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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 Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Anal Fissure: Is it becoming a medical disorder?
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An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored.A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure.Pharmacological s

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Medical Image Segmentation using Modified Interactive Thresholding Technique
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Medical image segmentation is one of the most actively studied fields in the past few decades, as the development of modern imaging modalities such as magnetic resonance imaging (MRI) and computed tomography (CT), physicians and technicians nowadays have to process the increasing number and size of medical images. Therefore, efficient and accurate computational segmentation algorithms become necessary to extract the desired information from these large data sets. Moreover, sophisticated segmentation algorithms can help the physicians delineate better the anatomical structures presented in the input images, enhance the accuracy of medical diagnosis and facilitate the best treatment planning. Many of the proposed algorithms could perform w

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Publication Date
Thu Mar 22 2018
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Assessment of medical solid waste generation rates for teaching hospitals in Baghdad city
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Publication Date
Mon Feb 18 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Control Over The Medical Evacuation Program in light of the Government's Accounting System
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The accounting system of government is considered an important tool to follow up the financial transactions that reflect the activities of governmental units and by which the useful information for estimating governmental annual revenues and expenditures are provided through the state public budget because it is an information system that provides detailed past performance, as well as measures the efficiency of the governmental agencies performance in implementing the budget, and the of success governmental units is measured through the type of services and programs offered, their size and the possibility of achieving the objectives assigned to them. The medical evacuation program is one of the medical and curative health services provid

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Publication Date
Wed Dec 08 2021
Journal Name
J. Inf. Hiding Multim. Signal Process.
Predication of Most Significant Features in Medical Image by Utilized CNN and Heatmap.
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The growth of developments in machine learning, the image processing methods along with availability of the medical imaging data are taking a big increase in the utilization of machine learning strategies in the medical area. The utilization of neural networks, mainly, in recent days, the convolutional neural networks (CNN), have powerful descriptors for computer added diagnosis systems. Even so, there are several issues when work with medical images in which many of medical images possess a low-quality noise-to-signal (NSR) ratio compared to scenes obtained with a digital camera, that generally qualified a confusingly low spatial resolution and tends to make the contrast between different tissues of body are very low and it difficult to co

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Scopus
Publication Date
Tue Jan 01 2013
Journal Name
Iraqi Postgraduate Medical Journal
Patient Satisfaction with Health Services at Medical Ward in Al-Kindy Teaching Hospital
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OBJECTIVE: To evaluate the patient satisfaction to hospital services and identify factors that influences this satisfaction.

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Sat Jan 01 2022
Journal Name
Education For Health
Determinants of social accountability for medical schools in Iraq: A qualitative case study
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Publication Date
Wed Jun 28 2023
Journal Name
Internet Technology Letters,
The Blockchain for Healthcare 4.0 Apply in Standard Secure Medical Data Processing Architecture
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Cloud-based Electronic Health Records (EHRs) have seen a substantial increase in usage in recent years, especially for remote patient monitoring. Researchers are interested in investigating the use of Healthcare 4.0 in smart cities. This involves using Internet of Things (IoT) devices and cloud computing to remotely access medical processes. Healthcare 4.0 focuses on the systematic gathering, merging, transmission, sharing, and retention of medical information at regular intervals. Protecting the confidential and private information of patients presents several challenges in terms of thwarting illegal intrusion by hackers. Therefore, it is essential to prioritize the protection of patient medical data that is stored, accessed, and shared on

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Publication Date
Tue Sep 11 2018
Journal Name
Iraqi Journal Of Physics
Estimation of kidney tumor volume in CT images using medical image segmentation techniques
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Kidney tumors are of different types having different characteristics and also remain challenging in the field of biomedicine. It becomes very important to detect the tumor and classify it at the early stage so that appropriate treatment can be planned. Accurate estimation of kidney tumor volume is essential for clinical diagnoses and therapeutic decisions related to renal diseases. The main objective of this research is to use the Computer-Aided Diagnosis (CAD) algorithms to help the early detection of kidney tumors that addresses the challenges of accurate kidney tumor volume estimation caused by extensive variations in kidney shape, size and orientation across subjects.
In this paper, have tried to implement an automated segmentati

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Crossref
Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Social Medical Care for the Deformed Children: A Field Study in Baghdad City
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The Child is the first sedum for the human society performing, and we deal in our
research to explain the nature of the mutual relations in between the form and the medicine
social caring foundation. So the motherhood and the childhood nowadays become the most
dedicated in the researchers works, whom interesting in the social affairs, and that whom
work in the medicine field as scientists.
So the child is the future man and must be in wright body construction that need to great
care and interest to make him wright mind through capability of performing anything support
to him.
In our research we deal with the main factors in which lead to infect the child by the
creative malfunction, like the environmental and m

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