Mutual Information-based Teamwork Evaluation in Real Environment: Exploratory Investigation with Professional Surgeons

Vincenzo Ronca^1,2*Lidia Castagneto Gissey³Maria Irene Bellini³Alessandra Iodice³Pietro Aricò^1,2Gianluca Di Flumeri^1,4Andrea Giorgi^1,5Alessia Vozzi^1,5Rossella Capotorto⁵Stefano Bonelli⁶Laura Moens⁶Fabio Babiloni^1,7,8Giovanni Casella³Gianluca Borghini^1,9

• ¹BrainSigns, Rome, Lazio, Italy
• ²Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy, Rome, Italy
• ³Department of Surgery, Policlinico Umberto I, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy, Rome, Italy
• ⁴Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Lazio, Italy
• ⁵Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy, Rome, Italy
• ⁶DeepBlue srl, Rome, Italy
• ⁷Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy, Rome, Italy
• ⁸Department of Computer Science, Hangzhou Dianzi University, Hangzhou 310018, China, Hangzhou, China
• ⁹Department of Molecular Medicine, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Lazio, Italy

Purpose: Teamwork involves intricate interactions among individuals or groups with shared goals. It necessitates effective communication, defined roles, decision-making, and allocation of cognitive and emotional resources. Objective teamwork assessment demands a comprehensive set of metrics. While subjective and behavioural metrics, like self-evaluation and task completion time, are generally employed, they are prone to bias and lack of objectivity, acknowledging the inherent limitations in capturing the unconscious processes of human behaviour. Method: To mitigate this limitation, the present study proposed a novel approach for the teamwork evaluation based on neurophysiological signals (Electroencephalogram - EEG) compatible with real world applications, i.e., surgical teams engaged in real surgery. At the best of our knowledge, there are no scientific evidence of an objective teamwork measure performed among more than two members and relying on neurophysiological signals in real environments. Therefore, the present work aimed at i) developing and investigating the This is a provisional file, not the final typeset article reliability of an objective EEG-based Teamwork index employing Mutual Information (MI) methods; and ii) providing additional and objective insights to the surgeons' supervisors in healthcare training. Finding: The results demonstrated the capability of the EEG – based training index in providing additional and objective information, and its added-values and reliability with respect to conventional measures (all R > 0.62, all p < 0.002). Furthermore, the EEG – based Teamwork index allowed to determine (all p < 0.001) surgeons' experience level (Expert vs. Novice) in terms of cooperative behaviour. Conclusion: The results pave opportunities for targeted interventions, adaptive training sessions, and optimizations in team dynamics, and open up opportunities for applying neurophysiological measurements for teamwork evaluation in all operational fields where a proper and granular teamwork optimization could play a crucial role in terms of safety.