Patient-clinician communication research is crucial for understanding interaction dynamics and for predicting outcomes that are associated with clinical discourse. Traditionally, interaction analysis is conducted manually because of challenges such as Speaker Role Identification (SRI), which must reliably differentiate between doctors, medical assistants, patients, and other caregivers in the same room. Although automatic speech recognition with diarization can efficiently create a transcript with separate labels for each speaker, these systems are not able to assign roles to each person in the interaction. Previous SRI studies in task-oriented scenarios have directly predicted roles using linguistic features, bypassing diarization. However, to our knowledge nobody has investigated SRI in clinical settings. We explored whether Large Language Models (LLMs) such as BERT could accurately identify speaker roles in clinical transcripts, with and without diarization. We used veridical turn segmentation and diarization identifiers, fine-tuning each model at varying levels of identifier corruption to assess impact on performance. Our results demonstrate that BERT achieves high performance with linguistic signals alone (82% accuracy/82% F1-score), while incorporating accurate diarization identifiers further enhances accuracy (95%/95%). We conclude that fine-tuned LLMs are effective tools for SRI in clinical settings.

The authors have declared no competing interest.

This work was funded by the National Institutes of Health Pioneer Award (Dr. Johnson) DP1-LM-014558.

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This study utilized transcripts containing protected health information (PHI) from the EF dataset, under a Data Use Agreement between the University of Washington (UW) and the University of Pennsylvania (UPenn). The protocol was approved by the UW IRB (STUDY000005436), listing UPenn as the relying institution via the SMART Master Reliance Agreement.

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Email: jangkjseas.upenn.edu, sabinjauw.edu, andreahuw.edu, Basam.AlasalyPennMedicine.upenn.edu, Sriharsha.MopideviPennMedicine.upenn.edu, Kevin.Johnson1PennMedicine.upenn.edu

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