The integration of Generative Artificial Intelligence (GenAI) into health professions education (HPE) is rapidly transforming learning environments, raising questions about its impact on teaching and learning. This mixed methods study explores clinical educators’ and undergraduate students’ perceptions and attitudes about using GenAI tools in HPE at a tertiary hospital in Singapore. Using the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) as theoretical frameworks, we designed and administered a survey and conducted interviews to assess participants’ perceived usefulness, ease of use, and concerns related to GenAI adoption. Quantitative survey data were analyzed for frequencies and percentages, while qualitative responses underwent thematic analysis. Results showed that students demonstrated higher GenAI adoption rates (68.7%) compared to educators (38.5%), with GenAI perceived as valuable for efficiency, research, and personalized learning. However, concerns included over-reliance on GenAI, diminished critical thinking, and ethical implications. Educators emphasized the need for institutional guidelines and training to support responsible GenAI integration. Our findings suggest that while GenAI holds great potential for enhancing education, structured institutional policies and ethical oversight are crucial for its effective use. These insights contribute to the ongoing discourse on GenAI adoption in HPE.

Purpose: Diagnosing sarcopenia necessitates the measurement of skeletal muscle mass. However, guidelines lack a standardized imaging modality with thresholds validated among Asians. This systematic review compared ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and bioelectrical impedance analysis (BIA)/body composition monitoring in the detection of sarcopenia within Asian populations.Methods: PubMed and Embase were systematically searched for studies analyzing ultrasonography, CT, MRI, and BIA in diagnosing sarcopenia among Asians. Study quality was assessed using the Newcastle-Ottawa scale.Results: Pooled findings from 21,598 patients across 25 studies were examined. In receiver operating characteristic analysis, ultrasound displayed a pooled mean area under the curve (AUC) of 0.767 (95% confidence interval [CI], 0.709–0.806), with mean sensitivity of 81.1% (95% CI, 0.744–0.846) and specificity of 73.1% (95% CI, 0.648–0.774), for detecting sarcopenia in Asian populations. CT exhibited an AUC of 0.720 (sensitivity, 54.0%; specificity, 92.0%). MRI demonstrated an AUC of 0.839 (sensitivity, 67.0%; specificity, 66.0%). BIA displayed an AUC of 0.905 (95% CI, 0.842–0.968), 80.7% sensitivity (95% CI, 0.129–0.679), and 82.4% specificity (95% CI, 0.191–0.633).Conclusion: Various modalities aid in diagnosing sarcopenia, and selection should be individualized. Although only BIA and dual-energy x-ray absorptiometry are recommended by the Asian Working Group for Sarcopenia and the European Working Group on Sarcopenia in Older People, ultrasound imaging may hold diagnostic value for sarcopenia in the Asian population. In certain groups, diagnostic use of CT and MRI is warranted. Future research can standardize and validate modality-specific thresholds and protocols within Asian populations.

Background: Multimodal prehabilitation programs, which may incorporate nutritional supplementation and exercise, have been developed to combat sarcopenia in surgical patients to enhance post-operative outcomes. However, the optimal regime remains unknown. The use of beta-hydroxy beta-methylbutyrate (HMB) has beneficial effects on muscle mass and strength. However, its effect on muscle quality in the perioperative setting has yet to be established. This study aims to explore the impact of a multimodal prehabilitation program using a bundle of care that includes high-protein oral nutritional supplementation (HP ONS) with HMB and resistance exercise on muscle quality and functional outcomes in sarcopenic surgical patients. Methods: Sarcopenic adult patients undergoing elective major gastrointestinal surgeries were recruited for this pilot interventional cohort study. They were enrolled in a 2–4-week multimodal prehabilitation program comprising resistance exercise, nutritional supplementation, vitamin supplementation, comorbid optimization and smoking cessation. Participants were provided three units of HP ONS with HMB per day pre-operatively. The primary outcome was changes in intramuscular adipose tissue (IMAT) as a proxy of muscle quality, assessed using Artificial Intelligence (AI)-aided ultrasonography. Secondary outcomes include changes in anthropometric measurements and functional characteristics. Outcomes were measured before prehabilitation, after prehabilitation and 1 month post-operatively. Results: A total of 36 sarcopenic patients, with a median age of 71.5 years, were included in this study. There was an increase in the IMAT index after two weeks of prehabilitation (p = 0.032) to 1 month after surgery (p = 0.028). Among functional parameters, improvement was observed in gait speed (p = 0.01) after two weeks of prehabilitation, which returned to baseline post-operatively. The median length of hospital stay was 7 (range: 2–75) days. Conclusions: The increase in the IMAT index in a sarcopenic surgical cohort undergoing prehabilitation may be due to altered muscle metabolism in elderly sarcopenic patients. A prehabilitation regime in sarcopenic patients incorporating HP ONS with HMB and resistance exercise is feasible and is associated with increased gait speed.

