Cognitive and motor improvement by tummy time practice in preemies from low-income settings: a randomized clinical trial.

Introduction: Early intervention and parental education for preemies are limited in some low-income countries. Thus, this study aimed to assess whether daily tummy time (TT) associated with usual care (UC) enhances motor and cognitive development in preemies from low-income countries. The main and secondary aim was to assess prone head elevation (PHE) and motor and cognitive functions, respectively. Methods: Thirty-one preemies with a mean gestational age at birth of 33.3 ± 1.6 weeks and weighing <2,500 g were included and 18 completed all assessments. Parents from the TT group were asked to perform TT with their preemies for at least 20 min during daily activities and playtime. Motor and cognitive functions were assessed by a blinded examiner using the motor and cognitive composite scores of Bayley-III after two and four months of corrected age. PHE was given by the angle from the tragus of the ear to the supporting surface of the infant; measurements were obtained using the Kinovea® software at baseline, after two, three, and four months of corrected age. Results: The Bayley-III motor composite score of the TT group was higher than the UC group after two and four months of corrected age. The PHE angle increased over time but did not differ between groups. Discussion: Nevertheless, TT expanded the perspective of preemies to explore their bodies and environment, favoring the stimuli for motor and cognitive patterns. The loss of participants (31%) was one of the limitations of the study, illustrating the challenge of providing continued early interventions to preemies from low-income countries. In this sense, TT practice is a home intervention that may improve motor and cognitive function of preemies immediately after hospital discharge.

Zone In Not Out! The Key to Winning High-Level Tetris.

Automating a perceptual-motor task will not win you a perceptual-motor contest. Despite claims that mindless automaticity is the essence of expertise, the view espoused here is that automaticity is worthwhile only because it enables the expert to plan and strategize. Indeed, the purpose of learning to manually shift gears is to eventually ignore that function to focus instead on actual driving. To perform well, the expert must transition their attention from a task's low-level components to its high-level nuances. This is best understood in real-world scenarios (e.g. driving, in which performance is dynamic and sometimes competitive). This argument is based on a years-long, longitudinal case study of learning to play the puzzle game, Tetris. Tetris is intensively perceptual-motor with complicated manual routines needed to manage expert game speeds. For this case study, the player began as an advanced novice but successfully transitioned to championship level in the 2020 Classic Tetris World Championship. Initially, the challenge was gaining enough skill to make and execute perceptual-motor decisions in a fraction of a second. However, once that process became automatic, the player could spend those freed mental resources elsewhere. Performance was better for all games when the player was mentally engaged and used their focused attention to plan ahead rather than just automatically respond to the game pieces. We argue that the end goal for automating perceptual-motor skills in competitive, dynamic environments is to free cognitive space in the brain for the user to excel strategically.

Developing veterinary basic clinical skill items based on Korean Veterinary Entrustable Professional Activity.

IMPORTANCE: Developing clinical skills is an essential element of veterinary education to ensure the competency of veterinary graduates. Although the Korean Veterinary Education Graduation Competencies were established in 2016, reflecting domestic needs and international trends in competency-based veterinary education, they have yet to be implemented in Korean veterinary education. OBJECTIVE: This study aimed to establish the basic veterinary clinical skills required to ensure graduates of Korean veterinary universities have the day-one competency to independently perform their professional duties. METHODS: The Education Committee of the Korean Association of Veterinary Medical Colleges, composed of veterinary school professors and an experienced veterinarian in the clinic, reviewed domestic and international veterinary education-related materials to define basic clinical skills. RESULTS: The Korean Veterinarian Entrustable Professional Activities (KVEPA) was introduced, followed by the subsequent development of 54 essential clinical skills based on the KVEPA. CONCLUSIONS AND RELEVANCE: The veterinary basic clinical skills established through this study can be used as a specific guide for clinical education in Korean veterinary school, and is expected to play an important role in meeting the needs of the educational sector of the veterinary education accreditation standards.

