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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
Fri Sep 15 2023
Journal Name
Bionatura
A comparison of VCAM-1 and ICAM-1 as atherosclerosis risk factors in patients with systemic lupus erythematosus from Iraq
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All major organs may be impacted by the connective disease systemic lupus erythematosus, a separate risk factor for coronary artery disease (CAD). Adhesion molecules like intercellular adhesion molecules (ICAM) and vascular cell adhesion molecules (VCAM) can detect endothelial damage and dysfunction, which appear to play a crucial role. This study investigated whether people with SLE had elevated subclinical and clinical atherosclerosis risk factors. Traditional CAD risk factors such as smoking, hypertension, and hyperlipidemia cannot entirely explain this elevation. It is thought that immunological dysfunction also increases CAD risk in SLE patients. The study aimed to assess early endothelial changes in SLE Iraqi female patients w

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Publication Date
Sun Dec 23 2018
Journal Name
International Journal Of Biosciences
Serum and salivary levels of thyroid antibodies (TPO-Ab&Tg-Ab) in the of hypothyroid patients with and without periodontitis
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Hypothyroidism is the decrease in thyroid hormones production and thyroid gland function. Hashimoto’s thyroiditis is the most common cause of hypothyroidism with production of autoantibodies directed toward autoantigens thyroglobulin (Tg) and thyroid peroxidase (TPO). This study was carried out to determine and compare serum and salivary levels of thyroid antibodies (TPO-Ab and Tg- Ab) in hypothyroid patients (with and without periodontitis) and healthy control; as well as to estimate the possibility to evaluate and measured these antibodies in the saliva as measured in the serum. Serum and saliva samples were collected from sixty hypothyroid patients with age ranged (20-64) years (30 of patients were with periodontitis and 30 without per

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Publication Date
Mon Dec 07 2020
Journal Name
Iranian Journal Of Parasitology
Serum levels of il-12 and il-23 in breast cancer patients infected with toxoplasma gondii: A case-control study
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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Ability of Nutrient Antioxidants to Influence Oxidative Stress and Lower the Dose of Prednisolone in Patients with Alopecia Areata
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Alopecia areata is a common disorder, hypothesized to be autoimmune in etiology. Cortisone taken orally may stimulate new hair growth. Prednisone (orally administered steroid (has proved effective for patients with alopecia areata, but its potential side effects include weight gain, metabolic abnormalities, acne and menstrual problems.

This clinical study was designed to assess the clinical significance of the nutrient antioxidants (vitamin A, vitamin E and vitamin C) in reducing the dose of corticosteroids (prednisolone), and as a consequence, their side effects in patient with alopecia. The results of this study reveal the potential clinical significance of the therapy for two months with these antioxidants in reducing the dose

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Publication Date
Tue Dec 02 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary α-Amylase and Albumin Levels in Patients with Chronic Periodontitis and Poorly or Well Controlled Type II Diabetes Mellitus
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Background: Recent studies suggest that chronic periodontitis (CP) and type2 diabetes mellitus (T2DM) are bidirectionally associated. Analysis of saliva as a mirror of oral and systemic health could allow identification of α amylase (α-Am) and albumin (A1) antioxidant system markers to assist in the diagnosis and monitoring of both diseases. The present study aims at comparing the clinical periodontal parameters in chronic periodontitis patients with poorly or well controlled Type 2Diabetes Mellitus, salivary α-Am, A1, flow rate (FR) and pH then correlate between biochemical, physical and clinical periodontal parameters of each study and control groups. Materials and Methods: 80 males, with an age range of (35-50) years were divide

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Publication Date
Fri Jan 01 2021
Journal Name
Review Of International Geographical Education
Comparing environmental awareness under the Corona pandemic between students of the Faculty of Physical Education and Sports Sciences at the University of Kufa
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The purpose of this paper is to identify environmental awareness under the Corona pandemic among students of the Faculty of Physical Education and Sports Sciences at the University of Kufa. and comparison of environmental awareness under the Corona pandemic between students of the Faculty of Physical Education and Sports Sciences at the University of Kufa. The two researchers used the descriptive approach in the style of the survey and comparisons to identify the research community in the students of the College of Physical Education and Sports Sciences at the University of Kufa for the academic year 2020-2021, who numbered (210) students, then a sample of (80) students was chosen randomly, with a percentage of (38.09%) from the research co

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Scopus
Publication Date
Sat Jun 26 2021
Journal Name
Journal Of The College Of Education For Women
Education and the Challenges of Globalization during the Corona Pandemic: A Field Study from Baghdad University Professors’ Point of View: ميسم ياسين عبيد
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study aims to examine education and the challenges of globalization in light of Corona pandemic. The examination involves surveying a randomly selected sample from the University of Baghdad’s professors, particularly from the colleges of Education for Women, Arts, and Sciences. The purpose of this examination is to learn about the dimensions of globalization, its effects on the educational process, and the importance of distance education during the spread of Corona virus quarantine. To achieve this, the researcher followed a descriptive and analytical approach by applying a questionnaire to a sample of 70 teachers who were randomly selected electronically. Results have shown that 78.6% emphasized the contribution of globalization duri

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
The current research aims to identify the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham
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  • Identifying the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham.
  • Identifying the statistically significant differences in the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham according to the gender variable.
  • And the descriptive approach was used, due to its relevance to the nature of the research objective.

    To verify this, the visual culture skills test consisted of (22) items of the multiple choice type, where the (Koder Richardson 20) equation was applied to calculate the stability of the visual culture skills test. For the skill of writing

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Publication Date
Wed Oct 31 2018
Journal Name
Al-kindy College Medical Journal
Peers Pressure And Families Smoking Habit Influence On Smoking Behavior among male Students attending Secondary Schools At second Al- Kurkh education Directorate /Baghdad.
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Background:  There is a strong desire of adolescent to have a peer group and to be appreciated and also to become a member of this group which can affect one each other. There for; encourage, adapting,and imitating of friends and group consider as the main reasons behind starting of smoking among youngsters. Smoking habits in the family were found tobe acause of smoking pressure among adolescentas peer pressure. Smoking habit may be started before 18 years of age in most adult smokers.

Objectives: To study the effect of peer pressure and family smoking habiton the prevalence of smoking among secondary school students.

Type of the study:  A cross

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Publication Date
Fri Nov 02 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Validity of Testicular Biopsy Among Azoospermic Patients Prior to Intracytoplasmic Sperm Injection
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Objective: To evaluate the clinical significance of open diagnostic testicular biopsy as prognostic predictor of
successful sperm retrieval among azoospermic infertile patients.
Design: Prospective study.
Setting: Infertility clinic and assisted reproduction unit at the institute of embryo research and infertility
treatment, Baghdad University.
Patients: Sixty infertile azoospermic patients.
Intervention: Pieces of testicular tissue taking during open diagnostic multiple bilateral testicular biopsies was
prepared for histological examination and grouped according to well-defined histopathological patterns.
Measurement of testicular size and serum reproductive hormones (FSH, LH, Testosterone, and PRL) were done

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