Actionable Real-Time Modeling of Surgical Team Dynamics via Time-Expanded Interaction Graphs

Surgical team performance arises from complex interactions between technical execution and non-technical skills, including communication and coordination dynamics. However, current surgical AI systems predominantly model visual workflow signals, lacking structured representations of intraoperative team interactions over time. We propose a real-time actionable approach for modeling surgical team dynamics using time-expanded interaction graphs, where team members are modeled as time-indexed nodes and communication exchanges define directed edges. This spatio-temporal expansion enables dynamic interaction modeling, while allowing efficient inference with a static graph neural network. The model predicts procedural efficiency as the deviation from the expected duration and supports real-time deployment. Beyond prediction, we perform a counterfactual analysis to identify minimal changes in communication structure and interpretable behavioral variables associated with improved predicted outcomes. Experiments on recorded surgical procedures show that structured modeling of team interactions improves early identification of prolonged interventions and provides coherent, actionable explanations. This work advances surgical AI toward real-time, team-aware, and actionable decision support in the operating room.

Boosting Team Modeling through Tempo-Relational Representation Learning

Team modeling remains a fundamental challenge at the intersection of Artificial Intelligence and the Social Sciences. Social Science research emphasizes the need to jointly model dynamics and relations, while practical applications demand unified models capable of inferring multiple team constructs simultaneously, providing interpretable insights and actionable recommendations to enhance team performance. However, existing works do not meet these practical demands. To bridge this gap, we present TRENN, a novel tempo-relational architecture that integrates: (i) an automatic temporal graph extractor, (ii) a tempo-relational encoder, (iii) a decoder for team construct prediction, and (iv) two complementary explainability modules. TRENN jointly captures relational and temporal team dynamics, providing a solid foundation for MT-TRENN, which extends TReNN by replacing the decoder with a multi-task head, enabling the model to learn shared Social Embeddings and simultaneously predict multiple team constructs, including Emergent Leadership, Leadership Style, and Teamwork components. Experimental results demonstrate that our approach significantly outperforms approaches that rely exclusively on temporal or relational information. Additionally, experimental evaluation has shown that the explainability modules integrated in MT-TRENN yield interpretable insights and actionable suggestions to support team improvement. These capabilities make our approach particularly well-suited for Human-Centered AI applications, such as intelligent decision-support systems in high-stakes collaborative environments.

xAI-Drop: Don't Use What You Cannot Explain

Graph Neural Networks (GNNs) have emerged as the predominant paradigm for learning from graph-structured data, offering a wide range of applications from social network analysis to bioinformatics. Despite their versatility, GNNs face challenges such as oversmoothing, lack of generalization and poor interpretability, which hinder their wider adoption and reliability in critical applications. Dropping has emerged as an effective paradigm for reducing noise during training and improving robustness of GNNs. However, existing approaches often rely on random or heuristic-based selection criteria, lacking a principled method to identify and exclude nodes that contribute to noise and over-complexity in the model. In this work, we argue that explainability should be a key indicator of a model's robustness throughout its training phase. To this end, we introduce xAI-Drop, a novel topological-level dropping regularizer that leverages explainability to pinpoint noisy network elements to be excluded from the GNN propagation mechanism. An empirical evaluation on diverse real-world datasets demonstrates that our method outperforms current state-of-the-art dropping approaches in accuracy, effectively reduces over-smoothing, and improves explanation quality.