Enhancing motor skill learning through multiple sessions of online high-definition transcranial direct current stimulation in healthy adults: insights from EEG power spectrum.

The purpose of this study was to evaluate the influence of high-definition transcranial direct current stimulation (HD-tDCS) on finger motor skill acquisition. Thirty-one healthy adult males were randomly assigned to one of three groups: online HD-tDCS (administered during motor skill learning), offline HD-tDCS (delivered before motor skill learning), and a sham group. Participants engaged in a visual isometric pinch task for three consecutive days. Overall motor skill learning and speed-accuracy tradeoff function were used to evaluate the efficacy of tDCS. Electroencephalography was recorded and power spectral density was calculated. Both online and offline HD-tDCS total motor skill acquisition was significantly higher than the sham group (P < 0.001 and P < 0.05, respectively). Motor skill acquisition in the online group was higher than offline (P = 0.132, Cohen's d = 1.46). Speed-accuracy tradeoff function in the online group was higher than both offline and sham groups in the post-test. The online group exhibited significantly lower electroencephalography activity in the frontal, fronto-central, and centro-parietal alpha band regions compared to the sham (P < 0.05). The findings suggest that HD-tDCS application can boost finger motor skill acquisition, with online HD-tDCS displaying superior facilitation. Furthermore, online HD-tDCS reduces the power of alpha rhythms during motor skill execution, enhancing information processing and skill learning efficiency.

Critical soft skill competencies that clinical nurse educators consider important to evaluate in nurses.

AIM: Guided by Benner's framework, From Novice to Expert, this study aimed to identify (1) critical soft skills to be evaluated in nurses and (2) levels of nursing behaviour indicating achievement of soft skills to provide a framework for developing a soft skills rubric. BACKGROUND/INTRODUCTION: Nurse shortages are often attributable to high turnover rates among nurses. To improve this situation, healthcare facilities implement transition programmes and continuing education with a primary focus on developing and maintaining nurses' knowledge and performance (hard skills). However, balancing hard and soft skills (beliefs, values and attitudes) is key to nurses' quality of care and ultimately to their retention. Despite the importance of soft skills, their intangible nature creates problems in evaluating nurses' attainment of these skills and in providing constructive feedback to help them set concrete goals for improving their practice. METHODS: This qualitative descriptive study described critical soft skills in the nursing context. A purposeful sampling strategy was used to enrol 13 clinical nurse educators from multiple hospital units; each had more than 2 years of clinical nurse educator experience and had completed preceptor training. One-to-one interviews with these individuals were audio recorded, transcribed and subjected to direct content analysis using NVivo 12. The study follows the Consolidated criteria for reporting qualitative research (COREQ) guidelines for qualitative studies. FINDINGS: Five main competencies, comprising 20 subcompetencies, were identified: personal growth, effective interactions, professionalism, teamwork and the caring role. For each subcompetency, four skill levels were delineated using clinical indicators. CONCLUSION: This study's findings can enhance understanding of clinical nurse educators' perceptions regarding soft skills required of nurses. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The soft skills identified can be incorporated into a rubric to be used by clinical nurse educators to evaluate and guide nurses' professional development and contribute to improving quality of care. No patient or public contribution is required for this study.

Example-based learning in heuristic domains: can using relevant content knowledge support the effective allocation of intrinsic, extraneous, and germane cognitive load?

Introduction: Worked examples support initial skill acquisition. They often show skill application on content knowledge from another, "exemplifying" domain (e.g., argumentation skills have to be applied to some contents). Although learners' focus should remain on the skill, learners need to understand the content knowledge to benefit from worked examples. Previous studies relied on exemplifying domains that are familiar and contain simple topics, to keep learners' focus on skill acquisition. Aim: We examined whether using a relevant exemplifying domain would allow learners to acquire both skills and content knowledge simultaneously, or whether relevant content distracts from the main learning goal of skill acquisition. Methods and results: In a training study with 142 psychology students, we used example-based learning materials with an exemplifying domain that was either relevant or irrelevant for participants' course outcomes. We assessed cognitive load, declarative knowledge about skills and course-related content knowledge, and argumentation quality. Incorporating relevant content knowledge in worked examples did not reduce learning outcomes compared to a condition using an irrelevant exemplifying domain. Discussion: Contrary to previous research, the results suggest that worked examples with a relevant exemplifying domain could possibly be an efficient teaching method for fostering skills and content knowledge simultaneously.

