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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
Fri Apr 01 2022
Journal Name
International Journal Of Early Childhood Special Education
Digital culture skills among chemistry students at the College of Education for Pure Sciences, Ibn al-Haytham in Iraq
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Publication Date
Wed Jan 13 2016
Journal Name
مجلة الأطروحة للعلوم الإنسانية
Evaluation Of The Curricula Of Arabic Language Departments In The Faculties Of Education In Iraqi Universities In The Light Of The Total Quality Standards
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The study aimed to achieve the following: Developing comprehensive quality standards for evaluating the curricula of Arabic Language Departments in Colleges of Education at Iraqi universities. Evaluating the curricula of Arabic Language Departments in light of comprehensive quality standards. The study was delimited to: The Arabic language curricula—namely (grammar, morphology, literature, rhetoric, criticism, and prosody)—taught in Arabic Language Departments across their four academic years for the academic year (2010/2011). Arabic Language Departments in Colleges of Education at Iraqi universities (Baghdad, Diyala, Mosul, Basra, and Babylon). Faculty members of Arabic Language Departments in Colleges of Education at Iraqi universitie

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Publication Date
Thu Aug 10 2023
Journal Name
Migration Letters
The Effectiveness of E-Training in Developing the Skills of Designing E-Courses for Teachers of Arabic in the Colleges of Education in Iraq
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This study aimed to examine the effects of electronic training to improve the skills of designing electronic courses for teachers of Arabic language in the colleges of education in Iraq. The descriptive approach is applied and the sample included 145 teachers of Arabic who were selected randomly from the colleges of education in Iraq. Moreover, the results reflected that e-training is effective in improving the skills related to designing online educational courses for teachers of Arabic in the colleges of education in Iraq. Besides, there was no difference between the mean of the respondents' responses to the total score of the tool on the role of electronic training to develop the skills related to electronic courses designing for teacher

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Computerized Interactive Program in Developing Mathematical Skills among First Cycle Students in Basic Education Schools in the Sultanate of Oman
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The current research aims to identify the effectiveness of a computerized program in developing mathematical skills among the first cycle students in basic education schools in the Sultanate of Oman. The two researchers used the quasi-experimental approach on an intentional sample consisting of (40) male and female students at Al Kawakeb School for Basic Education (1-4). Two of the basic fourth-grade classes and then randomly distributing them into two groups, one is experimental (20) male and female students who followed the computerized interactive program, and the other is (20) male and female students followed the traditional way. On the other hand, its reliability has reached (0.81), and the results of the research have concluded th

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Publication Date
Thu Dec 01 2022
Journal Name
Baghdad Science Journal
DC-SIGN Receptor Level in Rheumatoid Arthritis Patients in Baghdad; Serological study
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Rheumatoid arthritis (RA), is an autoimmune, and inflammatory disease that is closely related to the destruction of cartilage and bone. DC-SIGN are important types of C-type lectin receptors (CLRs), expressed on dendritic cells and macrophages, and have a central role in regulating innate and adaptive immunity, function as pattern recognition receptors, and as cell adhesion molecules. Recent evidence has demonstrated that DC-SIGN is involved in the pathophysiological of chronic inflammation, so DC-SIGN has been linked to several autoimmune and may play an essential indicator in the pathogenesis and progression of RA. Therefore, the purpose of this study is to determine the serum level of DC-SIGN in RA patients, as well as the level of DC

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Increase serum leptin level in Helicobacter pylori infection in Iraqi gastritis patients
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Background: H.pylori colonized gastric mucosal
epithelium will virtually develop gastritis and had the
capacity to persist for decades. Pathogenesis is
dependent upon strain, virulence host genetic
susceptibility, and environmental cofactors. Leptin is
a member of the class 1 cytokine family so altered
leptin production during ifnect and inflammation that
leptin part of the cytokine cascade ,which
orchestrates the defense mechanism.
Objective: Examin the effect of H.pylori infection
on serum leptin level.
Methods: One hundred and thirty(130) Patients
attending the Endoscopic Unit at "Gastroenterology
and Hepatology Teaching Hospital/ Baghdad Medical
City"were included in this study with ages rang

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Publication Date
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Journal Name
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Background: Chronic kidney disease is a worldwide health problem, with adverse outcomes of cardiovascular disease and premature death, can be divided into five stages, depending on how severe the damage is to the kidneys, or the level of decrease in kidney function, the final stage of chronic kidney disease is called end-stage renal disease, salivary immunoglobulin A is the main immunoglobulin found in mucous secretions, including tears, saliva, colostrum and secretions from the genitourinary tract gastrointestinal tract, prostate and respiratory epithelium . It is also found in small amounts in blood.This study aimedto measuresalivary flow rate and salivaryimmunoglobulin Alevels in chronic kidney disease patients on hemodialysis treatment

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Publication Date
Thu Jan 01 2026
Journal Name
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Immunoglobulin E responses in Patients with Cutaneous and Visceral Leishmaniasis in Iraq
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Leishmaniasis is caused by certain intracellular Leishmania species and is common in the tropics, where it exhibits a wide range of clinical manifestations. Both cellular and humoral immunological responses play crucial roles in disease progression. This study identified the fundamental role of B lymphocytes during the progression of leishmaniasis in human hosts. A cross-sectional study of patients with cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) from different parts of Iraq was conducted, and their respective serum IgE levels were measured before any treatment was administered. Sandwich ELISA was used for quantitative measurement of IgE in CL, VL, and control subjects. The results revealed a higher level of IgE con

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EVALUATION SOME BIOCHEMISTRY PARAMETERS IN HYPERTHYROID AND HYPOTHYROID PATIENTS IN BAGHDAD CITY
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Wed Jan 01 2020
Journal Name
Middle East Research Journal
The Evolution of Medical Risks and the Standard Adopted for Informing the Patient – A Comparative Study of Positive Legislations
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The right of the patient to know the medical risks surrounding the medical intervention is one of the most prominent rights based on the principle of "physical safety", which has undergone several stages of development until it reached the development of the patient's independence in making medical decision without relying on the doctor, The patient's prior informed consent is informed of his / her medical condition. We will study this development in accordance with the French March 4, 2002 legislation on the rights of patients in the health system, whether it was earlier and later. We will highlight the development of the patient's right to "know the medical risks surrounding medical intervention" The legislation and its comparison with th

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