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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 Aug 16 2016
Journal Name
Case Studies In Surgery
Ameloblastoma: A clinical study of 25 Iraqi patients
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Objective: Geographic differences in clinical and pathological aspects of ameloblastoma have been suggested, therefore the purpose of this study was to analyze cases of ameloblastoma in terms of clinical and radiographic manifestations, histopathological types, treatment modalities and recurrence rate and compare them with reports from other parts of the world. Methods: The medical reports of patients diagnosed with ameloblastoma were reviewed and the data concerning the age, gender, chief complaint, the anatomical site of the lesion, radiographic appearance, histopathological diagnosis, treatment approach and recurrence were retrieved. Surgical treatment consisted of either enucleation with curettage and peripheral ostectomy or resection;

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Publication Date
Mon Mar 01 2010
Journal Name
Journal Of Al-nahrain University
DETERMINATION OF SERUM TRACE ELEMENTSMAGNESIUM, COPPER, ZINC, AND SELENIUM IN ASTHMATIC PATIENTS BY ATOMIC ABSORPTION SPECTROPHOTOMETRY
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The aim of this study is to evaluate the levels of trace elements Magnesium (Mg), Zinc (Zn), Copper (Cu), and Selenium (Se) in blood sera of asthmatic patients by Atomic Absorption Spectrophotometry (AAS). The concentrations of Mg, Cu, and Zn have been determined by Flame Atomic Absorption spectrophotometry (FAAS), and Se with flameless Graphite Furnace Atomic Absorption Spectrophotometry (GFAAS). The study involves (55) asthmatic patients as study group and (28) subjects as control from both genders. Serum levels of Mg, Cu, and Se were significantly higher (p<0.001 for all) in patients when compared with healthy subjects, while Zn level was relatively significant (p<0.05). Our observations confirm the efficacy and applicability of (AAS) in

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Publication Date
Sun Dec 01 2024
Journal Name
The Medical Journal Of Tikrit University
ChemiluminescenceMicroparticle Immunoassay in the Diagnosis of Hepatitis C Virus among Patients on Hemodialysis: A Comparative Study
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Browse Iraqi academic journals and research papers

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Publication Date
Wed Aug 30 2023
Journal Name
Baghdad Science Journal
Studying the Effect of COVID-19 on Liver Enzymes and Lipid Profile in Iraqi Recovering Patients
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  The Covid-19 virus disease has been shown to affect numerous organs and systems including the liver. The study aimed to compare lipid profiles and liver enzyme levels in individuals who had recovered from Covid-19 infection. To achieve the study objectives, liver Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline phosphatase (ALP),  Random Blood Sugar (RBS) and Lipid profile which include cholesterol, High-Density Lipoprotein (HDL), Triglycerides (T.G), Low-Density Lipoprotein (LDL), and Very low-density Lipoprotein (VLDL) were determined.

One hundred twenty serum samples were obtained, of which fifty samples were utilized as the control healthy persons (not affected by COVID) and seventy samples came f

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Publication Date
Sat Jan 01 2022
Journal Name
Annals Of Parasitology
Serum levels of C-reactive protein and ferritin in COVID-19 patients infected with Toxoplasma gondii
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During infection, T. gondii disseminates by the circulatory system and establishes chronic infection in several organs. Almost third of humans, immunosuppressed individuals such as HIV/AIDS patients, cancer patients, and organ transplant recipients are exposed to toxoplasmosis. Therefore, the study aimed to investigate the possibility that Toxoplasma infection could be a risk factor for COVID-19 patients and its possible correlation with C-reactive protein and ferritin. Overall 220 patients referred to the Al Furat General Hospital, Baghdad, Iraq were enrolled from 2020–2021. All serum samples were tested for T. gondii immunoglobulins (IgG and IgM) antibodies, C-reactive protein and ferritin levels. In patients with COVID-19, the results