A temporal quantitative analysis of visuomotor behavior during four twisting somersaults in elite and sub-elite trampolinists.

Vision has previously been correlated with performance in acrobatic sports, highlighting visuomotor expertise adaptations. However, we still poorly understand the visuomotor strategies athletes use while executing twisting somersaults, even though this knowledge might be helpful for skill development. Thus, the present study sought to identify the differences in gaze behavior between elite and sub-elite trampolinists during the execution of four acrobatics of increasing difficulty. Seventeen inertial measurement units and a wearable eye-tracker were used to record the body and gaze kinematics of 17 trampolinists (8 elites, 9 sub-elites). Six typical metrics were analyzed using a mixed analysis of variance (ANOVA) with the Expertise as inter-subject and the Acrobatics as intra-subject factors. To complement this analysis, advanced temporal eye-tracking metrics are reported, such as the dwell time on areas of interest, the scan path on the trampoline bed, the temporal evolution of the gaze orientation endpoint (SPGO), and the time spent executing specific neck and eye strategies. A significant main effect of Expertise was only evidenced in one of the typical metrics, where elite athletes exhibited a higher number of fixations compared to sub-elites (p = 0.033). Significant main effects of Acrobatics were observed on all metrics (p < 0.05), revealing that gaze strategies are task-dependent in trampolining. The recordings of eyes and neck movements performed in this study confirmed the use of "spotting" at the beginning and end of the acrobatics. They also revealed a unique sport-specific visual strategy that we termed as self-motion detection. This strategy consists of not moving the eyes during fast head rotations, a strategy mainly used by trampolinists during the twisting phase. This study proposes a detailed exploration of trampolinists' gaze behavior in highly realistic settings and a temporal description of the visuomotor strategies to enhance understanding of perception-action interactions during the execution of twisting somersaults.

[The Ibode performing surgical assistance]. / L'Ibode pratiquant l'assistance chirurgicale.

Among the various activities carried out by scrub nurse, the role of operating assistant, now renamed operating assistant, has been enriched by the recent reengineering of its field of activity. New procedures are entrusted to these professionals, some of which require Ibode training.

The application effect of the segmented teaching method in training medical students on clinical practice skills.

BACKGROUND: The surgical clinical practice skill training is an important part of medical undergraduate education. Surgical skills are complex and difficult to master. However, the traditional teaching method has some disadvantages, for example, low student participation, weak learning atmosphere, inadequate mastery of the subject matter. We innovatively put forward the segmented teaching method in the field of clinical practice skills training. The segmented teaching method refers to dividing a specific teaching content into several relatively independent parts and providing segmented practice for each part. This approach enhances students' learning outcomes.The aim of this controlled study is to investigate the effects of the segmented teaching methods on clinical practice skills training in medical students. METHODS: 31 medical students participating in clinical practice skill training at The First Affiliated Hospital of University of South China from March to April 2024 were randomly assigned to either the experimental group (n = 16) receiving segmented teaching method or the control group (n = 15) receiving traditional teaching method. After completion of practical exercises, both groups underwent operational assessments, theoretical assessments, Mini-Clinical Evaluation Exercise (Mini-CEX), and Student Evaluation of Educational Quality (SEEQ) for teaching quality evaluation. A comparative analysis of the results between the two groups was conducted. RESULTS: After implementing the program, there were no statistically significant differences (P > 0.05) between the experimental and control groups in theoretical assessment scores, Mini-CEX clinical judgment scores, and SEEQ teaching quality evaluation scores. However, compared to the control group, the experimental group demonstrated better operational assessment scores, higher Mini-CEX scores in history taking, physical examination, professionalism, doctor-patient communication, organizational efficiency, and comprehensive abilities, with statistically significant differences (P < 0.05). CONCLUSION: The application of segmented teaching method in clinical practice skill training for medical students yields favorable training outcomes.

