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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 Feb 04 2014
Journal Name
American Journal Of Pharmacological Sciences
Self Medication Practice among Iraqi Patients in Baghdad City
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The practice of self medication is continuously increasing worldwide due to its important roles in curing minor conditions or symptoms. This study was conducted to evaluate the factors associated with self medication practice of Iraqi respondents residing in Baghdad City. This study was designed as cross sectional study in which data was collected via direct interviews with respondents using a previously prepared questionnaire. This study investigated 348 respondents from different age groups. The majority of respondents were male aged between 30-60 years, married with secondary or academic level of education and employed with accepted monthly income. The main reason for practicing self medication was previous experience with the same condi

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Publication Date
Wed Aug 27 2025
Journal Name
Cells
Neuromodulatory Signaling in Chronic Pain Patients: A Narrative Review
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Chronic pain is a complex and persistent condition involving sustained nociceptive input, maladaptive neuroplastic changes, and neuroimmune interactions. Central to its pathophysiology is the dysregulation of neuromodulatory signaling pathways, including neurotransmitters (e.g., dopamine, serotonin, norepinephrine), neuropeptides (e.g., substance P, CGRP), and neurotrophic factors (e.g., BDNF), which modulate both central and peripheral sensitization mechanisms. In disorders such as fibromyalgia, altered monoaminergic transmission has been implicated in the attenuation of descending inhibitory control, thereby enhancing pain perception and reducing responsiveness to conventional therapies. Concurrently, neuroinflammation, driven by

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Health Situations Teaching Of Biology The Manner Teaching Its Relation To Ability Mind and Students Technical Medical Institute
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The Present study aims at answering the following questions:
1-What is the level of the teaching style of biology teachers who teach (human and his
health)

2-what is the level of healthy attitude to the teachers of biology who teach (human and his
health).
3- is there any relation between the teaching style of biology teachers who teach (human and
his health)and their student's Ability Mind.
4- is the any relation between the level of the healthy attitude to the teachers of biology who
teach (human and his health).
The researcher made the following for the purpose of answering the question of the study:
1-The card of observing the level of the teaching style (lecture style )to the teachers of
biology

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
The efficiency of cluster analysis to analyzing medical image of Covid-19 patient by using K-means algorithm
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Publication Date
Sun Dec 04 2016
Journal Name
Baghdad Science Journal
A study of anti fungal activity of a combination of essential oils from medical herbs against water molds
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The aim of this study is to evaluate the anti fungal activity of a combination of essential oils against water molds. HPLC analysis was done to evaluate the quantity and quality of the active compounds in this combination which extracted from three herbs( Peppermint Menthapiperita ,Thyme Thymusvulgaris, Common sage Salvia officinalis L.) and the active compounds are Camphor,Menthol,,Thujone and Thymol with different concentrations. In this study (MIC) , (MFC) were measured and (LD50) determined after 48,96 h from fingerlings treatment of common carp in aquariums .The results of (MIC) were 0.025µl/ml for Aphanomyces sp. and 0.015µl/ml for both Achlya sp. and Fusariumsolani which showed significant differences(p<0.05) from Malachite gre

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Publication Date
Sun Feb 16 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Proceedings of the 1st International Medical Conference of Al-Rafidain University College (RUCIC2025), Baghdad, Iraq. 13 February 2025
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Publication Date
Fri Jan 02 2026
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
How Much Do Mothers Know? Evaluating Awareness of Medical Justifications for First Cesarean Deliveries: A Cross-sectional Study
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Background: The rising rate of cesarean deliveries has generated concern about whether all procedures are medically justified. Limited data exist on how well first-time mothers understand the indications for their cesarean section in Iraq. Objective: To assess maternal knowledge of the medical reasons for the first cesarean delivery and its relationship with sociodemographic, obstetric, and neonatal characteristics. Methods: A cross-sectional study was conducted from October to December 2023 among 158 Iraqi women who underwent their first cesarean delivery. Data were collected using a structured, self-administered online questionnaire that assessed demographic, obstetric, and knowledge-related factors. Results: Less than half of the

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Publication Date
Wed Oct 28 2015
Journal Name
International Journal Of Medicine And Pharmaceutical Sciences (ijmps
THE STUDY OF NUCLEAR REACTIONS FOR PRODUCTION OF ISOTOPES FOR MEDICAL RADIOACTIVE ARSENIC BY USING DIFFERENT CROSS SECTIONS
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This presented study is to make comparison of cross sections to produce 71As, 72As, 73As and 74As via different reactions with particle incident energy up to 60 MeV of alpha 100 MeV of proton as a part of systematic studies on particle-induced activations on enriched Ge, Ga, Rb and Nb targets and neutron capture. Theoretical calculation of production yield, and suggestion of optimum reaction to produce 71As, 72As, 73As and 74As, based on the main published and approved experimental results of excitation functions were calculated.

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Publication Date
Thu Jun 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Isotherms and Kinetics Study for Adsorption of Nitrogen from Air using Zeolite Li-LSX to Produce Medical Oxygen
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This research investigates the adsorption isotherm and adsorption kinetics of nitrogen from air using packed bed of Li-LSX zeolite to get medical oxygen. Experiments were carried out to estimate the produced oxygen purity under different operating conditions: input pressure of 0.5 – 2.5 bar, feed flow rate of air of 2 – 10 L.min-1 and packing height of 9-16 cm. The adsorption isotherm was studied at the best conditions of input pressure of 2.5 bar, the height of packing 16 cm, and flow rate 6 Lmin-1 at ambient temperature, at these conditions   the highest purity of oxygen by this system 73.15 vol % of outlet gas was produced. Langmuir isotherm was the best models representing the experimental data., and the m

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The relationship between medical and nursing staffing and its impact on the quality of health service / Applied Research.
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The research aims to find out the relationship between the medical and nursing staffing and its impact on the quality of provided health service in the Yarmouk Teaching Hospital, and to understand the nature of the relationship between doctors and nurses, it has been the adoption of cooperation and conflict Kmngaran independent knowledge of the relationship between doctors and nurses and the quality of health service as a variable certified by eating five dimensions (tangibility, reliability, safety, responsiveness, empathy). The research was adopted to collect data on the questionnaire prepared medical and nursing to the angel and adopted included Likert Quintet her, and distributed to doctors working in the Yarmouk hospital in

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