# Trainee Action Recognition through Interaction Analysis in CCATT Mixed-Reality Training

arXiv: https://arxiv.org/abs/2509.17888 · HTML: https://mlsanity.com/paper/2509.17888/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 6 of its 28 references that are in the map.
- First posted on arXiv 22 Sep 2025.

## Builds on (most cited first, 6 of 6)

- [You Only Look Once: Unified, Real-Time Object Detection](https://mlsanity.com/paper/1506.02640/) (2015)
- [Mining the Benefits of Two-stage and One-stage HOI Detection](https://mlsanity.com/paper/2108.05077/) (2021)
- [HOICLIP: Efficient Knowledge Transfer for HOI Detection with Vision-Language Models](https://mlsanity.com/paper/2303.15786/) (2023)
- [Exploring Predicate Visual Context in Detecting Human-Object Interactions](https://mlsanity.com/paper/2308.06202/) (2023)
- [NurViD: A Large Expert-Level Video Database for Nursing Procedure Activity Understanding](https://mlsanity.com/paper/2310.13347/) (2023)
- [Multimodal Transformer for Nursing Activity Recognition](https://mlsanity.com/paper/2204.04564/) (2022)

## Built on by (most cited first, 1 of 1)

- [Diagnosis of Human Object Interaction Detectors for Real World Educational Applications](https://mlsanity.com/paper/2606.02789/) (2026)

## Abstract (arXiv)

This study examines how Critical Care Air Transport Team (CCATT) members are trained using mixed-reality simulations that replicate the high-pressure conditions of aeromedical evacuation. Each team - a physician, nurse, and respiratory therapist - must stabilize severely injured soldiers by managing ventilators, IV pumps, and suction devices during flight. Proficient performance requires clinical expertise and cognitive skills, such as situational awareness, rapid decision-making, effective communication, and coordinated task management, all of which must be maintained under stress. Recent advances in simulation and multimodal data analytics enable more objective and comprehensive performance evaluation. In contrast, traditional instructor-led assessments are subjective and may overlook critical events, thereby limiting generalizability and consistency. However, AI-based automated and more objective evaluation metrics still demand human input to train the AI algorithms to assess complex team dynamics in the presence of environmental noise and the need for accurate re-identification in multi-person tracking. To address these challenges, we introduce a systematic, data-driven assessment framework that combines Cognitive Task Analysis (CTA) with Multimodal Learning Analytics (MMLA). We have developed a domain-specific CTA model for CCATT training and a vision-based action recognition pipeline using a fine-tuned Human-Object Interaction model, the Cascade Disentangling Network (CDN), to detect and track trainee-equipment interactions over time. These interactions automatically yield performance indicators (e.g., reaction time, task duration), which are mapped onto a hierarchical CTA model tailored to CCATT operations, enabling interpretable, domain-relevant performance evaluations.