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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 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
Fri Mar 06 2026
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
Fri Jun 20 2014
Journal Name
Jurnal Teknologi
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 Jun 27 2021
Journal Name
Turkish Online Journal Of Qualitative Inquiry
The Discoursal Aspects of Medical Encounters
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This paper exclusively deals with medical encounters. . Structurally and thematically, it manifests itself in five parts. The First part deals with medical encounters as well as essential speech activities which cover (a) frames (certain types of talk) (b) the patient’s account and the patient’s story or more precisely the patient telling his story and (c) the act of questioning the patient. The Second part revolves round genre and register. The former, in most cases, suggests that the format of medical encounters is conversational. With register; we have a converse reality that restrictively tries to narrow things and give them a certain flavor. The Third part realizes the technicalities of medical encounters (a) the setting of an inte

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Publication Date
Sun Dec 01 2013
Journal Name
Political Sciences Journal
Mr. Hassan Ezzedine al-Ulum The social contract and popular power when Imam Ali
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حسن السيد عز الدين بحر العلوم العقد الاجتماعي والسلطة الشعبية عند الإمام علي (عليه السلام )

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Publication Date
Sat Mar 26 2022
Journal Name
Neuroquantology
Efficiency Evaluation of Optical System Includes Different Stop Apertures When Using Relative Moving Factor
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In this work, optical system with different aperture shapes (circular, square, elliptical and triangle aperture) has been used for efficiency evaluation when the system involved moving factor in ideal case (aberration free). The optical system evaluate far moving object, therefore the image forming at image plane due to point spread function (image formula of incoherently illuminated point object). A mathematical treatment has been used to getting results by Gaussian numerical calculations method. The results show priority of circular aperture when optical system that submits of moving factor.

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Publication Date
Fri Jun 20 1930
Journal Name
College Of Islamic Sciences
Education in the Koran: (Objective study)
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The name of God the Merciful
Praise be to Allah, Lord of the Worlds, and prayers and peace be upon the prophets and messengers Prophet Muhammad and his family
And his companions who followed his approach to the Day of Judgment. After that, Islam has paid great attention to the aspects of education
The promise of a way to degrade and correct behavior, and to reach the individual to the highest levels through his intellectual upbringing
Mentally, mentally, mentally and intellectually, education at all times and places is the best way to communicate to a human being
The degree of happiness in religion and the other, as it develops all aspects of his personality, and supports the love of goodness for himself
For people, edu

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
TOTAL QUALITY MANAGEMENT IN EFL EDUCATION
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The purpose of this study is to identify the extent of the EFL teachers’ implementationoftotal quality management (TQM)principles through teaching English as a foreign language in Iraqi secondary schools.A total of 180 EFL teachers fromsecondary schools in Baghdad during the academic year 2010/ 2011 participated in the study. Data was collected using a scale to identify the extent of implementation of total quality management principles by 140 EFL teachers in their classroom. To support the data collected from the scale,40 teachers were observed by EFL educational supervisors during their lessons. The collected data was analyzed using frequency, means and standard deviation to identify the extent of implementation of (TQM) principles.

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Publication Date
Sun Nov 01 2020
Journal Name
Systematic Reviews In Pharmacy
Recent Development In Oxine Complexes And Their Medical Application: A Review.
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This review is concluded of 8-Hydroxyquinline (8HQ) compound and derivatives which has a very significant interests with a strong fluorescence , furthermore the relationship between divalent metal ions and characteristic of chelating . In the same way coordinated features have increase of its organic action and inorganic behavior by giving many samples of compounds which are a good chelating agents ligands with more capable of forming very stable complexes.Therefore, the role of (8HQ) is not limited on complexes only but its applications in different fields so this review will focus on demonstration preparation methods and properties of (8HQ) derivatives with their complexes and applications, hopefully that we will cover a part of scientifi

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