Medical Students' Competency in EFAST (Extended Focused Assessment Sonography for Trauma) Components: A Prospective Observational Study.

OBJECTIVE: Ultrasound training in undergraduate medical education is developing, and its incorporation into the curriculum requires careful planning. Extended Focused Assessment Sonography for Trauma (EFAST) is commonly taught to medical students as one of the primary applications of ultrasound. Because false-negative EFAST scans can affect patients' clinical outcomes, it is essential to evaluate the individual components of this skill. We aim to determine which EFAST components students perform sub-optimally after initial training. METHODS: In this prospective observational study, 90 medical students from two final-year cohorts were assessed in EFAST components after uniform training during the emergency medicine clerkship. All validated components of the standard EFAST exam were assessed, and a descriptive analysis of individual components of EFAST was performed. RESULTS: The hepatorenal space, splenorenal space, and pelvic space fluid investigations had the lowest completion rates. Pericardial fluid, pelvic free fluid, and right thoracic pleural fluid investigations were often incorrectly applied. Fanning was most commonly missed in hepatorenal, splenorenal, and pelvic free fluid investigations, and between 12% and 50% of EFAST components had omitted reporting. CONCLUSIONS: There were significant incomplete assessments for free intraperitoneal fluid, primarily due to a lack of fanning in the hepatorenal, splenorenal, and pelvic areas. Trainers can effectively enhance student performance and outcomes by targeting these challenging areas. Further research might reveal whether residents and physicians show similar trends in EFAST completion.

Using the Preschool Life Skills Program to Support Skill Development for Children with Trauma Histories.

The Preschool Life Skills (PLS) program has a wealth of evidence demonstrating efficacy in remediating important social and learning-to-learn skill deficits in at-risk preschoolers. Those same skill deficits also are common in older children in foster or residential care, most of whom have experienced some sort of trauma or other adverse childhood events. This study sought to evaluate individualized PLS curricula for two boys with substantial trauma histories and demonstrate how the PLS program could be delivered within a trauma-informed framework. We delivered the program and evaluated skill acquisition in a one-to-one setting in a UK-based clinic, and asked caregivers to assess skills at home. Results showed that both boys acquired skills targeted in their individual curriculum, but maintenance was sometimes inconsistent. Social validity assessments suggested that both boys enjoyed the training but were less definitive about its overall benefits. Caregivers rated the program highly and reported skill improvements at home. We discuss the implications of these findings in terms of adapting the PLS program to children with trauma histories.

Optimizing Learning Outcomes when Teaching Sight Words using Fruits and Vegetables as Reinforcers.

Reinforcers frequently chosen may not offer the same nutritional value as fruits and vegetables. Prior researchers have explored preferences and the effectiveness of salty and sweet foods compared to fruits and vegetables, but the criteria for demonstrating effectiveness have often been arbitrary rather than academic. In addition, it remains unclear how the integration of these potentially nutritious reinforcers might affect learning or hinder learning efficiency. Therefore, the objective of this study was to investigate whether introducing fruits or vegetables as potential reinforcers could sustain responding achieved with salty or sweet reinforcers. The implications of this model for incorporating a variety of reinforcers while maintaining responding are also discussed.

Constructing tests for skill assessment with competence-based test development.

