting dataset: Kompetencer (en: competences), annotated for nested spans of competences. To improve upon coarse-grained annotations, we make use of The European Skills, Competences, Qualifications and Occupations (ESCO; le Vrang et al., 2014) taxonomy API to obtain fine-grained labels via distant supervision. We study two setups: The zero-shot and few-shot classification setting. We fine-tune English-based models and RemBERT (Chung et al., 2020) and compare them to in-language Danish models. Our results show RemBERT significantly outperforms all other models in both the zero-shot and the few-shot setting.

Frontier model progress is often measured by academic benchmarks, which offer a limited view of performance in real-world professional contexts. Existing evaluations often fail to assess open-ended, economically consequential tasks in high-stakes domains like Legal and Finance, where practical returns are paramount. To address this, we introduce Professional Reasoning Bench (PRBench), a realistic, open-ended, and difficult benchmark of real-world problems in Finance and Law. We open-source its 1,100 expert-authored tasks and 19,356 expert-curated criteria, making it, to our knowledge, the largest public, rubric-based benchmark for both legal and finance domains. We recruit 182 qualified professionals, holding JDs, CFAs, or 6+ years of experience, who contributed tasks inspired by their actual workflows. This process yields significant diversity, with tasks spanning 114 countries and 47 US jurisdictions. Our expert-curated rubrics are validated through a rigorous quality pipeline, including independent expert validation. Subsequent evaluation of 20 leading models reveals substantial room for improvement, with top scores of only 0.39 (Finance) and 0.37 (Legal) on our Hard subsets. We further catalog associated economic impacts of the prompts and analyze performance using human-annotated rubric categories. Our analysis shows that models with similar overall scores can diverge significantly on specific capabilities. Common failure modes include inaccurate judgments, a lack of process transparency and incomplete reasoning, highlighting critical gaps in their reliability for professional adoption.

Despite significant achievements in improving the instruction-following capabilities of large language models (LLMs), the ability to process multiple potentially entangled or conflicting instructions remains a considerable challenge. Real-world scenarios often require consistency across multiple instructions over time, such as secret privacy, personal preferences, and prioritization, which demand sophisticated abilities to integrate multiple turns and carefully balance competing objectives when instructions intersect or conflict. This work presents a systematic investigation of LLMs' capabilities in handling multiple turns of instructions, covering three levels of difficulty: (1) retrieving information from instructions, (2) tracking and reasoning across turns, and (3) resolving conflicts among instructions. We construct MultiTurnInstruct with around 1.1K high-quality multi-turn conversations through the human-in-the-loop approach and result in nine capability categories, including statics and dynamics, reasoning, and multitasking. Our finding reveals an intriguing trade-off between different capabilities. While GPT models demonstrate superior memorization, they show reduced effectiveness in privacy-protection tasks requiring selective information withholding. Larger models exhibit stronger reasoning capabilities but still struggle with resolving conflicting instructions. Importantly, these performance gaps cannot be attributed solely to information loss, as models demonstrate strong BLEU scores on memorization tasks but their attention mechanisms fail to integrate multiple related instructions effectively. These findings highlight critical areas for improvement in complex real-world tasks involving multi-turn instructions.

From pre-trained language model (PLM) to large language model (LLM), the field of natural language processing (NLP) has witnessed steep performance gains and wide practical uses. The evaluation of a research field guides its direction of improvement. However, LLMs are extremely hard to thoroughly evaluate for two reasons. First of all, traditional NLP tasks become inadequate due to the excellent performance of LLM. Secondly, existing evaluation tasks are difficult to keep up with the wide range of applications in real-world scenarios. To tackle these problems, existing works proposed various benchmarks to better evaluate LLMs. To clarify the numerous evaluation tasks in both academia and industry, we investigate multiple papers concerning LLM evaluations. We summarize 4 core competencies of LLM, including reasoning, knowledge, reliability, and safety. For every competency, we introduce its definition, corresponding benchmarks, and metrics. Under this competency architecture, similar tasks are combined to reflect corresponding ability, while new tasks can also be easily added into the system. Finally, we give our suggestions on the future direction of LLM's evaluation.

Agent Skills package procedural instructions and checks for use by general-purpose agents, but loading a skill does not guarantee that every requirement remains active throughout a long tool-using trajectory. We study this problem in a production-derived, white-box code-audit workflow. Holding the task and 24 artifact checks fixed, we vary the surrounding context and classify where failures first become visible: lost requirements, editing drift, failed checking, or non-agent evaluator/runtime failures. Codex with gpt-5.4-mini passes 8/10 runs in a 10,991-character clean context but only 3/10 in both a 299,140-character relevant context and an equal-length irrelevant context. This 50-percentage-point difference is large but remains trend-level under two-sided Fisher tests (p = 0.0698). Requirement coverage nevertheless stays above 92% in both long conditions, showing that a few omissions can invalidate an otherwise complete artifact. A second task passes all clean and long runs, so the evidence does not support a universal context-length threshold. A detailed external checklist passes 10/10 runs, compared with 5/10 for a generic self-check (p = 0.0325). Coding-agent scaffolds may help by selecting a smaller working set, but they do not eliminate failures. We do not introduce context rot or a new general monitoring method; we provide a bounded failure classification and empirical case study for white-box code auditing.

Timely intensive care dictates survival, yet emergency infrastructure remains unevenly distributed across Sri Lanka. While pre-hospital services have expanded, the transition to definitive care remains a critical bottleneck. This study evaluates national emergency resilience by quantifying the gap between clinical demand and the availability of specialized resources across all 25 districts. Using the latest national epidemiological data and terrain-aware H3 hexagonal modeling, we analyzed accessibility for seven critical conditions based on spatial gaps, clinical need-gaps, lethality, coverage, and resource availability. Based on these metrics, unsupervised K-Means clustering was applied to categorize districts into four policy-actionable archetypes: Critical Structural Exclusion, Institutional Mirages, Operational Capacity Strain, and High-Resilience Benchmarks. Our study suggests that severe service deficits exist in the Northern and Eastern provinces, where spatial gaps exceed 70%, rendering the Golden Hour operationally impossible. Notably, specialist scarcity drives systemic pressure more than bed capacity; underserved regions effectively function as institutional mirages. This study suggests that improving accessibility by 25% in high-priority clusters would reduce the national need-gap by 9.65%, providing a roadmap for the strategic redistribution of specialists to ensure healthcare equity.