A Unified XAI-LLM Approach for EndotrachealSuctioning Activity Recognition

Endotracheal suctioning (ES) is an invasive yet essential clinical procedure that requires a high degree of skill to minimize patient risk - particularly in home care and educational settings, where consistent supervision may be limited. Despite its critical importance, automated recognition and feedback systems for ES training remain underexplored. To address this gap, this study proposes a unified, LLM-centered framework for video-based activity recognition benchmarked against conventional machine learning and deep learning approaches, and a pilot study on feedback generation. Within this framework, the Large Language Model (LLM) serves as the central reasoning module, performing both spatiotemporal activity recognition and explainable decision analysis from video data. Furthermore, the LLM is capable of verbalizing feedback in natural language, thereby translating complex technical insights into accessible, human-understandable guidance for trainees. Experimental results demonstrate that the proposed LLM-based approach outperforms baseline models, achieving an improvement of approximately 15-20\% in both accuracy and F1 score. Beyond recognition, the framework incorporates a pilot student-support module built upon anomaly detection and explainable AI (XAI) principles, which provides automated, interpretable feedback highlighting correct actions and suggesting targeted improvements. Collectively, these contributions establish a scalable, interpretable, and data-driven foundation for advancing nursing education, enhancing training efficiency, and ultimately improving patient safety.

Summary of the Unusual Activity Recognition Challenge for Developmental Disability Support

This paper presents an overview of the Recognize the Unseen: Unusual Behavior Recognition from Pose Data Challenge, hosted at ISAS 2025. The challenge aims to address the critical need for automated recognition of unusual behaviors in facilities for individuals with developmental disabilities using non-invasive pose estimation data. Participating teams were tasked with distinguishing between normal and unusual activities based on skeleton keypoints extracted from video recordings of simulated scenarios. The dataset reflects real-world imbalance and temporal irregularities in behavior, and the evaluation adopted a Leave-One-Subject-Out (LOSO) strategy to ensure subject-agnostic generalization. The challenge attracted broad participation from 40 teams applying diverse approaches ranging from classical machine learning to deep learning architectures. Submissions were assessed primarily using macro-averaged F1 scores to account for class imbalance. The results highlight the difficulty of modeling rare, abrupt actions in noisy, low-dimensional data, and emphasize the importance of capturing both temporal and contextual nuances in behavior modeling. Insights from this challenge may contribute to future developments in socially responsible AI applications for healthcare and behavior monitoring.