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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 Jun 11 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Effectiveness of prophylactic agents in prevention of oral mucositis in patients with head and neck cancer receiving radiotherapy
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Background: Oral mucositis is regarded as one of the major complications of radiation therapy especially in patients with head and neck cancer. The aim of this study was to evaluate the efficacy of glutamine in preventing or minimizing the development of mucositis of the oral cavity. Subjects and methods: Forty-six participants were randomly selected amongst those who were planned to receive radiation therapy for head and neck region cancers. They were randomly divided into two groups of 23 subjects, one group received glutamine and the second group received a placebo. Results: Glutamine had a statistically significant effect in reducing the occurrence and/or severity of oral mucositis in the treated patients compared to patients in the con

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Publication Date
Mon Dec 01 2008
Journal Name
Saudi Medical Journal
Treatment of perniosis with oral pentoxyfylline in comparison with oral prednisolone plus topical clobetasol ointment in Iraqi patients.
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AA Noaimi, BM Fadheel, Saudi medical journal, 2008 - Cited by 25

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Publication Date
Sun Jan 01 2023
Journal Name
The Egyptian Journal Of Hospital Medicine
A Study of the Relation between Human Cytomegalovirus and IL-35 in Rheumatoid Arthritis Disease Patients in Iraq
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ackground An autoimmune and inflammatory illness called rheumatoid arthritis (RA) occurs when your immune system mistakenly attacks normal cells in your body. Interleukin-35 is a brand-new cytokine that belongs to the immunosuppressive and anti-inflammatory IL-12 family. β -herpesvirus that produces inflammation and stays dormant in its host for life is the human cytomegalovirus. Human herpesvirus (HCMV) has been at the core of several RA-related theories. Objective The current study looked at the association between RA and serum IL-35 levels as well as the association between RA and CMV. Patients and methods Blood samples were taken in the Baghdad Teaching Hospital and Typical Rheumatology Unit from January 2022 to Mars 2022 for the curre

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Publication Date
Mon Nov 02 2020
Journal Name
International Journal Of Pharmaceutical Research
Evaluation of Serum Adropin Levels in Nonalcoholic Fatty Liver Disease as A Complication of Hypothyroidism In Iraqi Patients
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Publication Date
Wed Mar 01 2017
Journal Name
International Journal Of Cardiology
The role of myocardial performance index in assessment of left ventricular function in patients with valvular mitral regurgitation
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Background: Mitral regurgitation (MR) is the most commonly encountered valve lesion in modern clinical practice. Severe mitral regurgitation may cause systolic dysfunction. Left ventricular ejection fraction may not be an accurate measurement of LV function in patients with mitral insufficiency. Myocardial performance index (MPI) is a simple non invasive measure of myocardial function. Methods: The study involved 50 patients with valvular mitral regurgitation and 50 healthy subjects as a control group. Transthoracic echocardiography was carried out for all patients and control group. The echocardiographic measurements included left ventricular end diastolic and end systolic dimensions, left atrial diameter, ejection fraction (EF), and myoca

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Detection of Thrombi in Left Atrial chamber by Transoesophageal Ecchocardiography in patients suffer from Non-rheumatic Atrial Fibrillation
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Background: Background : Patients with non-rheumatic atrial fibrillation have high risk of thromboembolism especially ischemic stroke usually arising from left atrial appendage .Transoesophageal echocardiography provides useful information for risk stratification in these patients as it detects thrombus in the left atrial or left atrial appendage. Objective : This study was conducted at Al-Kadhimiya Teaching Hospital to assess the prevalence of left atrial chamber thrombi in patients with chronic non-rheumatic atrial fibrillation using transoesophageal echocardiography and its clinical significance as well as to verify the superiority of transoesophageal over transthoracic echocardiography in the detection of these abnormalities. Type of

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Assessment of Thyroid Functions in Multiple Sclerosis Patients Treated with Disease Modifying Therapies: Thyroid Functions in Multiple Sclerosis
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Background:

Multiple sclerosis is a chronic disease believed to be the result of autoimmune disorders of the central nervous system, characterised by inflammation, demyelination, and axonal transection, affecting primarily young adults. Disease modifying therapies have become widely used, and the rapid development of these drugs highlighted the need to update our knowledge on their short- and long-term safety profile.

Objective:

The study aim is to evaluate the impact of disease-modifying treatments on thyroid functions and thyroid autoantibodies with subsequent effects on the outcome of the disease.

Materials and Methods:

A retro prospective study

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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
EVALUATING THE EFFECTIVE CREATIVE LEADERSHIP ROLE OF THE DEAN AND HEADS OF SCIENTIFIC DEPARTMENTS IN THE COLLEGE OF PHYSICAL EDUCATION AND SPORTS SCIENCES AL-MUSTANSIRIYAUNIVERSITY
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Publication Date
Wed Oct 02 2024
Journal Name
International Development Planning Review
EVALUATING THE EFFECTIVE CREATIVE LEADERSHIP ROLE OF THE DEAN AND HEADS OF SCIENTIFIC DEPARTMENTS IN THE COLLEGE OF PHYSICAL EDUCATION AND SPORTS SCIENCES AL-MUSTANSIRIYAUNIVERSITY
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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
The Reality of Alternative Assessment for Teachers of the First Cycle of the Basic Education in the Sultanate of Oman: Use, Self-Efficacy, and Attitude
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This study aims at identifying the reality of alternative assessment for teachers of the first cycle of the basic education in the Sultanate of Oman with respect to the degree of teachers' use of alternative assessment strategies, level of self-efficacy for alternative assessment strategies, and attitude towards alternative assessment, and their relationship with other variables. To achieve the aims of the study, a descriptive research approach was utilized. A 5-point self-rated questionnaire was developed. It consists of three sections: Actual use of alternative assessment strategies (21 items), self-efficacy for alternative assessment strategies (21 items), and attitude towards alternative assessment (27 items). The psychometric proper

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