Competence-based test development is a recent and innovative method for the construction of tests that are as informative as possible about the competence state (the set of skills an individual has available) underlying the observed item responses. It finds application in different contexts, including the development of tests from scratch, and the improvement or shortening of existing tests. Given a fixed collection of competence states existing in a population of individuals and a fixed collection of competencies (each of which being the subset of skills that allow for solving an item), the competency deletion procedure results in tests that differ from each other in the competencies but are all equally informative about individuals' competence states. This work introduces a streamlined version of the competency deletion procedure that considers information necessary for test construction only, illustrates a straightforward way to incorporate test developer preferences about competencies into the test construction process, and evaluates the performance of the resulting tests in uncovering the competence states from the observed item responses.

Attitude of Medical and Dental Undergraduate Students Towards Learning of Communication Skills at a Medical College: A Descriptive Cross-sectional Study.

INTRODUCTION: Proper physician-patient communication has shown to impact patients' satisfaction, and better health outcomes. On the contrary, negative impacts of poor communication have been attributed as one of the causes of increasing workplace violence. It is imperative to identify the attitude of the students towards communication skill learning. The aim of the study was to find out the attitude of undergraduate students towards communication skill learning using the communication skill attitude scale. METHODS: This cross-sectional study was carried out from October, 2022 to July 2023 among undergraduate medical and dental students. Data was collected after obtaining the ethical approval from Institutional Review Committee (IRC number 2079/80/82) using a preformed proforma and the previously validated communication skills attitude scale questionnaire. Convenience sampling was done. The demographic details, educational characteristics, opinions regarding communication learning and median of positive and negative attitude scale scores were calculated using Statistical Package for the Social Sciences (SPSS). RESULTS: The total median (interquartile range) positive attitudes scale (PAS) and negative attitudes scale (NAS) scores were 52.00 (48.00-87.00) and 31.00 (28.00-34.00) respectively. The first year of undergraduates had higher PAS scores 56.00 (50.00-60.00) than final year 48.50 (44.25-55.00). The students who were in favour of CS learning during the clinical years of training had a higher PAS median score, 54.00 (49.00-58.00). CONCLUSIONS: The undergraduates had overall positive attitude towards CS learning but negative attitudes were also noted, with deterioration in the scores from first to final year of undergraduation, reiterating the importance of strengthening CS learning in the curriculum early-on in the study period.

Evaluation of advanced multi-purpose trauma moulage-based training on clinical skills for dealing with trauma-affected individuals in undergraduate nursing students.

BACKGROUND: Simulation-based training courses have been developed and widely accepted.The use of simulators can prevent bitter consequences that may sometimes put human lives in danger. Increasing the skill of nursing students in dealing with trauma patients is of great importance. The aim of this study is to evaluate the effectiveness of the simulation-based trauma training program for the management of trauma patients in nursing students. METHOD: It is an observational approach that focuses on improving the learning of trauma care skills. For this study, 6th and 8th semester nursing students were selected by appropriate sampling method. Previously, these students completed the trauma training course without simulation. Training of trauma skills was done using multi-purpose trauma mollage And we subsequently analyzed the effectiveness of the trauma simulation training program using the OSCE test. In the inferential statistics section, after examining the data distribution (Kolmogrove-Smirnov and Shapiro-Wilk tests), the Wilcoxon test was used to measure significance. SPSS 22 software was used. RESULTS: The results indicated that the lowest mean score obtained based on a scale of zero to one hundred was for the movement limitation of the injured long bone and the highest was in the skill of oral-nasal intubation and ventilation. The results of the paired t-test showed that clinical skills for dealing with trauma-affected individuals in undergraduate nursingafter simulation training was significantly higher . CONCLUSION: The implementation of the simulation is accompanied by an increase in the skills of the participants, which leads to the application of the acquired knowledge in real-life scenarios and positive changes. In the learning of the participants, the evaluation of conventional trauma training in Iran, like other countries, shows the need for specialized training through simulation. To ensure the continued effectiveness of simulation-based trauma training courses, it is recommended that administrators and policymakers encourage regular faculty participation in the program. Long term effects of trauma simulators training in nursing student requires further study.

