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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
Sat Dec 01 2018
Journal Name
Journal Of Coloproctology
Role of adiponectin in patients with inflammatory bowel disease unclassified
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Abstract<p> Background Inflammatory bowel disease (IBD) is a lifestyle idiopathic, chronic, and inflammatory intestinal disorders that required long-term medications and care.</p><p> Aim of the study Assess the level of adiponectin in IBDU and its relation with different parameters like lipid profile and Body Mass Index (BMI).</p><p> Type of the study A case-controlled study.</p><p> Patients and methods The total number of study groups was sixty individuals, forty of them were patients with inflammatory bowel disease unclassified and the rest were control healthy subjects. Serums were examined for lipid profile (cholesterol, triglycer</p> ... Show More
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Publication Date
Tue Mar 30 2021
Journal Name
Baghdad Science Journal
Hypothyroidism and AMH in Iraqi Patients with Chronic Kidney Disease
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This study was conducted to investigate thyroid function and Anti-Müllerian hormone (AMH) in (Chronic kidney disease) CKD patients by evaluating their levels in CKD patients, 50 patients were diagnosed to have CKD stage-5, their ages ranged between 20-50 years (25 males and 25 females) who attended the Nephrology and Transplant Center in Medical City of Baghdad- Iraq, they were recruited from April 2018 to July 2018 and were enrolled into the study. The control group consisted of 20 healthy individuals, their ages ranged between 20-48 years (10 males and 10 females). The study showed non-significant (p>0.05) increase in AMH level in CKD patients compared to the control group. On the other hand, TSH was recorded a highly significant (

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Publication Date
Tue Dec 01 2015
Journal Name
International Journal Of Current Microbiology And Applied Sciences
Expression Analysis of Salivary Microrna-31 in Oral Cancer Patients
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Oral carcinoma is the 6th most common cancer in the world. MicroRNAs are small non-coding single stranded RNAs. They have been shown to be capable of altering mRNA expression; thus some are oncogenic or tumor suppressive in nature. The salivary microRNA-31 has been proposed as a sensitive marker for oral malignancy since it was abundant in saliva more than in plasma. A total of 55 whole saliva samples were collected from 35 cases diagnosed with OC their ages and gender matched with 20 healthy subjects. TaqManq RT-PCR was performed for RNA samples. Mean age was 52.23+13.73 years in cases (range:17-70 years) with male predominance represented 69%. Risk of smoking and alcoholism was highly significant. The median fold change of miR-31 was sign

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Publication Date
Sat Oct 01 2022
Journal Name
The Egyptian Journal Of Hospital Medicine
Evaluation of Certain Physiological Biomarkers in Iraqi Endometrial Carcinoma Patients
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Background: Endometrial Cancer (EC) is the malignant tumor originating from endometrium cell (lining of the uterus). EC incidence and mortality have increased in recent years. Routinely used methods for EC diagnosis and treatment are histopathological tissue culture after surgery and postoperative radiotherapy, however there is still not enough efficient treatment for recurrence or progression of this disease. So, there is a critical need for further EC identification by new biological ways for the prognostic diagnosis of it. Objective: This study aimed to look for ways by which could help in diagnosis of EC before the hysterectomy. Materials and Methods: 55 patients with EC and 57 healthy women were involved in this study (up to 45 years)

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
HLA Typing in Iraqi Patients with Obesity and Primary Osteoarthritis.
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Background: Osteoarthritis (OA) is a degenerative joint disease. It is one of the major causes of disability in developed and developing countries. Human leukocyte antigen (HLA) as part of immune system has a role in the disease process.Objectives: To investigate whether there is an association between HLA class II-DRB and OA.Methods: A case control study with 26 patients with osteoarthritis and 22 apparently healthy obese control persons matching in ethnicity were enrolled in this study during the period between October 2012 till March 2013. Direct interview was done with each patient and HLA typing was done by molecular method using Sequence Specific Primer (PCR-SSP) method using One Lambda Kit-USA. Results: The results showed that fem

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Publication Date
Sat Dec 30 2023
Journal Name
Al-kindy College Medical Journal
Assessment of Serum Metalloendopeptidase level in Patients with Double Diabetes
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Background: Double diabetes is the term used to describe situations in which a patient exhibits characteristics that are a combination of type 1 and type 2 Diabetes Mellitus. Metalloendopeptidase or Neprilysin is membrane-bound metallopeptidase. It has a wide range of physiological function and a variety of substrates. It has a significant impact on the proteolytic functions of the kidney, cardiovascular health, immunological response, cell proliferation, and fetal development. It also has a preventative effect on the onset of type 2 diabetes, obesity, and cancer.

Objective: The study aims to assess the level of MEP in patients wi

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Publication Date
Fri Oct 01 2010
Journal Name
Iraqi Journal Of Community Medicine
Clinico-epidemiological and Histopathological Study of Syringoma in Iraqi Patients
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KE Sharquie, HA Hassan, AA Noaimi, IRAQI JOURNAL OF COMMUNITY MEDICINE, 2010

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Publication Date
Wed Jan 01 2020
Journal Name
Transplantation Proceedings
Outcomes of SGLT2 Inhibitors Use in Diabetic Renal Transplant Patients
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Publication Date
Sat Dec 31 2022
Journal Name
Al-kindy College Medical Journal
Pulmonary CT findings in Patients Recovered from COVID-19 Pneumonia
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Background: The COVID-19 infection is a more recent pandemic disease all over the world and studying the pulmonary findings on survivors of this disease has lately commenced.

Objective: We aimed to estimate the cumulative percentage of whole radiological resolution after 3 months from recovery and to define the residual chest CT findings and exploring the relevant affecting factors.

Subjects and Methods: Patients who had been previously diagnosed with COVID-19 pneumonia confirmed by RT-PCR test and had radiological evidence of pulmonary involvement by Chest CT during the acute illness were included in the present study. The radiol

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Publication Date
Mon Mar 15 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Educational Program on Female Students’ Knowledge toward Premenstrual Syndrome in Secondary Schools in Third Al- Rusafa Education Directorate, Iraq
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Objective: To evaluate the effectiveness of educational program on female students’ knowledge toward premenstrual syndrome.
Methodology: A quasi-experimental design study conducing on (140) student purposely in four secondary schools at Al-sadder city (70) student for study group and (70) for control group. The prevalence of PMS selected through American College of Obstetricians and Gynecologists (ACOG) (2015) criterias to select PMS students before program. The education program were set in four steps, the first step (pre-test) is to assess the knowledge , before the implementation of the program, the second step is implementing the program, following two steps post-test I and II between each test two weeks. Validity is determined

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