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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 Jan 01 2015
Journal Name
World Journal Of Experimental Biosciences
Evaluation of anti-Helicobacter pylori antibodies level in sera of patients with chronic hepatitis B
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The relationship between chronic hepatitis B virus and Helicobacter pylori infection was evaluated to determine, seventy five patients with chronic hepatitis B infection (8-70 years) were investigated. The results were compared with the results of 50 healthy volunteers. Anti-H. pylori antibodies IgA and IgG were measured by Indirect fluorescent antibody test (IFAT) in sera of patients and healthy groups. The percentage of anti-H.pylori IgA antibodies (26.67%) were significantly (P<0.01) higher than healthy control group. While, no significant difference was found between the percentages of anti-H. pylori IgG antibodies (48 %) in patient sera and these kind of antibodies in sera of healthy control group (P > 0.05). The present results indica

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Publication Date
Sun Dec 01 2013
Journal Name
Baghdad Science Journal
Studying the possibility of confection of hepatitis C and hepatitis G viruses in Iraqi patients
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The aim of this study was spot light to the possibility of confection between hepatitis C&G viruses in Iraqi patients. The groups was studied included two groups as follow: 1- first group: its (Infected group) the patients of this group have Anti-HCV abs in their serum by using Indirect ELISA technique. 2- second group: its (Control group) the persons of this group have no Anti-HCV abs in their serum by using indirect ELISA technique. The result of this study was observed there was two patients from the first group have Anti-HGVabs in their serum with infection percent 2.70%, also the same result was found in the second group wich mean there was two persons have Anti-HGVabs in their serum with infection percent 8.33% .So when we comparin

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Publication Date
Fri Nov 01 2013
Journal Name
The Iraqi Postgraduate Medical Journal
Efficacy and safety of topical podophyllin 5% ointment in patients with mild plaque-type psoriasis
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KE Sharquie, AA Noaimi, WK Al-Janabi, The Iraqi Postgraduate Medical Journal, 2013 - Cited by 3

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Publication Date
Thu Jul 06 2023
Journal Name
Iraqi Journal Of Biotechnology
Impact of Helicobacter pylori in some Blood Parameters Change of Iraqi Patients with Gastritis Disease
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In order to find the relationship between Helicobacter pylori infection and hematological disease are disorders which primarily affect the blood and blood-forming organs. One hundred and three blood samples were taken for people aged (20-68) years for the period from 10/1/2021 to 1/3/2022, divided into three groups. The first group included 44-person H. pylori-infected with symptoms of infection, the second group had 19-person H. pylori-infected but without symptoms, and the third group included 40 people without H. pylori infection. All studied groups were carried out to measure anti-IgG Ab, Vac A and Ferritin by Enzyme Linked Immunosorbent Assay (ELISA) technique. The statistical analysis indicates a non-significant difference in Vac A (p

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Publication Date
Fri Jan 01 2021
Journal Name
Biochemical Cellular Archive
detection of anti-helicobacter pylori cag a antibody in sera of patients with eye diseases
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The study conducted to investigate the association between Helicobacter pylori infection and eye diseases (Glaucoma, Cataract, CSR and Uveitis). One hundred and four patients with multiple eye disorders (10-80) years were observed from 10/9/2020 to 18/11/2020 and compared to thirty-one healthy people (19 female and 12 male). Each participant was tested for H. pylori CagAAbs and TNF-α using an enzyme-linked immunosorbent assay (ELISA). The results have shown that there was a non-significant difference (p≥0.05) in the concentration of CagAantibodies in sera of patients with eye diseases except in the case of CSR (central serous chorioretinopathy), which was a significant difference (P≤0.05) compared to the control group. Also, the result

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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Functional Performance For Patients Post Heart's Valves Replacement at Cardiac Surgery Centers in Baghdad City
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Abstract
Objectives: The study is carried out to assess functional performance for heart's valve replacement patients and find out relationship with sociodemographic data and clinical data
Methodology: Descriptive design is carried out at cardiac surgery centers in Baghdad ; Ibn -Al Betar Specialized for cardiac surgery center and Al-Iraqi center for cardiac disease. its initiation from December28the 2013 to September 1st 2014,A non- probability (purposive) sample of 50 adults patients are attended cardiac surgery centers at Baghdad city and who have heart valves replacement. The data collection through development of questionnaire which is composed from three parts(socio demographic data, clinical information, functional performa

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Publication Date
Tue Aug 23 2022
Journal Name
International Journal Of Health Sciences
Correlation between paraoxonase-1 arylesterase activities and clopidogrel drug in patients with coronary artery disease
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Background: Coronary artery disease (CAD) is one of the leading causes of death worldwide. Clopidogrel, antiplatelet drug, has been widely used for management of CAD. Arylesterase, the activity of Paraoxonase-1 (PON-1), is mainly contributed in the biotransformation of clopidogrel to its active thiol form. The purpose of this study was to investigate the effect of receiving clopidogrel drug on the arylesterase activities in CAD patients. The effect of receiving clopidogrel drug on the antioxidant activity of arylesterase was also monitored by determination of malondialdehyde (MDA) level. Methods: One hundred CAD patients, who were followed-up for 5 days after reciving clopidogrel, and 50 healthy volunteers were included in our study

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Publication Date
Sun Dec 27 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Estimation of Beta Two Microglobulins, Fetuin-A, Resistin Serum Level in Iraqi Multiple Myeloma Patients
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Multiple myeloma is hematological disease produces many complications in the bone, kidney, neural and other complications. The study aims to measure serum biomolecules like fetuin-A and resistin and determined the possibility to use these biomarkers as disease predictor. blood samples were isolated from 58 patients and 24 sex and age-matched control, serum then isolated, and proper ELISA kit then used to a determined level of B2 microglobulin, resistin, and fetuin-A. The result demonstrated significant increase in   B2 microglobulin, fetuin-A and resistin in patients compare to control (1.3470.714 vs. 0.9130.253), p = 0.000, (14.00310.352 vs. 9.2594.264), p= 0.005, (1.9673.595 vs. 0.6040.622), p = 0.009, respectively.   These di

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Quality of Life of Patients with Type II Diabetes Mellitus in Al- Hilla City-Iraq
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Diabetes mellitus is a global problem nowadays due to increase the disease cases all over the world, in both the developed and developing countries which may affect the quality of life (QOL ) of diabetic patients. This study was conducted to assess the quality of life of patients with type 2 diabetes mellitus (DM) and to determine some selected clinical and sociodemographic factors that affect the quality of life of these patients in Al Hila city-Iraq. This was a cross sectional study in which 100 patients with type 2 diabetes mellitus attending diabetic outpatient clinics of Merjan Teaching Hospital-Al Hila. To assess the quality of life of those diabetic patients, the World Health Organizations Quality of Life Assessment (WHOQOL) was a

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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Practices regarding Patients Discharge Planning post Cardiac Surgery at Cardiac Centers in Baghdad city
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Objective (s): to assess nurses' practices regarding discharge planning post-cardiac surgery and to find out the relationship between nurse practices and demographic characteristic (age, gander, level of education, years of experiences, and years of experiences in surgical ward).
Methodology: A descriptive study was carried out at cardiac centers and hospitals in Baghdad (Ibn Al- Bitar specialized center for cardiac surgery; Iraqi center for heart disease and Ibn al Nafees hospital). For the period of 6th February 2017 up to 1st of June 2018. A non-probability (purposive) sample of (58) nurses (male & female) who were working in surgical wards. The data was collected, by using of a questionnaire, which consists of two parts, part

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