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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
Sun Jan 01 2012
Journal Name
مجلة الهندسة والتكنولوجيا
Histopathological Effects of Burkholderia Mallei Isolated from Patients with Wound Infections on Mice
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Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Hydatid Cyst Disease among Patients hospitalized at Baghdad teaching hospital: clinico-epidemiological study
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Background. Echinococcosis/ hydatitdosis is a zoonotic parasitic disease caused by the infestation of the larval form of the tapeworm of the genus Echinococcus .The Liver, lungs, and kidneys are the common areas of infestation.Objectives: To describe hydatid disease in hospitalized patients from a clinico-epidemiological perspectives.Methods:: A retrospective study was conducted over a period of 6 months extending from 15th of November 2011 to the 15th of May 2012 by reviewing records of 125 patients who were hospitalized at Baghdad Teaching Hospital during 2011and received medical and surgical treatment for hydatid cyst disease. The information covered the socio-demographic and clinical characteristics of the patientsResults:.The presen

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Publication Date
Mon Sep 30 2024
Journal Name
Iraqi Journal Of Science
Study of Some Hormonal and Biochemical Parameters among Patients with Chronic Liver Diseases
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It has been revealed previously that chronic liver disease (CLD) may be associated to hormonal fluctuations. The current study, therefore, aimed to evaluate some hormones in CLD patients compared with non-CLD individuals. This case control study was conducted at Gastroenterology and Hepatology Teaching Hospital, Medical city, Baghdad, Iraq during December 2021 to May 2022. One hundred and twenty male patients with CLD (age:14-75 years) and 120 control males (age: 24-70 years) were involved in this study. Serum samples were taken from all individuals and were then analysed for many tests which included hormones (Cortisol, testosterone, prolactin, insulin  and thyroid stimulating hormone TSH); biochemical analysis (Prothrombin time

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Publication Date
Mon May 30 2022
Journal Name
The Journal Of Infection In Developing Countries
SARS-CoV-2 viral shedding and susceptibility: perspectives on gender and asymptomatic patients
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Despite efforts to contain and manage the SARS-CoV-2 outbreak which was declared a public health emergency of international concern in January 2020 by the World Health Organization (WHO), the COVID-19 pandemic still remains a major global challenge. Patients who display the classical symptoms of the infection are easily identified, tested, isolated and monitored. However, many cases of infected asymptomatic patients have been documented. These patients are not easily identified even though many evidences suggest that they can spread the virus to others. How and why these COVID-19 asymptomatic presentations occur remain unclear. The many theories and views are conjectural, and supporting evidences are still needed. In this review, we

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Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Orbital Hydatid Disease: A case study of young patients with primary orbital lesion
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Background:This is a prospective study of three children presented to us in the Orbital clinic in AL ShahidGazi Al Hariri Hospital with painless proptosiswith suspension of Hydatid disease.Objectives: : Orbital hydatid disease is a rare lesion accounting for less than 1% of the total lesions of the body (1, 2). Orbital cysts presented as a primary lesion in our study which is rare to have such lesion without involvement of other organs (3). Humans represent the intermediate host where the commonly affected organ are liver and the lung (10-15%) (4). Methods:This is a prospective study of three Children presented to us in the Orbital clinic in Al Shahid Ghazi Alhariri Hospital with painless proptosis with suspension of Hydatid disease, dep

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Baghdad City Seasonal Forecasts Of Monthly Chronic Diseases patients Numbers Using SARIMA Models
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    One of the most important problems of IRAQI HEALTH MINISTRY and all healthy instruments in IRAQ is Chronic Diseases because it  have a negative effects on IRAQI population, this is the aim of our study ,to specify the important Chronic diseases which make the population fell weakly, they are six diseases as the IRAQ ministry of health specified (  Diabetes, blood pressure diseases ,Brain diseases ,  Cardiology, Asthma, epilepsy) we got these data from IRAQI HEALTH MINISTRY ,bureau of planning and studies ,for the period 2009-2012,as monthly observations , represent sum of peoples have chronic diseases in Baghdad .

     Our research obj

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Crossref
Publication Date
Tue Nov 06 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Patients' Knowledge about Chronic Diseases towards Risk Factors and Warning Signs of Stroke
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Objectives: to assess chronic diseases patients’ knowledge toward stroke risk factors and warning signs, besides
determining the relationship between chronic diseases patients’ knowledge and their sociodemographical
characteristics.
Methodology: A descriptive study was carried out at public medical clinics which has started from December
2
nd, 2008 to August 8th, 2009. A purposive "non-probability" sample of (300) chronic diseases individuals who
were clients of Public Medical Clinics who have one or more of the following chronic diseases (hypertension,
diabetes mellitus, heart diseases, and previous stroke), in Baghdad city. The data were collected through the use
of a constructed questionnaire which consists

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Publication Date
Tue Dec 02 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Oral health status, salivary physical properties and salivary Mutans Streptococci among a group of mouth breathing patients in comparison to nose breathing
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Background: Mouth breathing can lead to introduce cold, dry unprepared air that insults the tissue of oral cavity, nasopharynx and lung, leading in turn to pathological changes in oronasal cavity, nasopharyngeal and other respiratory tissue, mouth breathing associated with nasal obstruction may lead to many health problems, in particular oral health problems such as inflammation of gingiva, oral dryness, change in oral environment that may decrease pH, salivary flow rate and increase bacteria and dental caries.Aims of the present study were to assess the oral health condition among mouth breather associated with nasal obstruction, including dental caries, oral cleanliness and gingival health condition as well as to evaluate the changes in s

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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Correlation between Periodontal Health Status and Salivary Matrix Metalloproteinase-9 Levels in Smoker and Non-Smoker Chronic Periodontitis Patients (A Comparative Study)
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Background: Periodontal diseases are inflammatory diseases affecting the supporting tissues of the teeth. One of the leading environmental factors that are closely related not only to the risk but also to the prognosis of periodontitis is smoking. This study aimed to evaluate the influence of smoking on periodontal health status and to measure the levels of matrix metalloproteinase-9 in smokers and nonsmokers chronic periodontitis patients, also it aimed to test the correlation between the levels of matrix metalloproteinase-9 and the clinical periodontal parameters. Materials and Methods: Five milliliters samples of un-stimulated whole saliva and full-mouth clinical periodontal recordings (plaque index, gingival index, bleeding on probing,

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Crossref
Publication Date
Fri Dec 01 2023
Journal Name
History Of Medicine
A comparative study of integrin- linked kinase 1 and anti-smith antibody as diagnostic biomarkers in Iraqi patients with systemic lupus erythematosus
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Systemic lupus erythematosus (SLE) is the prototypic multisystem autoimmune disorder with a broad spectrum of clinical presentations encompassing almost all organs and tissues. Aimes of study determination of integrin- linked kinase 1(ILK-1) and anti-smith antibody(ASAB) levels in serum of Iraqi patients with systemic lupus erythematosus, in addition, that ILK-1 may be as a diagnostic marker of SLE disease, and study the effect of systemic lupus erythematosus on renal function in these patients. This study included 100 females’ patients with systemic lupus erythematosus attending to the Rheumatology Unit in Baghdad Teaching Hospital, Medical City, (Baghdad), in addition to 30 healthy females as controller group were chosen without any chr

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