Associations between whole-body reaction time, maximum jump height, and skeletal muscle mass when reaction time and jump height are investigated as a complex.

[Purpose] This study aimed to investigate the association between whole-body reaction time and maximum jump height as elements of agility performance requiring maximum jumping when measured separately as closed-skill sports or as a complex of open-skill sports and their association with skeletal muscle mass. [Participants and Methods] This study included 54 healthy adult volunteers. Reaction time and jump height in response to a light stimulus were measured separately (the "simple condition") and simultaneously (the "complex condition"), and the associations between the values under these two conditions were investigated. The associations between the skeletal muscle mass and the two elements under both conditions were also investigated. [Results] No correlation was found between the reaction times measured under the simple and complex conditions; however, a significant correlation was evident for the jump height. Skeletal muscle mass correlated significantly with jump height but not with reaction time. [Conclusion] The study results suggest that the relationship between open- and closed-skill sports differs between reaction time and jump height. Therefore, closed-skill sports training may be insufficient for improving open-skill sports and cognitive function and may affect decision-making strategies.

Bidirectional locomotion induces unilateral limb adaptations.

Humans can acquire and maintain motor skills throughout their lives through motor learning. Motor learning and skill acquisition are essential for rehabilitation following neurological disease or injury. Adaptation, the initial stage of motor learning, involves short-term changes in motor performance in response to a new demand in the person's environment. Repeated adaptation can improve skill performance and result in long-term skill retention. Locomotor adaptation is extensively studied using split-belt treadmill paradigms. In this study we explored whether bidirectional walking (BDW) on a split-belt treadmill can induce short-term gait adaptations. Twelve healthy volunteers participated in our single session, starting with 2 minutes of normal walking (NW), followed by four 5-minute blocks of BDW with a 1-minute passive rest in between blocks, and ending with another 2-minute of NW. We recorded body kinematics and ground reaction forces throughout the experiment. Participants quickly adapted to BDW with both legs showing decreased step lengths. However, only the backward-walking leg exhibited aftereffects upon returning to NW, indicating short-term adaptation. Notable kinematic changes were observed, particularly in hip extension and pelvis tilt, though these varied among participants. Our findings suggest that BDW induces unilateral adaptations despite bilateral changes in gait, offering new insights into locomotor control and spinal CPG organization.

Stone toolmaking energy expenditure differs between novice and expert toolmakers.

OBJECTIVES: This study investigates the energetic costs associated with Oldowan-style flake production and how skill differences influence these costs. MATERIALS AND METHODS: Nine adult participants, including novice and expert toolmakers, underwent a 2-h experimental session where we measured energy expenditure and flaking outcomes. We measured body mass (kg), percent body fat, and fat-free mass (kg) and used open-circuit indirect calorimetry to quantify energy expenditure. The lithic analysis used standard linear and mass measurements on the resulting cores and flakes. Qualitative observations from the video recordings provide insight into the subject's body positions and hand grips. RESULTS: Results reveal significant differences in energy expenditure between novice and expert toolmakers, with experts demonstrating lower overall energy expenditure. Additionally, experts produced more flakes, reduced greater core mass per unit of energy expenditure, and exhibited distinct body positions, hand grips, and core/flake morphologies compared with novices. DISCUSSION: The study provides novel insights into the bio-cultural impacts of stone toolmaking skill acquisition, suggesting that skilled performance reduces the metabolic costs of stone tool production. These findings contribute to debates surrounding the origins of human cultural capacities and highlight the importance of including energy expenditure measures in knapping experiments. Moreover, the results suggest that the presence or absence of expertise in the Paleolithic would have fundamentally altered selective pressures and the reliability of skill reproduction. This study enhances our understanding of differences in stone toolmaking skill and their implications for human energy allocation strategies during early technological evolution.

Comparison of short- and long-term effects of neurofeedback and transcranial electrical stimulation on the motor learning in healthy adults.