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Scopus
Publication Date
Thu May 04 2023
Journal Name
Journal Of Indian Association Of Biomedical Scientists
“Relationship between Cathepsin K and Total oxidative state in diabetes mellitus Iraqi Women patients with osteoporosis
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Introduction and Aim: Diabetes mellitus patients almost always struggle with a metabolic condition known as chronic hyperglycemia. According to the World Health Organization, osteoporosis is a progressive systemic skeletal disorder that is characterized by decreasing bone mass and microstructural breakdown of bone tissue that increases susceptibility to fracture and increased risk of breaking a bone. Here, we aimed to compare the levels of CatK and total oxidative state in patients with diabetes and osteoporosis among the female Iraqi population and study the possible relationship between them. Materials and Methods: This study included 40 females with diabetes (Group G1), 40 with diabetes and osteoporosis (Group G2) and 40 normal healthy f

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Publication Date
Fri Jan 01 2021
Journal Name
International Journal Of Agricultural And Statistical Sciences
DYNAMIC MODELING OF TIME-VARYING ESTIMATION FOR DISCRETE SURVIVAL ANALYSIS FOR DIALYSIS PATIENTS IN BASRAH, IRAQ
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Survival analysis is widely applied to data that described by the length of time until the occurrence of an event under interest such as death or other important events. The purpose of this paper is to use the dynamic methodology which provides a flexible method, especially in the analysis of discrete survival time, to estimate the effect of covariate variables through time in the survival analysis on dialysis patients with kidney failure until death occurs. Where the estimations process is completely based on the Bayes approach by using two estimation methods: the maximum A Posterior (MAP) involved with Iteratively Weighted Kalman Filter Smoothing (IWKFS) and in combination with the Expectation Maximization (EM) algorithm. While the other

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Scopus
Publication Date
Fri Jun 01 2012
Journal Name
J Med J
Relationship of seminal biochemical parameters and serum reproductive hormones with sperm function tests in asthenospermic patients
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Aim: The aim of this study is to determine the correlation between levels of certain seminal biochemical parameters and serum reproductive hormones, on the one hand, and sperm function tests, on the other hand, in asthenospermic patients. Patients and Methods: Sixty asthenospermic patients and twenty fertile men as a control group were included in this study. Semen samples were collected to perform seminal fluid analysis. Total protein, cholesterol, calcium, creatine kinase, and fructose were measured in the seminal plasma. Blood samples were collected for hormonal assay of serum reproductive hormones: testosterone, prolactin, luteinizing hormone, and follicle-stimulating hormone. Results: The results revealed a significant positive correla

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Scopus (4)
Scopus
Publication Date
Thu Oct 03 2013
Journal Name
J. Of University Of Anbar For Pure Science
Determination of thyroid hormone levels in the serum of Non- dialyzed patients with chronic renal failure
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Thyroid hormones, triiodothyronine (T3) and thyroxin (T4) play an important role in growth, development, and physiology of the kidney. The kidney has a central role in metabolism and clearance of these hormones as well as thyroid – stimulating hormone (TSH). Chronic renal failure (CRF) is a state of irreversible deceleration in renal function results in alterations in internal milieu, which affects the synthesis and secretory rate of hormones. To evaluate the thyroid hormone levels in non-dialyzed patients with chronic renal failure (CRF); 24 patients with CRF aged 30-70 years, mean±S.d. (48.458 ± 13.569) and 48 healthy volunteers who served as controls aged 30-70 years (43.104 ± 12.387) were studied for their thyroid function status u

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Publication Date
Thu Jan 14 2016
Journal Name
International Journal For Sciences And Technology
Evaluation of her/2-neu gene status using FISH/CISH techniques in Iraqi breast carcinoma patients
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The present study aimed to examine the concordance between FISH/CISH techniques for assessment of amplification of her2neu gene in Iraqi breast carcinoma patients. Seventy four (74) Iraqi breast cancer patients were involved at the study from the Histopathology Department at the Central Public Health Laboratory in Bagdad, Iraq. Amplification of HER2neu was detected in (33.8%) by fluorescence in situ hybridization and (13.51%) showed high amplification by chromogenic in situ hybridization and (32.43%) showed low amplification. The results of chromogenic in situ hybridization were significantly correlated with the results of two-color fluorescence in situ hybridization with the same tumors. In addition, the study involved the correlation betw

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