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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
Mon Apr 25 2022
Journal Name
Diversity
Genetic Structure and Diversity of Native Tench (Tinca tinca L. 1758) Populations in Hungary—Establishment of Basic Knowledge Base for a Breeding Program
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Tench is a cyprinid fish that has undergone human-induced translocations. The natural populations of the species are on the decline due to habitat loss and spawning grounds degradation. The genetic diversity of seven natural populations was investigated to establish the genetic knowledge base for successful conservation efforts and for selective breeding. Twelve microsatellite markers, the sequencing of a 615 bp section of mtDNA (Cytb) and PCR-RFLP analysis of two nuclear markers (Act) and (RpS7) were used to analyze the genetic variation and structure among 175 individuals. All microsatellite loci were found to have moderate levels of polymorphism. The pairwise Fst values between population pairings were moderate; the populations w

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Publication Date
Sun Feb 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Diagnosing the information technology (IT) capabilities and It’s Effect to Achieving A competitive Superiority Analytical Research in Baghdad soft drinks Company/Al- Zafaraniya
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Purpose: The current research attempts to diagnosis the reflection level of Information Technology (IT) Capabilities (Architectural, infrastructure, human resources, relationships resources, and dynamic capabilities) at Baghdad soft drinks Company/Al- Zafaraniya to achieving the competitive superiority represented by indicators (Cost, quality, flexibility, delivery and innovation). Recognizing the importance of the subjects studied, and because of the importance of the expected results of the field under consideration.

Design/Methodology/Approach: The experimental method has been used, the questionnaire used to collect th

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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Time of Emergence of Permanent Teeth and Impact of Nutritional Status among 4-15 Years Old Children and Teenagers in Basrah City /Iraq
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Background: The timing of eruption of permanent teeth is of considerable importance to the dental health planning for diagnostic, preventive and therapeutic measures for children and teenagers. The purposes of this study were to determine timing of maxillary and mandibular permanent teeth emergence (except third molars) and to evaluate the effect nutritional status by anthropometric measures on the eruption time of permanent teeth, investigations had been done according to jaw and gender variations. Materials and Methods: This study was conducted among four to fifteen years old children and teenagers from kindergarten and schools in Basrah city in the south region of Iraq. The total sample composed of 1807 children and teenagers that were

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Publication Date
Thu Aug 01 2024
Journal Name
Materials Science In Semiconductor Processing
Enhancing charge transfer in 0D/2D cobalt sulfide/boron-doped graphitic carbon nitride heterojunction photocatalyst for degradation of organic pollutants under LED illumination
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Semiconductor-based photocatalytic processes are widely applied as ecofriendly technology for degrading organic pollutants. Establishing photocatalytic heterojunctions with Z-type photocarriers transfer pathways is projected to be a superb strategy to enhance photocatalytic behavior. In this paper, novel and stable (0D/2D) heterojunctions of CoS-embedded boron-doped g-C3N4 (CoS/BCN) with a high rate of charges transfer/separation were assembled for degradation of malachite green dye (MG). The CoS/BCN photocatalyst achieves a photodegradation efficiency of 96.9 % within 1 h of LED illumination, which is 2.5 and 1.4-fold enhancement compared with bare g-C3N4 and BCN, respectively. Besides, the results of species-trapping trials exhibited that

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Publication Date
Fri Jan 01 2021
Journal Name
Int. J. Agricult.
FORECASTING THE EXCHANGE RATES OF THE US DOLLAR AGAINST THE IRAQI DINAR USING THE BOX-JENKINS METHODOLOGY IN TIME SERIES WITH PRACTICAL APPLICATION
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The goal of the study is to discover the best model for forecasting the exchange rate of the US dollar against the Iraqi dinar by analyzing time series using the Box Jenkis approach, which is one of the most significant subjects in the statistical sciences employed in the analysis. The exchange rate of the dollar is considered one of the most important determinants of the relative level of the health of the country's economy. It is considered the most watched, analyzed and manipulated measure by the government. There are factors affecting in determining the exchange rate, the most important of which are the amount of money, interest rate and local inflation global balance of payments. The data for the research that represents the exchange r

