Looking Beyond the Scale: Do Surgical Skill Models Learn Transferable Representations Across Assessment Rubrics?
Hanna HoffmannFelix von BechtolsheimStefanie SpeidelRebecca Hisey
Aug 2026
Machine LearningComputer Vision
Abstract
Vision-based surgical skill assessment has shown strong in-domain results, yet a fundamental question remains unasked: do these models learn transferable representations of surgical proficiency, or do they merely encode dataset-specific visual patterns?
This paper systematically analyzes what limits cross-domain skill transfer between the GOALS and OSATS assessment scales using the LASANA and JIGSAWS datasets. Each evaluated method serves a targeted diagnostic purpose: end-to-end training to test whether supervised skill learning transfers directly, Adaptive Sharpness-Aware Minimization (ASAM) to probe whether flatter loss landscapes improve generalization, and augmentation-based self-supervised and contrastive learning to assess whether domain-invariant pretraining decouples skill from visual context. Transfer is evaluated in both directions using a disjoint-participant held-out test set for JIGSAWS.
Results reveal an asymmetry: backbones pretrained on JIGSAWS achieve CCC values of 0.77 to 0.80 on LASANA, closely matching the end-to-end baseline, showing cross-rubric transfer is feasible when the target domain provides consistent supervision. Transfer to JIGSAWS fails across all methods, likely due to annotation inconsistencies. Control experiments with a Kinetics-pretrained backbone suggest task-specific heads carry the majority of the skill prediction burden, while the backbone need only provide adequate spatiotemporal features.
These findings offer a new perspective on vision-based skill assessment: the central question of whether skill representations transfer across scoring systems has not been previously investigated. Results indicate the visual component is dominant but not solely responsible for skill prediction; further work is needed to conclusively disentangle transferable skill features from those bound to a specific visual domain.
This work introduces a pioneering exploration of Self-Supervised Learning (SSL) within the SNN, and proposes a novel Spiking Self-Attention (SSA) and Spiking Transformer (Spikformer) that achieves 80+% accuracy on ImageNet.
Zhaokun Zhou, Kaiwei Che, Wei Fang et al.· arXiv.org· 69 citations· ⚡10
EquiPocket is proposed, an E(3)-equivariant Graph Neural Network for binding site prediction, which comprises three modules: the first one to extract local geometric information for each surface atom, the second one to model both the chemical and spatial structure of protein and the last one to capture the geometry of the surface via equivariant message passing over the surface atoms.
Yang Zhang, Wenbing Huang, Zhewei Wei et al.· International Conference on...· 43 citations· ⚡4
It is shown that the maximum hypergraph density of any multiclass hypothesis class is upper-bounded by its DS dimension, which proves a longstanding conjecture of Daniely and Shalev-Shwartz (2014) and determines the optimal dependence of the sample complexity on the DS dimension for multiclass as well as list learning.
Quantum measurements are the means by which we recover messages encoded into quantum states. They are at the forefront of quantum hypothesis testing, wherein the goal is to perform an optimal measurement for arriving at a correct conclusion. Mathematically, a measurement operator is Hermitian with eigenvalues in [0,1]. By noticing that this constraint on each eigenvalue is the same as that imposed on fermions by the Pauli exclusion principle, we interpret every eigenmode of a measurement operator as an independent effective fermionic mode. Under this perspective, various objective functions in quantum hypothesis testing can be viewed as the total expected energy associated with these fermionic occupation numbers. By instead fixing a temperature and minimizing the total expected fermionic free energy, we find that optimal measurements for these modified objective functions are Fermi-Dirac thermal measurements, wherein their eigenvalues are specified by Fermi-Dirac distributions. In the low-temperature limit, their performance closely approximates that of optimal measurements for quantum hypothesis testing, and we show that their parameters can be learned by classical or hybrid quantum-classical optimization algorithms. This leads to a new quantum machine-learning model, termed Fermi-Dirac machines, consisting of parameterized Fermi-Dirac thermal measurements-an alternative to quantum Boltzmann machines based on thermal states. Beyond hypothesis testing, we show how general semidefinite optimization problems can be solved using this approach, leading to a novel paradigm for semidefinite optimization on quantum computers, in which the goal is to implement thermal measurements rather than prepare thermal states. Finally, we propose quantum algorithms for implementing Fermi-Dirac thermal measurements, and we also propose second-order hybrid quantum-classical optimization algorithms.
This systematic review evaluates 55 studies from 2017 to 2023 on the application of machine learning techniques to ASD, highlighting key challenges and opportunities, particularly the need for models that can integrate complex data to improve diagnostic accuracy and treatment outcomes.
Rafael Muñoz-Terol, Jesús Peral, Sandra Amador et al.· Heliyon· 4 citations· ⚡1
This paper identifies two different routes through which models can acquire geometrically separable features: they can learn them from complementary co-occurrence signals in general language data, including text-number co-occurrence and cross-number interaction, or from multi-token addition problems.
A new method for surgically removing training examples from a model reveals that as datasets grow, the link between what a model learns and what it produces dissolves.
