Promoting competence in undergraduate medical students through the humanities: The ABCDE Paradigm


  • Satendra Singh
  • Navjeevan Singh
  • Upreet Dhaliwal UCMS Delhi


Attitude, Behavior, Communication, Competency-based education, Cultural diversity, Empathy, Humanities, Education, medical


Stakeholders, including patients and employers, find that skills pertaining to professionalism, humanism, diversity, communication, and ethics are as important for patient care as the doctor’s ability to diagnose and treat illness. Practitioners should be able to demonstrate these skills in real time, yet they are not explicitly taught in the medical course – students are expected to learn them through observation of role models. Some students may never witness such role modeling. Research suggests that the creative instincts of medical students could be utilized through exposure to the humanities to explicitly develop these skills. Medical educators worldwide are examining newer ways to actively train and assess learners in professionalism and related competencies.â  Using Rudyard Kipling’s “Five Ws and One H†guide to writing a scientific paper,â  we propose the ABCDE paradigm and demonstrate why it is most appropriate to use the medical humanities to teach professionalism and humanism.


Download data is not yet available.


Kirklin D, Meakin R. Editorial: Medical students and arts and humanities research–fostering creativity, inquisitiveness, and lateral thinking. Med Humanit [Internet]. 2003 Dec 1 [cited 2015 May 2];29(2):103. Available from:

Daaleman TP, Kinghorn WA, Newton WP, Meador KG. Rethinking professionalism in medical education through formation. Fam Med [Internet]. 2011 May [cited 2015 May 2];43(5):325–9. Available from:

Schwartzstein RM. Getting the right medical students–nature versus nurture. N Engl J Med [Internet]. 2015 Apr 23 [cited 2015 May 2];372(17):1586–7. Available from:

Taichman RS, Parkinson JW, Nelson BA, Nordquist B, Ferguson-Young DC, Thompson JF. Program design considerations for leadership training for dental and dental hygiene students. J Dent Educ [Internet]. 2012 Feb [cited 2015 May 2];76(2):192–9. Available from:

Simmenroth-Nayda A, Alt-Epping B, Gágyor I. Breaking bad news – an interdisciplinary curricular teaching-concept. GMS Z Med Ausbild [Internet]. 2011 Jan [cited 2015 May 2];28(4):Doc52. Available from:

Joiner AB, Husain N, Duddu V, Chaudhry IB. Medical professionalism education for psychiatry trainees: does it meet standards? Australas Psychiatry [Internet]. 2015 Feb [cited 2015 May 2];23(1):72–5. Available from:

Kiguli S, Mubuuke R, Baingana R, Kijjambu S, Maling S, Waako P, et al. A consortium approach to competency-based undergraduate medical education in Uganda: process, opportunities and challenges. Educ Health (Abingdon) [Internet]. Jan [cited 2015 May 2];27(2):163–9. Available from:

Kamaka ML. Designing a cultural competency curriculum: asking the stakeholders. Hawaii Med J [Internet]. 2010 Jun [cited 2015 May 2];69(6 Suppl 3):31–4. Available from:

Doukas DJ, Kirch DG, Brigham TP, Barzansky BM, Wear S, Carrese JA, et al. Transforming educational accountability in medical ethics and humanities education toward professionalism. Acad Med [Internet]. 2014 Dec 23 [cited 2015 May 2]; Available from:

Batistatou A, Doulis EA, Tiniakos D, Anogiannaki A, Charalabopoulos K. The introduction of medical humanities in the undergraduate curriculum of Greek medical schools: challenge and necessity. Hippokratia [Internet]. 2010 Oct [cited 2015 May 2];14(4):241–3. Available from:

Moon M, Taylor HA, McDonald EL, Hughes MT, Beach MC, Carrese JA. Analyzing reflective narratives to assess the ethical reasoning of pediatric residents. Narrat Inq Bioeth [Internet]. 2013 Jan [cited 2015 May 2];3(2):165–74. Available from:

Sharp D. Kipling’s guide to writing a scientific paper. Croat Med J [Internet]. 2002 Jun [cited 2015 May 2];43(3):262–7. Available from:

Ajzen I, Fishbein M. Attitude-behavior relations: A theoretical analysis and review of empirical research. Psychol Bull. 1977;84(5):888–918.

Medical Council of India. Code of Medical Ethics Regulations, 2002 [Internet]. New Delhi: Medical Council of India; 2009 [cited 2015 May 2]. 16 p. Available from:

Indian Council of Medical Research. BioMedical Ethics [Internet]. New Delhi: ICMR; 2006 [cited 2015 May 2]. 120 p. Available from:

Nazar M, Kendall K, Day L, Nazar H. Decolonising medical curricula through diversity education: lessons from students. Med Teach [Internet]. 2015 Apr [cited 2015 May 2];37(4):385–93. Available from:

Wilkinson W. Cultural Competency. TSQ Transgender Stud Q [Internet]. Duke University Press; 2014 Jan 1 [cited 2015 Jun 5];1(1-2):68–73. Available from:

Post SG, Ng LE, Fischel JE, Bennett M, Bily L, Chandran L, et al. Routine, empathic and compassionate patient care: definitions, development, obstacles, education and beneficiaries. J Eval Clin Pract [Internet]. 2014 Dec [cited 2015 May 2];20(6):872–80. Available from:

Fischer CN. Changing the science education paradigm: from teaching facts to engaging the intellect: Science Education Colloquia Series, Spring 2011. Yale J Biol Med [Internet]. 2011 Sep [cited 2015 May 2];84(3):247–51. Available from:

Singh S, Khosla J, Sridhar S. Exploring medical humanities through theatre of the oppressed. Indian J Psychiatry [Internet]. 2012 Jul [cited 2015 May 2];54(3):296–7. Available from:

Rajbongshi A. Compassion and kindness – prescription for healing. RHiME. 2015;2:46–47.