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Publication Date
Sun Mar 03 2013
Journal Name
Baghdad Science Journal
Sedimentological and diagenetic study of the Early Middle Miocene Jeribe Limestone Formation in selected wells from Iraq northern oilfields (Ajil; Hamrin; Jadid; Khashab)
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Five subsurface sections covering the entire length of the Jeribe Limestone Formation (Early Middle Miocene) were studied from four oilfields in northern Iraq. It is hoped to unravel this formation microfacies ; depositional environment; diagenetic attributes and their parental processes; and the relationship between these processes and the observed porosity patterns. The microfacies were found to include mudstone, wackestone, packstone, and grainstone, which have been deposited respectively in open platform, restricted platform, and edge platform which represent the lagoonal environment, while the deposits of the lower parts of the Jeribe formation especially in well Hamrin- 2 reflect a deeper fore slope environment. By using the lithofac

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Publication Date
Thu Nov 01 2012
Journal Name
Iraqi Postgraduate Medical Journal
Lactic Acid 5% Mouthwash is an Effective Therapeutic and Prophylactic Agent in Treatment of Recurrent Aphthous Ulcer (Single blind placebo controlled therapeutic study)
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KE Sharquie, SA Al Mashhadani, AA Noaimi, RK Al-Hayani, SA Shubber, Iraqi Postgraduate Medical Journal, 2012 - Cited by 1

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Publication Date
Sat Aug 01 2020
Journal Name
Journal Of Water Process Engineering
Humic acid coated sand as a novel sorbent in permeable reactive barrier for environmental remediation of groundwater polluted with copper and cadmium ions
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Plantation of humic acid nanoparticles on the inert sand through simple impregnation to obtain the permeable reactive barrier (PRB) for treating of groundwater contaminated with copper and cadmium ions. The humic acid was extracted from sewage sludge which is byproduct of the wastewater treatment plant; so, this considers an application of sustainable development. Batch tests signified that the coated sand by humic acid (CSHA) had removal efficiencies exceeded 98 % at contact time, sorbent dosage, and initial pH of 1 h, 0.25 g/50 mL and 7, respectively for 10 mg/L initial concentration and 200 rpm agitation speed. Results proved that physicosorption was the predominant mechanism for metals-CSHA interaction because the sorption data followed

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Publication Date
Mon Dec 14 2020
Journal Name
Plos One
Healthy lifestyle behaviors are major predictors of mental wellbeing during COVID-19 pandemic confinement: A study on adult Arabs in higher educational institutions
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Background

In the past infectious diseases affected the quality of lifestyle during home confinement. The study conducted examines the influence of home confinement during the COVID-19 pandemic outbreak on lifestyle, mental wellbeing, nutritional status, and sleeping pattern.

Method

An online multicategorical questionnaire was distributed to collect demographic information combined with the following tools: Food Frequency Questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), WHO-5 wellbeing score, and Pittsburgh Sleep Quality Index (PSQI). A snowball non-discriminate sampling procedure was

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Publication Date
Sun Mar 04 2012
Journal Name
Baghdad Science Journal
Evaluation of cellular immune response in Golden Hamsters experimentally infected with Leishmania donovani comparing with cellular immune response against chicken Red Blood Cells.
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The Evaluation of the immune response in Golden Hamsters experimentally infected with Leishmania donovani was determined in this study, particularly, the cellular immune response. Follow up has maintained to determine the Delayed Type of Hypersensitivity using skin test both in infected and control lab animals. Chicken red blood cells were used as a parameter to evaluate the immune system; they are dull and have the ability of immunization. Two concentrations of chicken R.B.C were examined to determine which gives the higher titration in Hamsters and those were 1.5 X 109 cell/ml and 3 X 109 cell/ml , the second concentration gave the maximum titration where then used in this work. After sensitization with Chicken R.B.C for both infected a

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