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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 Jan 01 2024
Journal Name
Iraqi Journal Of Hematology
Detection of active human cytomegalovirus in patients with multiple myeloma
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Abstract:<sec><title>BACKGROUND:

Human cytomegalovirus (HCMV) infection is ubiquitous and successfully reactivated in patients with immune dysfunction as in patient with multiple myeloma (MM), causing a wide range of life-threatening diseases. Early detection of HCMV and significant advances in MM management has amended patient outcomes and prolonged survival rates.

OBJECTIVES:

The aim of the study was to estimate the frequency of active HCMV in MM patients.

MATERIALS AND METHODS:

This is a case–control study involved 50 MM patients attending Hematology Center, Bag

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Publication Date
Mon Aug 21 2017
Journal Name
Biomedical And Pharmacology Journal
Gene Expression and Clinical Manifestations in Iraqi Patients with Acromegaly
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Publication Date
Wed Sep 16 2020
Journal Name
Al-kindy College Medical Journal
STUDY OF TINEA PEDIS IN DIABETIC VERSUS NON-DIABETIC PATIENTS
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Background : The aim of this work is to study the clinical features and causative fungi of tinea pedis in diabetic and non-diabetic patients. Result : Tinea pedis was estimated to be the second most common skin disease in the United States, after acne. Up to 15% of the U.S., population may have tinea pedis. Across Europe and East Asia, prevalence rates reach 20 %. Methods: The Complete history taking regarding: age, sex, occupation, residency, history of diabetes and diabetic profile (fasting blood sugar and post prandial).and Clinical examination of the feet Aim of the study : The aim of this work was to study the clinical features and causative fungi of tinea pedis in diabetic and non-diabetic patients Conclusion : Tinea pedis is more

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Publication Date
Tue Oct 12 2021
Journal Name
Neuroquantology
Biochemical Aspects in Sera of Iraqi Patients with Trigeminal Neuralgia
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Trigeminal Neuralgia (TN) is one of the most commonly painful cranial neuralgia characterized by paroxysmal attacks as short lasting facial pain along the trigeminal nerve branches. The aim of the present study is to innovate a biochemical relationship between (melatonin, GALNT12 and Zn) and TN and also to examine the biochemical action of tegretol (carbamazepine) as a treatment on the above biochemical parameters. Blood samples were collected from fifty four (54) trigeminal neuralgia patients diagnosed by magnetic radiation image (MRI). Patients were classified into four groups: G3 (40- 70) years composed of (12) diagnosed male (without treatment), G4 (48- 75) years composed of (12) diagnosed female (without treatment), G5 (34- 76)

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Publication Date
Thu Jun 04 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of oral health status in patients receiving antiepileptic medications
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Background: Epilepsy is a common neurological disorder of incidence rate 1-2%. Genetic, congenital, developmental, tumors, head trauma and central nervous system infections maybe the cause of epilepsy. This study aimed to determine the prevalence of stomatitis, xerostomia and taste disorder among patients taking carbamazepine or sodium valproate and to make salivary analysis for IgA, cystatin c and salivary flow rate. Material and method:This study performed in al- Yarmuk teaching hospital in Baghdad, Samples consist of (70) epileptics half of them treated with carbamazepine and other half treated with sodium valproate, and (18) healthy control group of both genders and with different ages to detect the prevalence of oral manifestations, s

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Publication Date
Tue Dec 09 2025
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Characterization of Gram-Positive bacteria in Gallstone among Iraqi Patients
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Background: Gallstone disease (GSD) is a significant global health burden with variable prevalence influenced by metabolic, genetic, and infectious factors. Increasing evidence suggests that Gram-positive bacteria, particularly Staphylococcus aureus and Enterococcus species, contribute to gallstone pathogenesis through enzymatic activity and biofilm formation. Objectives: To characterize Gram-positive bacteria within gallstones from Iraqi patients, evaluate their biofilm-forming capacity, and analyze the relationship between bacterial colonization, gallstone type, and cholesterol levels. Methods: A total of 100 gallstones were obtained from patients undergoing elective cholecystectomy between October 2024 and March 2025. Stones were

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Publication Date
Tue Jan 16 2018
Journal Name
International Journal Of Science And Research
Some Biochemical Assays in Hemodialysis Patients with Chronic Hepatitis C
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Abstract: The present study aimed to evaluate calcium, potassium, albumin, protein, creatinine, urea, uric acid levels, and the level of total sialic acid in the sera of patients with chronic renal failure who had been infected with Hepatitis C virus and in the sera of patients with chronic renal failure, and compare them with healthy volunteers. A total of 90 subjects with age 25-55 years, were divided into three groups. G1 represents 30 patients with chronic renal failure who had treated by dialysis and infected with chronic Hepatitis C virus (positive group). G2 represents 30 patients with chronic failure who had been treated by dialysis (negative group), while G3 represents 30 healthy volunteers (control group). The results showed

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
Hypothyroidism and Leptin in Iraqi Patients with Chronic Kidney Disease
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The present study aims at assessing the effects of chronic kidney disease (CKD) on thyroid hormone and leptin by evaluating the level of: leptin hormone along with thyroid hormone in CKD patients. The study has been conducted on  70 subjects, 50 patients with an age range between 20-50 years (25  males and 25 females) who were diagnosed to have CKD stage-5, and 20 normal controls whose ages ranged between 20-48 years (10  males and 10 females), who attended  the Nephrology and Transplant Center in Medical City of Baghdad- Iraq from April  2018  to July  2018. The study showed a highly significant (P<0.01) increase in TSH level in CKD patients in comparison with controls. While T3 and T4 levels observed highly significant decrea

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research &amp; Development
Prevalence of Urinary Tract Infections in Adult and Child Patients
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Publication Date
Sat Jan 01 2022
Journal Name
Annals Of Parasitology
The effect of toxoplasmosis on renal function in hemodialysis patients
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Toxoplasma gondii is an obligate intracellular protozoan parasite; it spreads via the circulatory system during infection and causes chronic infection in various organs. Toxoplasmosis affects nearly one third of people worldwide, especially immunocompromised people. This study aimed to determine the effect of toxoplasmosis on renal function in hemodialysis patients. Overall 300 patients referred to the Medical City, Al-Karama General Hospital, Baghdad, Iraq were enrolled from 2021 to 2022. All serum samples were tested for T. gondii immunoglobulins (IgG and IgM) antibodies, urea and creatinine levels. In patients undergoing hemodialysis, the results revealed a high positivity percentage for anti-Toxoplasma IgG. In hemodialysis patients infe

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