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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
Tue Jul 05 2022
Journal Name
Journal Of Pharmaceutical Care
Epidemiological and Clinical Factors Affecting the Response to Etanercept Among Patients with Rheumatoid Arthritis
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Publication Date
Thu Aug 01 2019
Journal Name
Biochemical And Cellular Archives
PARTIAL PURIFICATION AND CHARACTERIZATION OF ACID PHOSPHATASE FROM SERA OF OBESE DIABETES MELLITUS PATIENTS
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The study aimed to purification of acid phosphatase (ACP) from sera of obesetype 2 diabetes mellitus patients, this study included from thirty T2DM patients and thirty control, purification process was done with several steps included precipitation with inorganic salt (NH4 ) 2SO4 30%-80%, dialysis, ion exchange chromatography by DEAE sepharose anion column and size exclusion chromatography by Sepharose 6B.ACP, BMI, FBS, HbA1c, Lipid profile, Urea, Creatinie, Insuline, Homa-IR were determined. Results showed the precipitate and concentrated protein appeared four peaks in ion exchange column. ACP located in the first and second peak with purification fold (21.1), (37.2) yield of enzyme and specific activity (173.3) IU/ml, which obtained a si

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Publication Date
Thu Oct 01 2020
Journal Name
Biochemical & Cellular Archives
TOXOPLASMOSIS, DIABETES AND SOME IMMUNE FACTORS THAT EFFECT ON THE BURDEN OF PATIENTS’ IMMUNITY
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Publication Date
Sun Jul 12 2020
Journal Name
Medico-legal Update
Assessing the Response of a Sample of Iraqi Asthmatic Patients to Different Medication Regimens
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Asthma is a chronic inflammatory disease of respiratory airways characterized by distinctive history of respiratory symptoms due to variable airflow obstruction which reverses either spontaneously or in response to certain medications. Acetylcholine is a parasympathetic neurotransmitter which plays fundamental roles in the development of persistent asthma. Treatment guidelines recommend using medium doses of inhaled corticosteroids in addition to another controller bronchodilator instead of using high doses inhaled steroid alone for treatment of moderate to severe persistent asthma. The inhaled long acting muscarinic antagonist, tiotropium, was approved recently to control unresponsive asthma to inhaled corticosteroid with or without a long

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Publication Date
Fri May 25 2018
Journal Name
Open Public Health Journal
Comparative Study on the Clinicopathological Profiles of Breast Cancer Among Iraqi and British Patients
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Background: Breast cancer is the most common cancer in Iraq and the United Kingdom. While the disease is frequently diagnosed among middleaged Iraqi women at advanced stages accounting for the second cause of cancer-related deaths, breast cancer often affects elderly British women yielding the highest survival of all registered malignancies in the UK. Objective: To compare the clinical and pathological profiles of breast cancer among Iraqi and British women; correlating age at diagnosis with the tumor characteristics, receptor-defined biomarkers and phenotype patterns. Methods: This comparative retrospective study included the clinical and pathological characteristics of (1,940) consecutive female patients who were diagnosed with invasive b

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Publication Date
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
White Spot Lesions Among Patients Treated With Fixed Orthodontic Appliance at Different Time Intervals
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ABSTRACT Background:- White spot lesions are common esthetic problem that compromise the success of orthodontic treatment. This study aimed to assess white spot lesions in patients with fixed orthodontic appliance at different time intervals. Materials & Methods:- Thirty two patients (24 females and 8 males) were included in this study and they underwent clinical examination for white spot lesions using enamel decalcification index at four time intervals: (2-3 weeks after appliance insertion, 2, 4 and 6 months). Results:- The patients were free of white spot lesions at the appliance insertion visit. The mean of white spot lesions was 2.22 which were increased significantly during six months to reach 24.59 at the end of study. There was a si

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Publication Date
Fri Jan 01 2016
Journal Name
Diabetic Foot &amp; Ankle
Risk factors for occurrence and recurrence of diabetic foot ulcers among Iraqi diabetic patients
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There are a few studies that discuss the medical causes for diabetic foot (DF) ulcerations in Iraq, one of them in Wasit province. The aim of our study was to analyze the medical, therapeutic, and patient risk factors for developing DF ulcerations among diabetic patients in Baghdad, Iraq.

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Publication Date
Wed Aug 07 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Determination of the Cardiac Patients Knowledge toward Using Anticoagulant Medications at Missan Governorate Hospitals
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Objective- the study aim to determine the cardiac patient knowledge about anticoagulant medications using and its relationship with demographic data(age. gender. level of education. occupational). Methodology- A descriptive study(quasi-experimental)design was carried out to determine cardiac patient knowledge consider to using anticoagulant medications . Starting from(1th Jun 2017 to5th October 2018).To achieve the objectives of the study, a non-probability sample (a purposive sample) consisted of random sample comprised of (30) patients were taken anticoagulant medications ..The measurement of patient knowledge were collected through the use of questionnaire which is related to patient knowledge toward using the anticoagulant medication

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Publication Date
Tue Dec 02 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of chemotherapy on oral health status and salivary alkaline phosphatase among leukemic patients
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Background: Leukemia is a broad term given to a group of malignant diseases characterized by diffuse replacement of bone marrow with proliferating leukocyte precursors. Chemotherapy has been increasingly used to treat malignant conditions. The systemic sequelae as a result of these immunosuppressive techniques induce many oral and dental complications. This study was conducted to evaluate the effect of chemotherapy on oral health status and activity of salivary alkaline phosphates enzyme in patients with acute lymphocytic leukemia. Materials and methods: The study groups included 28 patients with acute lymphocytic leukemia; they were under chemotherapy, aged 20-25 year old. The control group includes healthy subjects matching with study

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Publication Date
Fri Dec 23 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Preparation and Evaluation of Oroslippery Tablets Contain Irbesartan and Hydrochlorothiazide Combination for Dysphagia Patients
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Oro slippery tablets (OSTs) is a technique used to improve swallowing of tablets for patients with dysphagia. The aim of this study was to formulate irbesartan and hydrochlorothiazide as Oroslippery tablets (OST) containing 150 mg irbesartan and 25 mg hydrochlorothiazide for dysphagia patients. A simple and rapid method of analysis was developed and validated according to the ICH guideline using HPLC with UV detector. Tablets were prepared by direct compression and then coated with the slippery coat of three different concentrations of the slippering substance “xanthan gum’ (2%, 3% and 4%) in Opadry Colorcone® and evaluated according to USP. Slipperiness test was performed using Albino rabbits. Results showed that 2% xanthan gum gav

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