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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 Mar 16 2019
Journal Name
Route Educational & Social Science Journal
Information awareness of students from Ibn Al-Haytham Education College of pure sciesnces and its influence on their analytical thinking skill
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this research is to identify the level of information awareness of the chemistry students in their fourth year studying at Ibn Al-Haytham Education College of pure sciences at the University of Baghdad. The research sample consisted of (107) male and female students out of the total number of (153) students studying during the (2017-2018) academic year, The sample therefore represents 71% of the total students. The research methodology used consisted of two parts. The first part is concerned with measuring information awareness using a multiple choice type of test related to (40) issues. The students were required to select the between (5) alternative answers for each issue. The objectives of the test and the issues used are to measure the

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Publication Date
Wed Aug 01 2012
Journal Name
مجلة دراسات عربية في التربية وعلم النفس
Concepts of renewable energy among students at the Ibn Al-Haytham College of Education and its relationship to their environmental awareness
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Publication Date
Wed May 12 2021
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
The Effect of the Programmed Education Strategy to Learning the Under Hand Service and Receiving Service Skills of Volleyball for Juniors
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In order to advance the education process and raise the educational level of the players, it became necessary to introduce new educational aids, programmed education in the education process, through which the basic skills to be learned are explained and clarified, and immediate feedback is provided that would enhance the information of the learner, and Reaching the goal to be achieved, taking into account the individual differences between the players, and thus it is possible to move away from the educational methods used in learning skills, which requires great effort and time, in addition to that the open playground may not perform the skill accurately and the player looks from one side, while when using the computer you look from severa

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Publication Date
Tue Dec 02 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of the Level of Melatonin, Cortisol and IgA in Saliva of Patients with Oral Lichen Planus Lesions
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Back ground: Oral lichen planus is a chronic inflammatory disease that affects the mucous membrane of the mouth. Several researchers suggest that oxidative stress is implicated in the pathogenesis of this disorder. It has been hypothesized that melatonin is powerful anti-oxidants and can easily cross the cell membrane and is considered a free radical scavenger of Hydroxid, Oxygen and Nitrogen dioxide, cortisol as a stress hormone and the immunoglobulin A as first line of defense and protection to the mucous membrane of the mouth are interrelated factors for the emergence of oral lichen planus. Aim of this study was to evaluate the level of melatonin, Cortisol and IgA in saliva of patients with oral lichen planus lesions in comparison with p

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Publication Date
Sun May 12 2013
Journal Name
International Journal Of Pharmacy And Pharmaceutical Sciences
PLEIOTROPIC EFFECTS OF ATORVASTATIN ON PRO-INFLAMMATORY CYTOKINES IN NEWLY DIAGNOSED IRAQI PATIENTS WITH TYPE 2 DIABETES MELLITUS
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Objective: Atorvastatin therapy is now recommended for reduction of cardiovascular risk in type 2 diabetic patients (T2DM), based on convincing evidence of reductions in mortality and vascular events in major clinical outcome trials. The aim is to evaluate the effects of atorvastatin on proinflammatory markers (TNF-α, IL-6), HbA1c andleptin in obese patients with type 2 diabetes. Methods: Sixty fivenewly diagnosed T2DM patients were randomly allocated into 2 groups; group I treated with metformin only; in group II atorvastatin was added with metformin. Twenty healthy subjects were enrolled as control group. While maintaining their usual eating habits, fasting blood samples were collected at baseline and after 12 weeks of treatment. Results

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Publication Date
Tue Aug 01 2023
Journal Name
The Nucleus
Studies on the role of retinol binding protien-4 in type 2 diabetic Iraqi patients with metabolic syndrome
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Several adipokines are produced and secreted from adipose tissue, such as retinol binding protein-4, which triggers metabolic syndromes and insulin resistance. Retinol binding protein-4 transfers vitamin A or retinol in the blood. Higher levels of retinol binding protein-4 are interrelated with progress of metabolic disease, comprising obesity, metabolic syndrome, and type 2 diabetes mellitus. The present study investigates the role of retinol-binding protein-4 levels in type 2 diabetic Iraqi patients with metabolic syndrome. Sixty type 2 diabetic patients aged 40–53 years were examined. Of these 30 patients has metabolic syndrome and 30 without metabolic syndrome. The patients sampled were from the National Diabetes Center/ Mustansiriyah

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Publication Date
Fri Jan 30 2015
Journal Name
Journal Of Madenat Alelem College
Estimation of Liver Enzymes and Total Bilirubin Level in the sera of patients infected with liver hydatid cysts
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This study included 46 patients with liver hydatid cyst diagnosed clinically and surgically. Control group consist of 22 healthy volunteers. The patients were divided according to the size of the cysts into more and less than 5 cm diameter size, 33 and 13, respectively. Also they were divided into primary and secondary hydatid cyst infection, 30 and 16, respectively. Significant increase of GOT, GPT and ALP levels were recorded due to hydatid cyst infection and had direct effect on the liver function, beside an increase in total bilirubin in patients serum compared with the control, also the same occurred in the secondary infection compared with primary infection, patients with> 5 cm showed significant increase in the above levels compared

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Publication Date
Sun Jul 03 2022
Journal Name
International Journal Of Health Sciences
effects of toxoplasmosis infection on the levels of IL-18 and anti-ds-DNA antibodies in SLE patients
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The present study was set to demonstrate the prevalence of toxoplasmosis infection and its effects on patients with systemic  lupus erythematosus (SLE) through determining their serum levels of anti-dsDNA and IL-18 antibodies. For this purpose, the sera from 132 SLE and/or toxoplasmosis patients and 30 healthy women, were collected. The study sample was divided into four groups of SLE, toxoplasmosis, SLE coinfected with toxoplasmosis, and healthy control. Anti-Toxoplasma IgG antibodies were examined for all the samples using ELISA kit. The results showed a high mean level of anti-Toxoplasma IgG among SLE patients coinfected with toxoplasmosis (104.8792±12.31585pg/ml) in comparison to that in toxoplasmosis patients (91.1705±12.577

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Level of uric acid and its, relationship with lipid peroxidation in sera of patients with acute coronary syndrome
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Unstable angina pectoris often leads to acute myocardial infarction. Since uric acid is thought to be risk factor for cardiovascular disease and considered a major antioxidant in human blood .The level of uric acid and lipid peroxidation in the sera of patients with unstable angina and myocardial infarction were measured and compared to the healthy individuals. Twenty-nine patients with unstable angina and twenty-nine patients with myocardial infarction were studied and compared to twenty-five healthy individuals. Uric acid was measured by using Human Kit. Malondialdelyde (MDA) a lipid peroxidation marker, was measured by thiobarbituric acid method .Significant elevation of uric acid and MDA were observed in the sera of pati

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of International Oral Health
Endothelin-1 is a surrogate biomarker link severe periodontitis and endothelial dysfunction in hypertensive patients: The potential nexus
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Aim and Objectives: The objective of this study was to illustrate the link between periodontitis (PO) and endothelial dysfunction in hypertensive patients. Materials and Methods: This cross‑sectional study involved 53 hypertensive patients with or without PO compared with 28 healthy controls. On the basis of the study protocol, the participants were divided into three groups: Group (1): 24 patients with hypertension only, Group (2): 29 patients with hypertension and PO, and Group (3): 28 healthy controls. Lipid profile, endothelin‑1 (ET‑1), and high‑sensitivity C‑reactive protein (hs‑CRP) were measured. Blood pressure and body mass index (BMI) were evaluated. Diagnostic criteria of severe PO periodontal indices including plaque

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