Singh S. Broadening horizons: looking beyond disability. Med Educ [Internet]. 2012 May [cited 2015 May 2];46(5):522. Available from:

Singh N. Whither medical humanities? Indian J Med Ethics [Internet]. Jan [cited 2015 May 2];9(3):166–9. Available from:

Gupta S, Singh S. Confluence: understanding medical humanities through street theatre. Med Humanit [Internet]. 2011 Dec 1 [cited 2015 Apr 28];37(2):127–8. Available from:

Gupta S, Agrawal A, Singh S, Singh N. Theatre of the Oppressed in medical humanities education: the road less travelled. Indian J Med Ethics [Internet]. Jan [cited 2015 May 2];10(3):200–3. Available from:

O’Mahony S. The extraordinary undergraduate career of Oliver St John Gogarty: has the modern medical student anything to learn from him? J R Coll Physicians Edinb [Internet]. 2013 Jan [cited 2015 May 2];43(2):169–74. Available from:

Kumar MD. Mentoring: A strategy for organisational excellence [Internet]. Indian MBA. 2006 [cited 2015 May 13]. Available from:

Bhatia A, Singh N, Dhaliwal U. Mentoring for first year medical students: humanising medical education. Indian J Med Ethics [Internet]. Jan [cited 2015 May 13];10(2):100–3. Available from:

Confluence: Lecture series. [Internet]. Medical Education Unit, University College of Medical Sciences, Delhi, India. [cited 2015 May 13]. Available from:

Medical Humanities Group. Medical Education Unit, UCMS Delhi [Internet]. 2015 [cited 2015 Jun 3]. Available from:

Research and Humanities in Medical Education. RHiME [Internet]. 2015 [cited 2015 Jun 3]. Available from:

Perappadan BS. No national data on HIV/AIDS among differently-abled, reveals RTI. The Hindu [Internet]. 2015 [cited 2015 Jun 3]; Available from:

Gupta R, Singh S, Kotru M. Reaching people through medical humanities: An initiative. J Educ Eval Health Prof [Internet]. 2011 Jan [cited 2015 Apr 28];8:5. Available from:

Singh S, Singh N, Dhaliwal U. Near-peer mentoring to complement faculty mentoring of first-year medical students in India. J Educ Eval Health Prof [Internet]. 2014 Jan [cited 2015 Mar 4];11:12. Available from:

Gupta S, Singh S. Confluence: understanding medical humanities through street theatre. Med Humanit [Internet]. 2011 Dec 1 [cited 2015 Apr 28];37(2):127–8. Available from:

Chowdhury SR. They capture the world in their mind’s eye. The Times of India [Internet]. 2012 [cited 2015 Jun 3]; Available from:

Madhu Sharma: Broadening horizons: looking beyond disability. Medical Education Unit, UCMS Delhi [Internet]. 2011 [cited 2015 Jun 3]. Available from:

Medical Council of India. Vision 2015. [Internet]. [cited 2015 Mar 29]. Available from:

Banaszek A. Medical humanities courses becoming prerequisites in many medical schools. CMAJ [Internet]. 2011 May 17 [cited 2015 May 2];183(8):E441–2. Available from:

Wachtler C, Lundin S, Troein M. Humanities for medical students? A qualitative study of a medical humanities curriculum in a medical school program. BMC Med Educ [Internet]. 2006 Jan [cited 2015 May 2];6(1):16. Available from:

Miller GE. The assessment of clinical skills/competence/performance. Acad Med [Internet]. 1990 Sep [cited 2014 Dec 22];65(9 Suppl):S63–7. Available from:

Donnon T, Al Ansari A, Al Alawi S, Violato C. The reliability, validity, and feasibility of multisource feedback physician assessment: a systematic review. Acad Med [Internet]. 2014 Mar [cited 2015 Apr 28];89(3):511–6. Available from:

Lehmann LS. Fostering student engagement in medical humanities courses. Virtual Mentor [Internet]. Amer Med Assoc; 2014 Aug 1 [cited 2015 Jun 5];16(8):595. Available from:

Carrese JA, McDonald EL, Moon M, Taylor HA, Khaira K, Catherine Beach M, Hughes MT. Everyday ethics in internal medicine resident clinic: an opportunity to teach. Med Educ [Internet]. 2011 Jul [cited 2015 May 2];45(7):712–21. Available from:




How to Cite

Singh, S., Singh, N., & Dhaliwal, U. (2015). Promoting competence in undergraduate medical students through the humanities: The ABCDE Paradigm. Research and Humanities in Medical Education, 2, 28–36. Retrieved from