Scalable LLM-based Coding of Dialogue in Healthcare Simulation: Balancing Coding Performance, Processing Time, and Environmental Impact

TL;DR

This study explores how prompt design and batching strategies for LLMs can optimize dialogue coding in healthcare simulations, balancing accuracy, speed, and environmental impact.

Contribution

It provides practical guidelines for using LLMs to automate dialogue analysis efficiently in real-time healthcare education settings.

Findings

Larger batch sizes increase processing speed and reduce energy consumption.

Higher batch sizes negatively affect coding accuracy.

Optimized prompt and batching strategies can balance performance, speed, and sustainability.

Abstract

Research shows that dialogue, the interactive process through which participants articulate their thinking, plays a central role in constructing shared understanding, coordinating action, and shaping learning outcomes in teams. Analysing dialogue content has been central to advancing team learning theory and informing the design of computer-supported collaborative learning environments, yet this progress has depended on labour-intensive qualitative coding. LLMs offer new possibilities for automating and enhancing the dialogue layer within emerging multimodal learning analytics approaches, with recent studies showing that they can approximate human coding through few-shot prompting. However, prior work has focused on replicating human coding accuracy for research purposes, rather than addressing a more educationally consequential question: how can we design prompts that allow an LLM to label team dialogue accurately and fast enough to be useful in real settings, such as in-person healthcare simulations, where results must be returned quickly and computational cost and sustainability also matter? This paper investigates how prompt design and batching strategies can be optimised to balance coding accuracy, processing time, and environmental impact in team-based healthcare simulation debriefing. Using a dataset of 11,647 utterances coded across 6 dialogue constructs, we compared 4 prompt designs across varying batch sizes, evaluating coding performance, processing time, and energy consumption, as well as the trade-offs between these metrics. Results indicate that increasing batch size improves speed and reduces energy use, but negatively impacts coding performance. Beyond demonstrating the feasibility of LLM-based qualitative analysis, this study offers practical guidance for scaling dialogue analytics in contexts where timeliness, privacy, and sustainability are critical.