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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
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Coronary angiogriphy in left ventricular dysfunction patients with no clinical evidence of ischemic heart disease
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Background : Coronary artery disease is theunderlying cause in approximately two thirds of
patients with systolic heart failure ;
Coronary artery angiogriphy may be useful to
define the presence ,
Anatomical characteristics ,and functional
significance of Coronary artery disease in
selected heart failure patients with or without signs
and aymptoms of Coronary artery disease.
Objectives: to verify the clinical usefulness of
coronary angiography (CA) in congestive heart
failure (CHF) patients with no history of ischemic
heart disease and to identify predictive factors for
performing coronary angiography to patients with
congestive heart failure with no obvious ischemia.
Methods :this is a cross-ses

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Publication Date
Tue Dec 21 2021
Journal Name
Open Access Macedonian Journal Of Medical Sciences
The Impact of Social Support on Students’ Behavior in the Context of Iraqi Medical Education
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BACKGROUND: Mental health problems are reflected and linked to human behavior in many aspects. Medical students are susceptible to a wide variety of events that compromise their mental well-being, social life as well as their academic achievements. AIM: This study aimed to find the impact of social support on medical students’ behavior in Iraq via assessing their depression, anxiety, and stress status. METHODS: A cross-sectional online survey-based study targeted all medical students in Iraq. The employed questionnaires covered mental health status of participants by evaluating their perceptions of depression, anxiety, and stress using. Data were analyzed using the Statistical Analysis System. RESULTS: The study revealed a signifi

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Educational And Psychological Researches
The impact of education differentiated strategy to modify the alternative conceptions Geographical concepts when students First grade average
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The aim of this study was to know ( the impact of education differentiated strategy to modify the alternative developments of geographical concepts when students first grade average) .
      To achieve the goal of this study , researcher relied on the experimental design of a partial set , the design is ( the experimental group with a control group of post-test )
.

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Publication Date
Sat Nov 10 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Satisfaction of Patients, Coronary Arteries in Related to Nursing and Medical Care
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Objectives of the study: The study aims to assess satisfy of the coronary artery patients for the care product from
the nurse and physician and to find out the relationship between patient satisfaction with the social and the
clinical characteristics of the patients.
Methodology: A descriptive design study conducted using the evaluation approach for the duration of June 3
rd
2012 to January 31, 2013. Non-probability sample of (60) patients who were visiting or admitted (inpatient or
outpatient) to the teaching hospital in Baquba with the diagnosis of coronary artery disease. A questionnaire have
been built and develop by the researcher based on review of literature and previous research, the form included of
(3) p

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Publication Date
Mon May 25 2026
Journal Name
Journal Of The College Of Law /al-nahrain University
The financial regulations approved in private universities and colleges in accordance with the Law of Private Higher Education No. (25) of 2016
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Publication Date
Wed Apr 30 2025
Journal Name
Journal Of International Studies
RESHAPING THE WORLD, RETHINKING ACTORS: THE ROLE OF SUB-STATE ACTORS IN FOREIGN RELATIONS
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International relations scholars have increasingly debated the evolving landscape of actors that challenge the traditional state-centric world order. A key element of this transformation is the rise of sub-state actors, which engages in alternative diplomacy parallel to the state, transcending traditional state-centric frameworks. This paper explores the significant shifts in international actorness over the late 20th century, focusing on the emergence and implications of sub-state diplomacy, or "paradiplomacy." First, the study introduces sub-state actors and their role in challenging the dominant state-centric discourse. It then examines the dynamic evolution of paradiplomacy, highlighting how sub-states have expanded their global

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Publication Date
Wed Dec 20 2023
Journal Name
Discourse And Interaction
Refusal and politeness strategies favoured among Iraqi and Malaysian learners in marriage proposals
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The study targets exploring the similarities and differences between Iraqi and Malaysian learners of English in refusing marriage proposals. Also, it examines the favored politeness strategies that learners use to protect their interlocutors’ face, heeding both their social distance and status. Data were gathered by a Discourse Completion Task (DCT) which contained six marriage situations. Responses were analyzed based on Beebe et al.’s (1990) refusal taxonomy and Scollon et al.’s (2012) politeness system. The findings indicated that both the Iraqi and Malaysian learners preferred the indirect refusal strategies in marriage proposals, as well as the hierarchical politeness in the form of independence strategies regardless of t

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Publication Date
Wed Dec 20 2023
Journal Name
Discourse And Interaction
Refusal and politeness strategies favoured among Iraqi and Malaysian learners in marriage proposals
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The study targets exploring the similarities and differences between Iraqi and Malaysian learners of English in refusing marriage proposals. Also, it examines the favored politeness strategies that learners use to protect their interlocutors’ face, heeding both their social distance and status. Data were gathered by a Discourse Completion Task (DCT) which contained six marriage situations. Responses were analyzed based on Beebe et al.’s (1990) refusal taxonomy and Scollon et al.’s (2012) politeness system. The findings indicated that both the Iraqi and Malaysian learners preferred the indirect refusal strategies in marriage proposals, as well as the hierarchical politeness in the form of independence strategies regardless of t

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Publication Date
Sun Jul 01 2001
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
INHERITANCE OF DARK HEAD AND SIPHON IN THE LARVAE OF CULEXQUINQEFASCIATUS SAY
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A new spontaneous mutation (dh) is described for Culex quinquefasciatus Say. This
phenotype was observed in the second generation to cause complete coloration of the head
capsule and the siphon of the larvae. This character is mainly detectable in the larval stage
and slightly in the adult stage.
The reciprocal mass matting between mutants from F2 generation and normal wild type
sibs, revealed that the mode of inheritance can be controlled by an autosomal recessive
gene(s). This happened for both sexes with slightly variability in their expression. No
significant larval mortalities were found in all crosses.

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Publication Date
Sun Sep 30 2012
Journal Name
College Of Islamic Sciences
Poetic necessity, when Maari
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Praise be to God, Lord of the worlds, and prayers and peace be upon the master of the messengers, his family and all his companions. And after:
      This research talks about a topic that has taken a great deal of attention and controversy among many Arabic language scholars, which is the subject of poetic necessity, but it does not talk about the necessity in general, but one of the scholars and writers who had stances and references to this issue was chosen in many places from their books. Abu Al-Ala 'Al-Maari was among the scholars who dealt with this issue on numerous occasions and occasions, and this was evident in his books.

    We chose this topic to see how Abu Al-Ala

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