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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 Jan 01 2014
Journal Name
International Journal Of Advanced Research
Evaluation of anti-Helicobacter pylori IgG level in the serum of patients with Rheumatoid arthritis
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Rheumatoid arthritis is an inflammatory chronic disease with an autoimmune pathogenesis. To determine the role of Helicobacter pylori as a trigger agent, twenty five patients with rheumatoid arthritis of ages (15-47) years have been investigated and compared with twenty healthy individuals. All the studied groups were carried out to measure the rheumatoid arthritis (RA) IgM, anti-CCP antibody IgG and IgA by ELISA test and by measured anti-IgG antibody level of H. pylori by using ELISA and IFAT techniques. The present study showed significant differences (P< 0.05) of anti-H. Pylori in sera of RA patients than control group, this lead to suggest that H. pylori had a role in pathogenesis of RA.

Publication Date
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
Toll like receptor 2(TLR2) in acne vulgaris patients before and after oral isotretinion therapy
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Background: Acne vulgaris is one of the top three most commonly encountered dermatological problems worldwide in both primary and secondary care. Human keratinocytes express functional TLR2 heterodimers. An increased expression of TLR2 was detected in the epidermis of inflammatory acne lesions, as observed in normal skin; the expression level increased with the degree of differentiation of the keratinocytes. TLR2 expression is upregulated in inflammatory acne lesions and induced by C. acnes. The current study conducted to assess the oral isotretinion treatment effect on the acne vulgaris patients by  evaluated the Toll Like Receptor 2 as a major  immune system marker in Acne vulgaris immune re

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Publication Date
Thu Jun 30 2011
Journal Name
Al-kindy College Medical Journal
THE PREVALENCE AND CLINICAL SIGNIFICANCE OF PERINUCLEAR ANTINEUTROPHIL CYTOPLASMIC ANTIBODY IN PATIENTS WITH INDETERMINATE COLITIS
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Background: Indeterminate colitis (IC), a term
originated by pathologists to characterize confounding
histopathlogic appearance of resected mucosa, has
become catch phrase for cases in which diagnostic
criteria at all levels elude classification as Crohn's
disease (CD) or ulcerative colitis (UC).
OBJECTIVES: evaluate the prevalence of pANCA
expression in the sera and its isotypes.
Patients and methods: PATIENTS GROUP
consisted of 60 patients (40 males and 20 females)
with indeterminate colitis and their age range was (19-
84 years). CONTROL GROUP consisted of 30 (15
males and 15 females) healthy volunteers and their
age range was (20- 66 years).
Antineutrophil cytoplasmic ( pANCA and cANCA)
te

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Publication Date
Thu Jan 01 2015
Journal Name
Health
Evaluation of Myocardial Performance in Hypertensive Patients with Type 2 Diabetes and Normal Ejection Fraction
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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Measuring Service Delivery Orientation For Doctor and patients Perspective Experimental Study in Numan General Hospital
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This research aims to Measurement provide the service from Two perspectives The first perspective Service Provider (doctors) and the second recipient of the service (patients) in Numan General Hospital, and represented the research problem in perceptions of medical staff in the hospital assigned to them responsibility by providing superior services satisfy customers, and how they maintained ready to assist customers and provide services that exceed their perceptions of these services through the use of the developer scale by (Frimpong and Wilson, 2012), includes orientation to provide the service scale four dimensions (Internal cooperative behaviors, service Competence, Service Responsiveness and Enhanced service) and includes do

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Publication Date
Tue Oct 01 2024
Journal Name
Medical Journal Of Babylon
Association between Single Nucleotide Polymorphisms rs3757318 and Vitamin D Deficiency in Iraqi Breast Cancer Patients
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Abstract<sec> <title>Background:

Multiple single-nucleotide polymorphisms (SNPs) located in the intergenic region between estrogen receptor 1 and CCDC170 (especially at rs3757318) are thought to be associated with breast cancer risk. additionally, the serum level of vitamin D is believed to be linked to different aspects of breast carcinogenesis.

Objectives:

To assess the potential association between rs3757318 SNP and breast cancer pathogenicity, specifically in relation to serum vitam

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Publication Date
Fri Jan 01 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology,
Role of CoQ10 and IGFBP-1 in Obese Male Patients with Diabetic Mellitus Type II
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Study the role of CoQ10 and IGFBP-1 in obese male patients with diabetic mellitus type 2. ELISA method was used to assay Serum CoQ10 and IGFBP-1. Blood was taken with drawn sample from 30 obese normal patients with age range (40-60) years, 30 diabetic patients with age range (40-60) years at duration of disease (1-5) years and 30 normal healthy patients. The mean difference between T2DM according to CoQ10 (12.5±1.1) was decreased than the mean of IFG (21.8±3.2) (P 0.002) and the mean difference between T2DM according to IGFBPs (0.65±0.06) was decreased than the mean of IFG (3.2±0.3) (P 0.000). While no significant difference between mean age of DM2 patients (55.5±1.06), and IFG (55.6±0.9) (p 0.90), no significant difference bet

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Publication Date
Wed Aug 07 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Knowledge toward Care of Unconscious Adult Patients at Teaching Hospitals in Al-Hilla City
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Objective: The study aims to evaluate nurses' knowledge toward care of unconscious adult patients and identify the relationship between nurses’ knowledge toward care of unconscious adult patient and their demographic characteristics of age, gender, Marital Status, level of qualification and years of experience. Methodology: A descriptive study (quantitative design) was carried out by using quasi experimental design to study nurses' knowledge, attitudes and practices toward care of unconscious adult patients at teaching hospitals in Al-Hilla City from September 2018 up to June 2019. A purposively sample has been chosen in which included 60 nurses who work in ICUs within two hospitals (Imam Al-Sadiq teaching hospital and Al-Hilla general

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Publication Date
Sun Dec 05 2010
Journal Name
Baghdad Science Journal
Immunoglobulins assessment (IgE,G,A,M) in some Iraqi patients with acute and chronic urticaria
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60 patients diagnosed as having urticaria were included in the study ; 30 patients were effected with acute urticaria and 30 patients were affected with chronic urticaria. In addition, 30 healthy adult volunteers were selected as control group .The patients and control groups sera were examined with enzyme linked immunosorbent assay ( ELISA) to detect total level IgE and radial immunodiffusion (RID) to detect levels of IgG , IgA and IgM . The total level of IgE in acute urticaria ( 1.45±0.13) IU/mL and chronic urticaria (2.12 ± 0.10) IU/mL patients were significantly higher than the control groups ( 0.85 ± 0.10)IU/mL (p<0.05). The level of IgG in acute urticaria ( 12.5± 0.42) g/L and chronic (13.16±0.40) g/L patients , IgA in acute (2.

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Publication Date
Thu Dec 31 2009
Journal Name
The Iraqi Journal Of Veterinary Medicine
Possible beneficial effects of amlodipine, lisinopril, and their Combination on lipid profile in hypertensive patients
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It is well known that monotherapy does not provide therapeutic response in all hypertensive. Somepatients show an excellent response, while in others there is a poor response. Combinationantihypertensive therapy is administered when blood pressure is inadequately controlled bymonotherapy to achieve a balanced and additive antihypertensive effect with minimum adverse effects.Both angiotensin converting enzyme (ACE) inhibitors and dihydropyridine type of calcium antagonistsare well established and widely used in monotherapy. An understanding of differences in themechanism of action of these agents allows a logical approach for the use of these agents as acombination therapy. This study was designed to evaluate the possible beneficial

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