Current large language models (LLMs) have demonstrated emerging capabilities in social intelligence tasks, including implicature resolution and theory-of-mind reasoning, both of which require substantial pragmatic understanding. However, how LLMs acquire this pragmatic competence throughout the training process remains poorly understood. In this work, we introduce ALTPRAG, a dataset grounded in the pragmatic concept of alternatives, to evaluate whether LLMs at different training stages can accurately infer nuanced speaker intentions. Each instance pairs two equally plausible yet pragmatically divergent continuations and requires the model to (i) infer the speaker’s intended meaning and (ii) explain when and why a speaker would choose one utterance over its alternative, thus directly probing pragmatic competence through contrastive reasoning. We systematically evaluate 22 LLMs across three key training stages: after pre-training, supervised fine-tuning (SFT), and preference optimization, to examine the development of pragmatic competence. Our results show that even base models exhibit notable sensitivity to pragmatic cues, which improves consistently with increases in model and data scale. Additionally, SFT and RLHF contribute further gains, particularly in cognitive-pragmatic scenarios. These findings highlight pragmatic competence as an emergent and compositional property of LLM training and offer new insights for aligning models with human communicative norms.

Large Language Models (LLMs) have significantly advanced healthcare innovation on generation capabilities. However, their application in real clinical settings is challenging due to potential deviations from medical facts and inherent biases. In this work, we develop an augmented LLM framework, KG-Rank, which leverages a medical knowledge graph (KG) with ranking and re-ranking techniques, aiming to improve free-text question-answering (QA) in the medical domain. Specifically, upon receiving a question, we initially retrieve triplets from a medical KG to gather factual information. Subsequently, we innovatively apply ranking methods to refine the ordering of these triplets, aiming to yield more precise answers. To the best of our knowledge, KG-Rank is the first application of ranking models combined with KG in medical QA specifically for generating long answers. Evaluation of four selected medical QA datasets shows that KG-Rank achieves an improvement of over 18% in the ROUGE-L score. Moreover, we extend KG-Rank to open domains, where it realizes a 14% improvement in ROUGE-L, showing the effectiveness and potential of KG-Rank.