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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 Dec 01 2013
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Baghdad Science Journal
Estimation of Testosterone, Estradiol and some Markers in Sera of Iraqi Patients with Benign Prostatic Hyperplasia.
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Benign prostatic hyperplasia (BPH) is one of the most common disease and major cause of morbidity in elderly men which may lead to bladder outflow obstruction and lower urinary tract symptoms (LUTS). Although sex steroid hormones play fundamental roles in prostate growth, their clinical significance is not completely clear. In the present study we assessed whether serum hormones levels as markers of prostate disease. This study includes (40) patients with benign prostatic hypertrophy and (40) control group with age rang (41-79) and (42-71) years respectively. The following biochemical investigations have been studied: Testosterone, Estradiol (E2), and Prostatic Specific Antigen (PSA) levels using ELISA method which correlated with t

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Publication Date
Mon Apr 04 2022
Journal Name
Neuroquantology
The Role of Adropin as a Novel Biomarker in Iraqi Patients with Parkinson's Disease and Osteoporosis
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Sun Mar 26 2017
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Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of L-Carnitine as an Adjuvant Supplement on Lipid Profile in Iraqi Diabetic Patients
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Diabetes is a complex set of diseases require continuous medical care, to control blood sugar and prevent complications is .The aim of this research is to determine the effect of administration of   L carentin to diabetics on the   lipid profile. The research was conducted on sixty diabetic patients were selected from endocrinology and diabetes center / Al-Rusafa, within selected criteria. The patients divided into 3 groups (control group of healthy people and two groups of patients with diabetes who were on metformin and glibenclamide, one group took a L  carnitine in a dose of 1000 mg twice daily and a group dealing with a placebo for a period of 3 months continuously). The study found that patients who took Lc

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
Patient Satisfaction and its Relationship to Dental anxiety among patients of Dental Clinics in Baghdad city
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Patient satisfaction and dental anxiety considered as an important factors in dental health care and treatment because they greatly affect the patient's cooperation with the dentist and the extent to which follows the guidelines, treatment and preventive instruction. The present study investigates the relationship between patient satisfaction and dental anxiety, as well as their relation to demographic variables such as gender, age, number of visits, and cultural level. The study was applied on a random sample of dental clinics in Baghdad city with total of (200) patient (108 male and 92 female). Two scales were used in this study, patient satisfaction scale PSS (included 9 aspects, constructed by authors) and Iraqi dental anxiety scale

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Publication Date
Sat Sep 05 2020
Journal Name
Al-kindy College Medical Journal
Prevalence of Oral Manifestations of Inflammatory Bowel Disease in Patients Admitted to Sulaymaniyah teaching hospital – Iraq
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The aim of this study is to evaluate the association between IBD and oral symptom and mucosal lesions in patients with Crohn’s disease and ulcerative colitis

Methods: This is a cross-sectional study that has been done in (Kurdistan center for Gastroenterology and hepatology) of Teaching Hospital in Sulaymaniyah-Iraq, which included 101 patients previously diagnosed with Inflammatory Bowel Disease who were interviewed regarding manifestations of inflammatory bowel disease especially oral manifestations. Required data were collected through a specially designed questionnaire,

Results: The patients’ mean age was 45.74±12.58 years. Patients with ulcerative colitis and Crohn’s disease w

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Publication Date
Mon Jul 04 2022
Journal Name
International Journal Of Health Sciences
The association between plasma IL-6 levels and several thalassemia-related clinical features in Iraqi patients
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The present study was set to investigate the potential association between the level of Interleukin-6 (IL-6), as a key component of the pro-inflammatory response, with different thalassemia’s biological and clinical features. For this purpose, one hundred fifty blood samples were collected from 100 beta-thalassemia patients, who attended the Genetic Hematology Centre at Ibn Al- Baladi Hospital in Baghdad, Iraq, and 50 healthy subjects who were employed as a control group. IL-6 levels were estimated using an ELISA Kit, whereas other thalassemia-related clinical features (such as HbA, HbF, ferritin, blood transfusions, splenectomy status, and the history of frequent infection) were additionally assessed. The results of the present s

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Wed Jun 01 2016
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Box and Jenkins use models to predict the numbers of patients with hepatitis Alvairose in Iraq
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The research aims to select the best model to predict the number of infections with hepatitis Alvairose models using Box - Jenkins non-seasonal forecasting in the future.

Data were collected from the Ministry of Health / Department of Health Statistics for the period (from January 2009 until December 2013) was used

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Publication Date
Wed Dec 20 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Systemic Melatonin Supplementation as an Adjunct to Non-Surgical Periodontal Treatment in Obese Patients with Periodontitis
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Background: Obesity is considered an important risk factor for periodontal disease. It has been reported that reactive oxygen species linking both diseases, systemic melatonin supplementation as antioxidant therapy, was addressed as an adjuvant to scaling and root surface debridement (SRP) to enhance the treatment of periodontitis. Objective: To investigate the efficacy of systemic melatonin administration in periodontitis-obese patients as an adjuvant to scaling and root surface debridement (SRP). Methods: A randomized clinical trial was conducted at a dental-specialized center. Eighty subjects were included and allocated into group-I: twenty periodontium-healthy, normal-weight people; group-II: 30 obese patients with stage-III tre

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Publication Date
Thu Jun 15 2023
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Axial spondyloarthritis (axSpA) is a chronic rheumatic inflammatory disease affecting mainly the spine and sacroiliac joints. Since the copper-to-zinc ratio (Cu/Zn) indicates an inflammatory response, the change in ratio is expected to correlate with axSpA. This study compared levels of Cu/Zn in the serum of axSpA patients. Serum samples were obtained from 53 patients with axSpA divided according to biological treatment into cohorts A and B, and 28 healthy control as cohort C. Serum levels of Cu and Zn were determined first by a fully automated chemistry analyzer TC-Matrix Plus, then the ratio was obtained. The elevated serum Cu concentration means of cohort B (189.32 ± 13.808 µg/dL) compared to cohort A (168.85 ± 7.244 µg/dL) a

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Publication Date
Sun Mar 06 2016
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Evaluating the Humoral Immunity and Interleukin 18 Receptor 1 in some Patients with Molluscum Contagiosum Infection
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The molluscum contagiosum virus (MCV) is a dermatotropic poxvirus. The causative agent of molluscum contagiosum (MC) is nonlethal, common and worldwide. Additionally, little inflammation is associated with MC papules. The present study aims to evaluate the immune status of MC patients by measuring the level of immunoglobulins IgG and IgM by using the radial immune diffusion assay (RIA) and the level of interleukin 18 receptor 1 (IL-18R1) by the Enzyme-linked immunosorbent assay (ELISA).The study is conducted during November 2013 to April, 2014 in outpatient clinic of Baquba Teaching Hospital. There are 75 patients, diagnosed with clinical lesions of MCV on different areas of the body, whose age is ranged between 2-50 years including 40(53.

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