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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
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Asthmatic Patients’ Quality Of Life in Jordan Fadel Hazza' Ali al-Mahameed.*
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Abstract A descriptive study was conducted in Al-Bashir teaching hospital in Amman city from 15th May 2004 to 15th August 2004 , in order to "Assess the adult asthmatic patients’ quality of life (QOL). Objective: This study aimed at identifying the domains of (Environmental, Physical, Daily Living Activity, Drug and Medication, Psychological , and Social), Methodology : A Purposive (Non-Probability) sample of (100) adult asthmatic patients visited the emergency department and outpatient clinic of chest department in Al-bashir hospital .A Questionnaire was constructed for the purpose of the study, and compris

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Publication Date
Sun Aug 11 2024
Journal Name
Irish Journal Of Medical Science (1971 -)
Serum fibulin-3 as a diagnostic and prognostic biomarker in patients with knee osteoarthritis
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Background Osteoarthritis is a chronic degenerative disorder with rising prevalence. Early detection of structural damage is difficult. Consequently, there is a pressing demand for reliable biomarkers that enable an earlier diagnosis of osteoarthritis. The aim is to investigate the level of serum fibulin-3 in patients with primary knee osteoarthritis and its correlation with disease severity. Subjects and methods A case–control study was conducted at the Baqubah Teaching Hospital from November 2023 to January 2024. One hundred twenty persons participated in this study (eighty females with the diagnosis of knee osteoarthritis in its early and late stages, and forty age-matched, apparently healthy control. Serum fibulin-3, ESR, CRP, and cal

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Publication Date
Sat Oct 06 2018
Journal Name
Journal Of Global Pharma Technology
Estimation of Some Trace Elements and Antioxidant Status in Breast Cancer Patients Undergoing Radiotherapy
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Breast cancer (BC) is the most prevalent tract cancer in the world, including Iraq. The classified breast tumors to benign, malignant, and radiotherapy. Cancer treatment depends on certain stages such as mastectomy then chemotherapy alone or with radiation therapy or endocrine therapy according to the prognostic features obtained from the pathology report. The present study included 100 females. The women were split into two groups, control group that consisted of 50 apparently healthy females and 50 patients with BC group who undergo the radiotherapy. The current study highlighted on some of the anthropometric measurements, including the oxidative stress index malondialdehyde (MDA), the concentrations of total antioxidant capacity (TAC), s

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Publication Date
Thu Jun 01 2023
Journal Name
Baghdad Science Journal
Comparison Study between Adipsin Levels in Sera of Iraqi Patients with Diabetes and Neuropathy
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The current study was designed to compare some of the vital markers in the sera of diabetic and neuropathy patients via estimating Adipsin, Fasting blood Glucose(FBG), Glycated(HbA1c) hemoglobin, Homeostasis Model Assessment Index (Homa IR ), Cholesterol, High density lipoprotein (HDL), Triglycerides (T.G), Low-density, and lipoprotein (LDL), Very Low Density Lipoprotein (VLDL), in sera of Iraqi patients with diabetes and neuropathy. A total  of ninety  subjects  were divided into three groups: group I (30 diabetic with neuropathy males) and group II (30 diabetic males without neuropathy), and 30 healthy sujects were employed as control group. The results showed a significant decline in Adipsin levels (p>0.05) in neuropathy, T2DM g

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Comparison between diode laser and scalpel for lip lengthening in patients with gummy smile
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Background: lip lengthening procedure is one of the surgical options for the correction of gummy smile in patients with short upper lip. Methods: A comparative clinical study was conducted on 15 patients requiring lip lengthening procedure for the esthetic correction of excessive gingival exposure with gummy smile. Scalpel was used in seven patients and diode laser in the remaining eight patients. Under infiltration anesthesia, about one cm strip of mucosa was excised at the vestibular depth and the mucosa of the lip was sutured to the alveolar mucosa. Results: The diode laser group demonstrated less postoperative pain and swelling. Regarding postoperative ecchymosis, three patients in the scalpel group developed ecchymosis and no cases

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Publication Date
Wed Sep 16 2020
Journal Name
F1000research
Green tea influence on iron overload in thalassemia intermedia patients: a randomized controlled trial
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Background: Although iron chelation therapies have been available for many years for thalassemia intermedia patients, iron accumulation remains the major cause of death. Therefore, the need for additional chelation options is in demand. This randomized controlled study aimed to understand the effects of green tea on iron balance in thalassemia intermedia patients.

Methods: Using a random selection method, 141 thalassemia intermedia patients were initially screened for inclusion in this trial; only 68 patients included after applying exclusion criteria. Two equal groups were generated (n=34/group): green tea (three cups/day after meals) + usual treatment (deferasirox iron chelat

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Publication Date
Sat Oct 01 2022
Journal Name
The Egyptian Journal Of Hospital Medicine
Evaluation of Some Pro-Inflammatory Cytokines Level in Sample of Iraqi Patients with Hyperthyroidism
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Background: Hyperthyroidism is a serious public concern, due the continuous increase in its prevalence and its impact on the mortality rates. Autoimmune hyperthyroidism is seen as a thyroid gland problem. Pro-inflammatory cytokines are crucial for the growth and development of hyperthyroidism, it was shown that the level of several pro-inflammatory cytokines were higher in the hyperthyroidism patients. Objective: This work was aimed to assessment the concentration of certain cytokine in hyperthyroid patients. Materials and Methods: Sixty hyperthyroidism patients and 30 healthy individuals with age range from (30-65) years old were enrolled in this study through their presence at the National Center for Diabetes Treatment and Research in Bag

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Publication Date
Tue Jan 01 2019
Journal Name
Diabetes &amp; Metabolic Syndrome: Clinical Research &amp; Reviews
Nephrotic range proteinuria; does it predict lung involvement in patients with type 2 diabetes
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Publication Date
Tue Jan 01 2019
Journal Name
Diabetes &amp; Metabolic Syndrome: Clinical Research &amp; Reviews
Nephrotic range proteinuria; does it predict lung involvement in patients with type 2 diabetes
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Publication Date
Mon Sep 30 2024
Journal Name
Iraqi Journal Of Science
Molecular and Immunological Detection of Hepatitis C Virus in Patients with Chronic Renal Failure
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Due to its association with hepatocellular carcinoma and being one of the ten most common malignancies worldwide, hepatitis C viral infection has become a severe public health concern. Therefore, establishing an accurate, reliable and sensitive diagnostic test for this infection is strongly advised. Real-time polymerase chain reaction (PCR) has been created to achieve this purpose. The current study was established to investigate the hepatitis C virus among Iraqi patients with chronic renal failure and to detect the virus immunologically by the fourth generation enzyme-linked immunosorbent assay technique and molecularly by real-time PCR. As a result, out of 50 patients with chronic renal failure undergoing dialysis, 39 patients tes

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