首个评估医学操作视频中流程状态演进的基准，揭示大模型在连续动作判断上的严重不足。

Current video benchmarks for multimodal large language models (MLLMs) focus on event recognition, temporal ordering, and long-context recall, but overlook a harder capability required for expert procedural judgment: tracking how ongoing interactions update the procedural state and thereby determine the correctness of later actions. We introduce SiMing-Bench, the first benchmark for evaluating this capability from full-length clinical skill videos. It targets rubric-grounded process-level judgment of whether interaction-driven state updates preserve procedural correctness across an entire workflow. SiMing-Bench is instantiated with SiMing-Score, a physician-annotated dataset of real clinical skill examination videos spanning cardiopulmonary resuscitation, automated external defibrillator operation, and bag-mask ventilation, each paired with a standardized step-wise rubric and dual-expert labels. Across diverse open- and closed-source MLLMs, we observe consistently weak agreement with physician judgments. Moreover, weak performance on rubric-defined intermediate steps persists even when overall procedure-level correlation appears acceptable, suggesting that coarse global assessment substantially overestimates current models' procedural judgment ability. Additional analyses with binary step judgment and step-aligned clips indicate that the bottleneck is not merely fine-grained scoring or temporal localization, but modeling how continuous interactions update procedural state over time.