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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
Tue Apr 28 2026
Journal Name
Baghdad Science Journal
Clinical Implications of Circulating miRNA-200a and Mucin 16 in Late-Stage Colorectal Cancer: A Study in Iraqi Patients
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Background: Colorectal cancer, the most common gastrointestinal cancer, is a significant health issue globally. Mucin 16 plays a critical role in cancer signal transduction pathways and is a potential glycoprotein target for cancer therapy. The miRNA-200 family also regulates the expression of numerous genes that play vital roles in cancer cells. This study aimed to investigate the changes in mucin 16 and miRNA-200a in patients with colorectal cancer (CRC). Subjects and Methods: Fifty-six patients with CRC, including 26 in stage 3 and 30 in stage 4, were included in this study, along with 38 healthy volunteers as a control group. Parameters such as mucin 16, miRNA-200a, total protein, albumin, globulin, and the albumin/globulin rati

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Extent of Fulfilling Total Quality Standards by Applied Sciences Colleges in the University of Technology and Applied Sciences in Light of the National Strategy of Education 2040 in the Sultanate Of Oman.
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Abstract

The study aims to identify the extent to which the applied colleges at the University of Technology and Applied Sciences meet the comprehensive quality standards in light of the national education strategy for the 2040 Vision in the Sultanate of Oman. To do this, the researchers used the descriptive approach. They used a questionnaire as a tool for data collection that was applied to (237) administrators, academics, and support functions. The study found that the extent to which the applied colleges at the University of Technology and Applied Sciences meet the comprehensive quality standards in the light of the National Education Strategy 2040 in the Sultanate of Oman recorded a high range. The study als

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Publication Date
Sat Nov 01 2014
Journal Name
Patient Preference And Adherence
Antibiotic-prescribing patterns for Iraqi patients during Ramadan
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Background: During Ramadan, Muslims fast throughout daylight hours. There is a direct link between fasting and increasing incidence of infections. Antibiotic usage for treatment of infections should be based on accurate diagnosis, with the correct dose and dosing regimen for the shortest period to avoid bacterial resistance. This study aimed to evaluate the practices of physicians in prescribing suitable antibiotics for fasting patients and the compliance of the patients in using such antibiotics at regular intervals. Materials and methods: An observational study was carried out during the middle 10 days of Ramadan 2014 in two pharmacies at Baghdad. A total of 34 prescriptions (Rx) for adults who suffered from infections were examined. For

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Publication Date
Sun Jan 01 2017
Journal Name
Journal Of Global Pharma Technology
Bacteriological and enzymatical study on rheumatoid arthritis patients
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The current study included the collection of 175 samples (blood-urea) of patients suffering from rheumatism, collected from Baghdad Teaching Hospital (Educational Laboratory), Al-Kindy Teaching Hospital, Al-Imamian Al-Kadhimya in Medical City in Baghdad at different duration between 2016/10/1-2017/2/1. The bacterial growth results showed that 80% of urea samples positive for bacterial culture, while the rate of samples did not show any bacterial grow this 20%. The isolation subjugates to morphological, microscopically and biochemical tests, as also diagnosis by Api system. The most frequent bacterial pathogenic is E. coli which appeared highly rate (41.97)% followed by E. cloacae (21.25)%, P. aeruginosa (12.5)%, Salmonella (10)% and the pro

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Scopus
Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Totas serum sialic acid among enteric fever patients
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In this study serum total sailie acid concentration were tested as a scrological marker of discases activity to cvalute the result of the test in the diagonosis oe enteric fever(TSA) was measured in the serum od (50) patines with typhi fever(50)pa-tients

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Publication Date
Sun Jun 07 2009
Journal Name
Baghdad Science Journal
Spectrophotometry of Saliva of Oral Squamous CellCarcinoma Patients
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Back ground: Spectral analyses of solutions have long been applied to various body fluids for the purpose of clinical study as well as research .Human saliva can be easily obtained by non invasive .In this study typical spectra (for UV and IR) of saliva of oral cancer Squamous cell carcinoma patients were determined under average conditions and evaluated in relation to the spectra of normal specimens. Materials and Methods: Seventeen patients of oral cancer Squamous cell carcinoma and seventeen age matched healthy subject were included in this study .Chewing - Stimulated Saliva was collected in plastic test tube and stored at -20° C. Bach of saliva samples were used for UV and IR measurements. Results: Many differences between the IR spect

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Publication Date
Sun Aug 01 2021
Journal Name
International Journal Of Agricultural And Statistical Sciences
STATISTICAL ANALYSIS OF PATIENTS INFECTED WITHCORONAVIRUS USING MANOVA
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Statistics has an important role in studying the characteristics of diverse societies. By using statistical methods, the researcher can make appropriate decisions to reject or accept statistical hypotheses. In this paper, the statistical analysis of the data of variables related to patients infected with the Coronavirus was conducted through the method of multivariate analysis of variance (MANOVA) and the statement of the effect of these variables.

Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Linguistic Analysis as Mean of Soliciting Patients concerns
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Publication Date
Thu Dec 30 2021
Journal Name
Al-kindy College Medical Journal
Cancer Patients’ Experiences and Understanding of Venous Thromboembolism
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Background: Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), presents an extra challenge in the management of patients with cancer, given the increase in morbidity and mortality in having both conditions. Cancer patients are well known to have a high risk of VTE; particularly; those who have had major surgery, chemotherapy and/or hormonal therapy. These groups of patients need to understand the risk factors and the prophylactic measures to prevent developing VTE. This review aims to provide an overview of the literature on cancer patients’ understanding of VTE and their experiences of cancer-associated thrombosis (CAT).

Method: A scoping review wa

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Publication Date
Sun Nov 04 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Determination of Quality of Life for Adult Patients
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Objective: The study aimed to determine quality of life domains for adult patients with limbs loss and to identify
the association between quality of life domains and demographic characteristics and medical information.
Methodology: A descriptive study was carried out at Baghdad artificial limb center, Al-Salam medical
rehabilitation center, Al-Ghadeer medical rehabilitation center and the rheumatoid and medical rehabilitation
center for the period from September 2007 to April 2008. A purposive ''non- probability'' sample of (200)
patients with limbs loss. Questionnaire form was constructed for the purpose of the study. Data were collected
through the application of the questionnaire and interview technique. Data were a

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