Researchers are exploring non-invasive neuromodulation techniques like transcranial direct current stimulation (tDCS) and neurofeedback (NFB) for enhancing motor learning. While tDCS modulates brain excitability using exogenous electric fields, NFB is an endogenous brain stimulation technique that enables individuals to regulate brain excitability in a closed-loop system. Despite their differing mechanisms, a direct comparison of their effects on motor learning is lacking. This study aimed to compare tDCS and NFB on online learning, short-term offline learning, and long-term offline learning in healthy participants, seeking to identify the most effective method for motor learning enhancement. In this parallel, randomized, single-blinded, controlled trial, 100 healthy participants were randomly assigned to one of five groups: real tDCS, sham tDCS, real NFB, sham NFB, and passive control. Primary outcomes included normalized reaction time (NRT), normalized response accuracy (NRA), and normalized skill index (NSI), measured through a serial reaction time task. Secondary outcomes involved physical and mental fatigue, assessed using a visual analog scale. The study involved 14 blocks of 80 trials each. Online learning was assessed by changes in NRT, NRA, and NSI between Block 3 and Block 9. Short-term and long-term offline learning were evaluated by changes in these measures between Block 9 and Block 11, and between Block 9 and Block 13, respectively. RESULTS: showed a significant decrease in NRA in the sham tDCS and passive control groups from block 3-9, with no changes in other groups. NRT significantly decreased in all intervention groups from block 9-11, with no change in the control group. The NSI significantly increased across all intervention groups between blocks 9 and 11, with large to very large effect sizes, while the passive control group saw a medium effect size increase. Furthermore, NRA significantly increased in the real NFB and real tDCS groups from block 9 to block 13. NRT also significantly decreased in all intervention groups when comparing block 13 to block 9, while the passive control group showed no significant changes. Notably, the reduction in NRT from block 9 to block 13 was significantly greater in the real tDCS group than in the control group, with a mean difference of 0.087 (95 % CI: 0.004-0.169, p = 0.031). Additionally, NSI significantly increased in all intervention groups except the control group from block 9 to block 13. In conclusion, neither NFB nor tDCS had a significant positive impact on online learning. However, both real and sham versions of tDCS and NFB resulted in notable improvements in short-term offline learning. The difference in improvement between NFB and tDCS, as well as between real and sham interventions, was not statistically significant, suggesting that the placebo effect may play a significant role in enhancing short-term offline learning. For long-term offline learning, both brain stimulation methods, particularly tDCS, showed positive effects, although the placebo effect also appeared to contribute.

Demand for digital skills, skill gaps and graduate employability: Evidence from employers in Malaysia.

Background: A major workforce inadequacy and the change in skill demanded have been observed due to the digital transformation. This study aims to identify the digital skills demanded by employers, focusing on exploring the skills gaps among the graduates that impact graduate employability. Methods: A cross sectional online survey was conducted among the companies registered with the Malaysian Productivity Corporation (MPC). Demand for digital skills was assessed using descriptive analysis of mean scores of the employers' rating in digital skills at present and in future. A pair sample t-test was performed to explore the existence of skill gaps, by comparing the demand versus competencies of the graduates' digital skills in the workplace. Results: Of the 393 responses collected, 376 responses were used for final analysis. The findings show that the current top three digital skills in demand are "information and data literacy", "problem-solving", and "digital content creation". Whereas the top digital skills for future demand are "problem-solving", "safety", and "communication and collaboration". In addition, the most significant (digital) skill gap is found in "communication and collaboration skills" followed by "problem-solving" and "safety" skills. Conclusions: These findings provide insights into the digital skills demanded by employers in IR 4.0, allowing the practitioners, education service providers and policymakers to do better planning on human capital management and training development. By focusing on identifying the current and future demand for digital skills while exploring the digital skill gaps among the graduates, this study provides insight into the employability skills required by the graduate before entering the job market.