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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
Sat Oct 01 2022
Journal Name
Iraqi Postgraduate Medical Journal
Helicobacter Pylori Infection among Dyspeptic Patients Referred for Endoscopy
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Functional dyspepsia is one of the most common gastrointestinal symptoms and attributed to various causes including Helicobacter pylori infection. AIM OF THE STUDY: To correlate Helicobacter pylori infection to functional dyspepsia and to identify the possible risk factors for this infection. PATIENTS AND METHODS: Fifty patients who were referred to the endoscopy unit for dyspepsia symptoms, secondary gastric causes of dyspepsia were excluded during endoscopy, gastric biopsies were taken for histopathological study and for bedside urease test for detection of Helicobacter pylori infection. RESULTS: 62% of non-ulcer dyspeptic patients were infected with Helicobacter pylori, 74.2% of the patients were above 30 years old, female gender patient

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Publication Date
Sun Sep 04 2016
Journal Name
Baghdad Science Journal
Study of the Immunological Status of Iraqi Vitiligo Patients
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Vitiligo is an acquired idiopathic skin disorder characterized by depigmented macules due to loss of cutaneous melanocytes. A potential role of the immune dysfunction has been suggested in vitiligo, so to test this hypothesis, certain cytokines (IL-17A and TNF-?) and immunoglobulins (IgM, IgG, IgA and total IgE) were investigated in all participants. The study included: 60 patients with age range between (6-55) year; 30(11 males and 19 females) were untreated and 30(12 males and 18 females) were treated with Narrow Band Ultraviolet-B (NB-UVB) and 30 (14 males and 16 females) apparently healthy control. Serum was separated and cytokines (IL-17A and TNF-?) and total immunoglobulin E (IgE) were detected by using Enzyme Linked Immunosorbent Ass

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Publication Date
Mon Jan 01 2024
Journal Name
Pakistan Journal Of Life And Social Sciences (pjlss)
Awareness of Patients Toward Warning Signs of Heart Attacks
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Publication Date
Wed Oct 01 2008
Journal Name
Iraqi Postgraduate Medical Journal
Angiolymphoid hyperplasia with eosinophilia (pseudopyogenic granuloma) among Iraqi patients
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KE Sharquie, MM Al-Waiz, AA Noaimi, Iraqi Postgraduate Medical Journal, 2008 - Cited by 1

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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Quality of Life Assessment for Patients with Colorectal Cancer
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Abstract A descriptive study to assess the quality of life (QOL) for patients with colorectal cancer. The study was conducted from Baghdad Teaching Hospital, Al-Yarmouk Teaching Hospital and Radiation Hospital and Nuclear medicine for the period from 1st July/2004 to 1st September/2004. The sample selected by purposive random of (50) patients diagnosed with colorectal cancer and all of them who were under chemotherapy treatment. A questionnaire was prepared for the purpose of the study and comprised of three parts including: 1- Socio-demographical characteristics. 2- Clinical characteristics. 3- and QOL

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Publication Date
Fri Apr 30 2021
Journal Name
Al-kindy College Medical Journal
Otolarygological Manifestations of Patients with Confirmed Covid-19 Infection
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Background: the coronavirus leads to upper respiratory tract-associated manifestations like nasal congestion, sore throat, and smell disorder

Objectives: To reveal the impact of COVID-19 pandemic on otolaryngology symptoms using our daily medical practice.

Subject and Methods: A cross-sectional study that was carried on in the isolation wards at Al-Kindy and Al-Nu’man Teaching Hospitals during three months from the 1st of Jun. till the end of Aug. 2020. It included 1270 patients who were diagnosed with COVID-19 infection seen in the ENT consultation clinic and admitted to the isolation wards.

Results: Otolaryngological manifestations were shown

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Publication Date
Fri Nov 01 2013
Journal Name
Iraqi Journal Of Community Medicine
Clinico-Histopathological Study of Calcinosis Cutis among Iraqi Patients
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AA Noaimi, IRAQI JOURNAL OF COMMUNITY MEDICINE, 2013 - Cited by 1

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Publication Date
Thu Jan 30 2020
Journal Name
Al-kindy College Medical Journal
Diabetic Patients Knowledge and Practice Regarding Annual Visual Checking
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Background: Diabetes mellitus (DM) is a significant cause of visual impairment; many diabetics do not have regular eye examinations, although it is known that early diagnosis and reduces the risk of blindness. There were many barriers that prevent diabetics from attending eye clinics.

Objectives: To assess knowledge, and practice about ocular complications among diabetic patients and to determine barriers preventing the diabetic patients annual visual checking

Methods: A cross-sectional study involving the interview was conducted among 300 diabetic patients attending out patient in Ibn Al Haitham Teaching Ophthalmology Hospital between November 2017 and June 2018.

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Publication Date
Mon Jun 03 2024
Journal Name
Journal Of Pioneering Medical Science
Prevalence of Diabetic Hyperglycemia Among Patients With Rheumatoid Arthritis
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Introduction: Rheumatoid arthritis (RA) is one of the most prevalent systemic inflammatory diseases worldwide. Cardiac complications present the most common mortality cause among RA patients. One of the most important comorbid conditions with RA is diabetic hyperglycemia mainly type 2 diabetes mellitus (T2DM). Aim of the study: The present study was conducted to assess prevalence of T2DM among patients diagnosed with RA from Iraq. Methodology: We included a randomly selected 100 rheumatoid arthritis. All included patients were subjected to anthropometric measurements, diabetic profile assessment and ESR, CRP and rheumatoid factor measurement. Results: Among the included RA patients, 28 patients were diagnosed with new-onset DM. Our

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Publication Date
Thu Jun 30 2011
Journal Name
Fac Med Baghdad
Prevalence of Anemia among Iraqi Patients after Renal Transplantation
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Background: Although the issue of anemia after renal transplantation (RT) has received increasing attention lately, the data on the exact prevalence of post-transplantation anemia (PTA) in the Iraqi patients are limited. Objective: In this study we sought to determine the prevalence of PTA among Iraqi patients and to correlate the renal allograft function measurements and the use of immunosuppressant with the prevalence of anemia. Patients and Methods: One hundred and twelve (74 male, 38 female) kidney transplant recipients (KTR) attending the kidney transplant center at surgical specialties hospital were studied. All patients were on maintenance, combined immunosuppressive therapy. The renal function tests [blood urea, serum cre

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