Background/Objective: To date, a validated Chinese (Mandarin) six-minute walk test (6MWT) translated instruction is not available. Translation of the Chinese 6MWT instruction is done in an ad hoc manner within the Chinese-speaking populations. This study aimed to develop a set of valid and reliable Chinese (Mandarin) instructions of the 6MWT. Methods: Translation was performed from the original English instruction via the recommended “Process of translation and adaptation of instruments” by the World Health Organization to generate the Chinese instructions. The Chinese instructions were tested with 52 healthy adult participants for its validity. Each participant underwent three 6MWTs and a cardiopulmonary exercise test. Randomization allowed participants to undergo the walk test in both the original English and the new Chinese instructions. Face and content validity, intra-rater and inter-rater reliability of the Chinese instructions of the 6MWT were established through the translation process. Criterion validity was established by analyzing the results of the 6MWT and cardiopulmonary exercise test. Results: Intraclass correlation coefficient for inter-rater reliability was excellent ($\mathrm{\text{ICC}}=0.999$ , 95% confidence $\mathrm{\text{interval}}=0.996$ –1.000). Similarly, the intra-rater reliability across the three raters was high (R1: $\mathrm{\text{ICC}}=0.996$ , 95% confidence interval $(\mathrm{\text{CI}})=0.812$ –1.000; R2: $\mathrm{\text{ICC}}=1.000$ , 95% $\mathrm{\text{CI}}=0.994$ –1.000; R3: $\mathrm{\text{ICC}}=1.000$ , 95% $\mathrm{\text{CI}}=0.998$ –1.000). The 6-min walk distances collected from the Chinese and English instructed trials correlated positively with the maximal oxygen consumption ($r=0.315$ , $p=0.023$ ; $r=0.309$ , $p=0.026$ ). Conclusion: This is the first study to develop and validate the Chinese (Mandarin) instructions of the 6MWT, and the translation is as reliable and valid as the original English instructions.

Background: Health literacy proficiency is essential for health care professionals to provide quality patient care. There is limited research exploring health literacy proficiency among undergraduate health science students. Objectives: To determine health literacy among health science students in Singapore using the electronic Health Literacy Questionnaire (HLQ). Design: A cross-sectional survey using purposive sampling was conducted among undergraduate health science students. Methodology: This study hypothesises that health literacy is influenced by gender, and it increases with the level of health science education, attributed to the increased exposure to the health care system and health care education as undergraduates progress through the years of study. Eligible students from the 4-year entry-level programmes of diagnostic radiography, dietetics, occupational therapy, physiotherapy, radiation therapy and speech and language therapy, aged from 21 to 50, were invited. Exclusion criteria were students who were no longer studying due to dropping out or having immediately graduated from these programmes and students in the accelerated programmes whose studies would be completed in less than 4 years. Results: In total, 111 respondents (72 females and 37 males) completed surveys (response rate, 7.7%) returned from physiotherapy ( n = 69), occupational therapy ( n = 25), diagnostic radiography ( n = 12) and dietetics ( n = 5), with nil from radiation therapy and speech and language therapy. All participants were English literate. Female participants demonstrated higher HLQ with a mean total score of 30.67 (standard deviation ( SD) = 0.61) versus male participants 29.83 ( SD = 0.53). Year 2, 3 and 4 students generally scored higher than Year 1 across all nine HLQ scales. Overall, dietetics students had the highest total score on the HLQ, while the diagnostic radiography students had the lowest scores for all the nine HLQ scales. Conclusion: This study established the health literacy level of health science students in Singapore. Gender and years of study influenced health literacy levels, supporting the hypothesis.

Background: Ageing population is a worldwide phenomenon with correspondingly higher proportion of older patients being treated in the hospital setting. Sarcopenia, which increases with age, has serious negative implications on health, hospitalisation, and overall postoperative recovery. There is no mutual consensus on perioperative management of sarcopenia in surgical patients in Singapore. The purpose of this study is to create greater clarity pertaining to the recognition of sarcopenia, the application of assessment criteria of sarcopenia and perioperative management of surgical patients in Singapore. Methods: A modified Delphi consensus consisting of a panel of experts from Singapore forming a multidisciplinary team, including surgeons, geriatricians, anesthesiologists, physiotherapists, and dieticians. Eight recommendations were proposed by the steering committee. Literature search from MEDLINE, Embase, and Scopus for articles up till June 2023 were performed to support recommendation statements. The expert panel voted on agreement to recommendation statements and graded the level of evidence supporting each statement through surveys to achieve consensus, set at 85% a priori. Results: The panellists underwent two rounds of anonymized, independent voting before reaching consensus for all eight statements. After the first round, seven statements reached consensus, including the corresponding grading for level of evidence. The statement which did not achieve consensus was revised with supporting literature and after the second round of survey, all eight statements and level of evidence reached consensus, completing the Delphi process. These eight statements covered themes to (1) encourage the identification of sarcopenia, (2) guide preoperative, and (3) postoperative management of sarcopenia. Conclusion: With the varying approaches in perioperative management, poor understanding of and identification of sarcopenia can result in suboptimal management of sarcopenia in surgical patients. Given the abundance of evidence linking beneficial impact on recovery and postoperative complications with prudent management of sarcopenia, it is imperative and urgent to achieve awareness and consensus.