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When Patients Say No: Rethinking Refusal in Bedside Medical Education
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ABSTRACT<sec> <title>Background

Bedside clinical teaching is a fundamental part of the medical education that offers invaluable opportunities for the students to build and improve their clinical and communication skills. However, there is a growing concern about the increasing refusal of patients to participate in clinical sessions, especially in certain settings where there are sensitive cultural traditions and decreased trust in institutions.

Aim

This paper discusses patient refusal during bedside clinical teaching and views it from three aspects, that of the medical student, the clinical educator and the patient, and proposes culturally sensitive strategies that balance patient autonomy with educational needs.

Perspective

Patient refusals reduce the students' chances of hands‐on learning, placing the educator under ethical strain and emotional fatigue. These refusals are not simply uncomfortable incidents, but they signal underlying systemic gaps such as lack of transparent communication with the patients, failure to adapt to the social development and deep cultural dissonance. While simulation offers partial relief, it cannot fully replace the human dimensions of real patient interactions.

Conclusion

Patients' reluctance is a meaningful message that needs to be heard. A thoughtful reform including coordinated efforts at the level of patient education, faculty support, student preparation and institutional policy is needed. Without reform, we risk graduating doctors who have never truly encountered the human side of medicine.

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Publication Date
Wed May 08 2019
Journal Name
Digest Journal Of Nanomaterials And Biostructures
IMPROVING SENSITIVITY OF In 2 O 3 AGAINST NO 2 TOXIC GAS BY LOADING TIN OXIDE
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The paper discusses the structural and optical properties of In 2 O 3 and In 2 O 3-SnO 2 gas sensor thin films were deposited on glass and silicon substrates and grown by irradiation of assistant microwave on seeded layer nucleated using spin coating technique. The X-ray diffraction revealed a polycrystalline nature of the cubic structure. Atomic Force Microscopy (AFM) used for morphology analysis that shown the grain size of the prepared thin film is less than 100 nm, surface roughness and root mean square for In 2 O 3 where increased after loading SnO 2 , this addition is a challenge in gas sensing application. Sensitivity of In 2 O 3 thin film against NO 2 toxic gas is 35% at 300 o C. Sensing properties were improved after adding Tin Oxi

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Sources of income subject to tax in the Iraqi Income Tax Law No.113 of 1982
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The tax is a financial amount collected from the taxpayer for the account of the public treasury.. and is the cornerstone of the close bond between members of the community and the country in which they live , as income tax is imposed on the profits and revenues achieved by people and often the constitution of most contemporary countries stipulate that the legislator is obligated to determine the sources of revenues and profits subjected to tax. Because the tax has a serious impact on people’s money because it is exposed to that money through direct deduction . Therefore, we note that the applicable income Tax Law stipulated that in order income to be subject to tax , it must be derived from one or more of the income sources st

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Publication Date
Sun Jan 01 2017
Journal Name
Engineering And Technology Journal
Study of the Diffusion Coefficient and Hardness for a Composite Material when Immersed in Different Solutions Polymer
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Publication Date
Thu Jul 20 2023
Journal Name
Journal Of Advanced Biotechnology And Experimental Therapeutics
No evidence of relationship between colorectal cancer susceptibility and ERCC2 gene polymorphisms
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Background: Excision repair cross-complementing group 2 gene (ERCC2) polymorphisms have been linked as being a risk factor for colorectal cancer (CRC) emergence. However, data from several studies are contradictory. To validate genetic biomarkers of the CRC; the impact of the following ERCC2 polymorphism (rs1799793 and rs238406) was examined on CRC susceptibility among sample of Iraqi population. Methods: A total of 126 subjects were enrolled in this case control study; 78 CRC patients and 48 apparently healthy individuals who are age, gender, smoking status and BMI matched. Polymerase chain reaction (PCR) was used for genotyping, followed by sequencing then the association between genetic polymorphisms and CRC risk was investigate

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Publication Date
Thu Dec 13 2018
Journal Name
International Journal Of Engineering &amp; Technology
Effect of Steel Fiber on Properties of High Performance No-Fine Concrete
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No-fine concrete (NFC) is cellular concrete and it’s light weight concrete produced with the exclusion of sand from the concrete. This study includes the mechanical properties of lightweight reinforced by steel fiber, containing different proportions of steel fiber. This study was done using number of tests. These tests were density, compressive strength, flexural strength and absorption. These tests of the molds at different curing time. The results of tests that implication of fiber to No. fine concrete did not affect significantly on the compressive strength, While the flexural strength were gets better. Results explained that, the flexural strength of (1%) fiber No- fine concrete molds are four times that of the reference mold

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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Determination of the Impact of Electronic Health Information Systems upon Medical, Medical Backing and Administrative Business Fields in Al-Kindy Teaching Hospital
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Objective(s): To determine the impact of the Electronic Health Information Systems upon medical, medical backing and administrative business fields in Al-Kindy Teaching Hospital and to identify the relationship between such impact and their demographic characteristics of years of employment, place of work, and education. Methodology: A descriptive analytical design is employed through the period of April 25th 2016 to May 28th 2016. A purposive "non- probability" sample of (50) subject is selected. The sample is comprised of (25) medical and medical backing staff and (25) administrative staff who are all

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Publication Date
Wed Jan 01 2020
Journal Name
دار الكتب والوثائق العراقيه
Introduction to Medical and Biological Statistics for Pharmacy Students and Medical Groups (Undergraduate &amp; Postgraduate) - ISBNiraq.org
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Introduction to Medical and Biological Statistics for Pharmacy Students and Medical Groups (Undergraduate & Postgraduate) - ISBNiraq.org

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Publication Date
Fri Jun 20 2014
Journal Name
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A Review of Snake Models in Medical MR Image Segmentation
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Developing an efficient algorithm for automated Magnetic Resonance Imaging (MRI) segmentation to characterize tumor abnormalities in an accurate and reproducible manner is ever demanding. This paper presents an overview of the recent development and challenges of the energy minimizing active contour segmentation model called snake for the MRI. This model is successfully used in contour detection for object recognition, computer vision and graphics as well as biomedical image processing including X-ray, MRI and Ultrasound images. Snakes being deformable well-defined curves in the image domain can move under the influence of internal forces and external forces are subsequently derived from the image data. We underscore a critical appraisal

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Publication Date
Sun Nov 30 2025
Journal Name
University Of Kirkuk Journal For Administrative And Economic Science
Anova For Fuzzy Data With Practical in The Medical Field
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This research study Blur groups (Fuzzy Sets) which is the perception of the most modern in the application in various practical and theoretical areas and in various fields of life, was addressed to the fuzzy random variable whose value is not real, but the numbers Millbh because it expresses the mysterious phenomena or uncertain with measurements are not assertive. Fuzzy data were presented for binocular test and analysis of variance method of random Fuzzy variables , where this method depends on a number of assumptions, which is a problem that prevents the use of this method in the case of non-realized.

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Publication Date
Wed Mar 30 2016
Journal Name
College Of Islamic Sciences
Problematic understanding of the question "What I overlooked something about you" when Sibweh
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This research is an attempt to unveil the cover and unveil a matter that has become mysterious to those who came after Sibweh of the grammar scholars; It took place as a result of the work of the scribes.

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