Despite the wide adoption of Large Language Models (LLM)s, clinical decision support systems face a critical challenge: achieving high predictive accuracy while generating explanations aligned with those predictions. Current approaches suffer from exposure bias, leading to misaligned explanations. We propose Reason2Decide, a two-stage training framework that addresses key challenges in self-rationalization, including exposure bias and task separation. In Stage-1, our model is trained on rationale generation, while in Stage-2, we jointly train on label prediction and rationale generation, applying scheduled sampling to gradually transition from conditioning on gold labels to model predictions. We evaluate Reason2Decide on three medical datasets, including a proprietary triage dataset and public biomedical QA datasets. Across model sizes, Reason2Decide outperforms other fine-tuned baselines and some zero-shot LLMs in prediction (F1) and rationale fidelity (BERTScore, BLEU, LLM-as-a-Judge). In triage, Reason2Decide is rationale source-robust across LLM-generated, nurse-authored, and nurse-post-processed rationales. In our experiments, while using only LLM-generated rationales in Stage-1, Reason2Decide outperforms other fine-tuned variants. This indicates that LLM-generated rationales are suitable for pretraining models, reducing reliance on human annotations. Remarkably, Reason2Decide achieves these gains with models 40x smaller than contemporary foundation models, making clinical reasoning more accessible for resource-constrained deployments while still providing explainable decision support.

Mobile GUI agents can execute tasks from natural-language instructions, but their evaluation remains difficult to make both realistic and reproducible. Existing benchmarks typically trade off these goals: simplified apps lack real-world mobile complexity, whereas live commercial apps introduce uncontrolled variation from recommendations, advertisements, accounts, and changing content. We propose AppSim-Bench, which addresses this trade-off through controllable simulated apps that preserve task-relevant interaction logic while supporting deterministic evaluation. Built through a coding-agent-assisted and human-verified workflow, it contains 557 tasks across 17 high-frequency Chinese and English apps. Its controllable backend data and outcome-based verification remove major sources of environmental stochasticity, enabling reproducible cross-model comparison. Evaluating 19 GUI agents, spanning general-purpose and GUI-specialized systems, we find that autonomous mobile execution remains far from solved. The best model completes only 50.27% of tasks, and 28.55% of tasks are not solved by any agent. Further analysis shows that failures concentrate in longer workflows, numerical reasoning tasks, and inefficient trajectories marked by high action overhead and budget exhaustion. Our project is available at https://github.com/Acrab-Lab/AppSim.