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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
Sun Jan 01 2023
Journal Name
Iraqi Journal Of Biotechnology
Molecular Detection of Candida spp. Isolated from Female Patients Infected with COVID-19 in Baghdad City
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Wed Jul 30 2025
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Effect of mirabegron on lipid profile (serum cholesterol and triglyceride) in Iraqi patients with overactive bladder
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Background Mirabegron is a β3-adrenergic receptor (β3-AR) agonist indicated for the treatment of overactive bladder. β3-AR agonists are located in the urinary bladder and adipose tissue, where they are involved in the regulation of thermogenesis and lipolysis. Objective To evaluate the effect of mirabegron on lipid profile (serum cholesterol and triglyceride) and BMI in patients with OAB. Materials and Methods In the medical city complex (Ghazi AL-Hariri Hospital) urology outpatient clinic, a prospective study of 40 patients diagnosed with OAB. These patients took a single dose of mirabegron 50 mg for 4 months and assessed its effect during this period on weight and fasting serum (s.) cholesterol and triglycerides. Results Investi

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Publication Date
Tue Mar 01 2022
Journal Name
Iraqi Journal Of Agricultural Sciences
CORRELATION OF TMPRSS2-ERG GENE FUSION STATUS WITH CLINICOPATHOLOGICAL CHARACTERISTICS IN PROSTATE CANCER OF IRAQI PATIENTS
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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of Metformin + Sitagliptin versus Metformin + Glibenclamide on Glycemic Control in Iraqis Type 2 Diabetic Patients
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Publication Date
Wed Jun 29 2022
Journal Name
Iraqi Journal Of Agricultural Sciences
CORRELATION OF TMPRSS2-ERG GENE FUSION STATUS WITH CLINICOPATHOLOGICAL CHARACTERISTICS IN PROSTATE CANCER OF IRAQI PATIENTS
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The aim of this study was to establish the existence and interaction of TMPRSS2 – ERG gene fusion status with clinicopathological features of prostate cancer patients. This research consisted of 123 embedded formalin-fixed tissues obtained from the prostate tumor patients. The above gene fusion is detected through the technique of fluorescent in situ hybridization (FISH) by means of a triple color probe. Seven samples have not been scored due to technical difficulties and 46 patients have fusion (39.6%), while the remaining (70) have not been seen with fusion. Of the 46 fusion-positive, 17 (36%) were caused by ERG-translocation, of the other 29 (63%) were caused by the interstitial segment deletion between the two genes due to the

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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Radiological Assessment of Mandibular Retromolar Canal (MRMC) Using CBCT-Radiographs in a Sample of Iraqi Patients
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Background: Because of its clinical and surgical importance and lack of precise information about this rare and important anatomical landmark, this study was designed to detect the presence, configurations and length of Mandibular Retromolar Canal (MRMC) with aid of CBCT visualization. Materials and methods: In this retrospective study the data was obtained from Specialist Health Center in AL-Sadder city in Baghdad for (100) patients with 200 inferior dental canal, all of them referred to CBCT scan (Kodak 9500, French origin). The scanning was done with tube voltage 90 kVp, tube current with 10mA and exposure time was 10 s., the field of view was measured with 5cm x 3.7cmwith 0.03mm voxel size Results: In the present study the prevalence of

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Sun Jun 04 2017
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Levels of Serum Lipid profile and Kidney Function Tests in Iraqi Hypertensive Patients: Duration Effect Study
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Hypertension is one of the leading causes of the global burden of disease, which causes serious health problems. The aim of this study is to investigate the lipid profile levels in sera of Iraqi hypertensive patients by measuring Total cholesterol (TC), triglyceride (TG) and low density lipoproteins (LDL) and kidney function levels by measuring uric acid, urea and creatinine. Seventy five individuals of Iraqi adults (Males) were divided into three groups: 25 hypertensive patients with duration of disease (1-10) year (group 1), 25 hypertensive patients with duration of disease (11-30) year (group 2) and 25 normal individuals as control group (group3). The findings indicate that serum (TC, TG and LDL) levels were significantly elevated (

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Publication Date
Tue Dec 31 2024
Journal Name
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Evaluation of Human β-defensin-3 Diagnostic Role in a Group of Iraqi Patients with Osteoporosis
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Publication Date
Wed Jan 01 2020
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The impact of JAK2V617F allelic burden on clinical and laboratory parameters in patients with myeloproliferative neoplasms
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Publication Date
Thu May 05 2022
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Evaluation of podophyllin and Trichloroacetic acid for the treatment of genital warts in Iraqi female patients
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Background: human paillomavirus infections (genital warts) are the most frequent sexually transmitted viral infections. a wide range of treatment options is available with different efficacy.

Objective: To evaluate the efficacy of podophyllin, trichloracetic acid (TCA) in the treatment of genital warts and side effects of them.

Subjects and methods: a total of sixty patients with genital warts were randomly selected, 30 in each group, in the Department of Dermatology, medical city for a Duration of 11 months from January 2009 to December 2009 treated with 35 % podophyllin in the tincture of benzoin or 50%  TCA) .Forty-eight patients were followed up for three months.

Results: wart

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