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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 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
Requirements for the application of quality management in the work of medical laboratories within the standard 15189 "A Case Study at Alawiya Women's and Childbirth Hospital"
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Abstract:

It is essential to provide health care directly or indirectly based on laboratory tests in order of diagnosing diseases. There is an urgent need for the results of such tests to be accurate and reliable. Therefore, the International Organization for Standardization has prepared special standards for medical laboratories to prove their efficiency, presented in standards 15189: 2012. The aim of the research is to determine the possibility of the Al-alwiya Women's Hospital in meeting the requirements of the standards 15189: 2012, which includes administrative requirements consisting of fifteen items and technical requirements consisting of ten items. The research is important because laboratories shou

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Vitamin E Level In Friedreich’s Ataxic Phenotype Patients In Four Major Hospitals In Baghdad
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Background: Friedreich ataxia (FRDA) is the most common form of inherited ataxia, comprising one-half of all hereditary ataxias with a carrier rate between 1 in 60 to 1 in 90 and with a disease prevalence of 1 per 29,000. It can occur in two forms the classic form or in association with a vitamin E dependent ataxia. The precise role of Vitamin E in the nervous system is unknown; An Oxidative attack is suspected to play a role in Ataxia with Vitamin E deficiency, as well as in Friedreich ataxia. Vitamin E is the major free-radical-trapping antioxidant.

Objective: Theobjectives of the study is to asses vitamin E level in patients with Friedreichs ataxia phenotype in Iraqi patients.

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Publication Date
Wed Jan 01 2020
Journal Name
Research Journal Of Pharmacy And Technology
Structural, Spectral and Thermal studies of new bidentate Schiff base ligand type (NO) derived from Mebendazol and 4-Aminoantipyrine and it's metal complexes and evaluation of their biological activity
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Publication Date
Fri May 01 2020
Journal Name
مجلة بحوث الشرق الأوسط
دراسة مقارنة لمستوى التمکین الإداری بین مشرفی التربیة الریاضیة (الاختصاص والفنی) لمدیریات التربیة فی محافظة بغداد A Comparative Study of the Level of Administrative Empowerment between the Physical Education Supervisors (Specialization and Technical) of Education Directorate in Baghdad Governorate
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Publication Date
Thu Jan 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Educational Program on Mothers’ Attitudes toward Readiness for Discharge Care at Home for a Premature Baby in Intensive Care Unit at Teaching Hospitals in Medical City Complex
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Objectives:
To evaluate mothers’ attitudes toward readiness for discharge care at home for a premature baby in Intensive Care Unit at teaching hospitals in Medical City Complex and to find out the relationship between mothers’ attitudes and their socio-demographic characteristics.
Methodology: A quasi-experimental study design was carried out through the period of 6th January 2020 to 2021 to 11th March 2021, to evaluate mother’s attitude toward discharge care plan for premature babies. The study carried out in Welfare Teaching Hospital, Nursing Home Hospital and Baghdad Teaching Hospital at Medical City Complex in Baghdad City on 30 mother of premature babies in neonatal intensive care units using the nonprobability sampling

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Publication Date
Fri Oct 11 2019
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Immunohistochemical Expression of Epidermal Growth Factor Receptor in Astrocytic Tumors in Iraqi Patients
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BACKGROUND: Diffuse astrocytomas constitute the largest group of primary malignant human intracranial tumours. They are classified by the World Health Organization (WHO) into three histological malignancy grades: diffuse astrocytomas (grade II), anaplastic astrocytomas (grade III) and glioblastoma (grade IV) based on histopathological features such as cellular atypia, mitotic activity, necrosis and microvascular proliferation. Epidermal growth factor receptor (EGFR) is a 170-kDa transmembrane tyrosine kinase receptor expressed in a variety of normal and malignant cells regulating critical cellular processes. When activated, epidermal growth factor receptor (EGFR) triggers several signalling cascades leading to increased proliferatio

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Serodiffusion of Helicobacter Pylori and HAV in Patients Attending Two Centers in Baghdad
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Background: Helicobacters are motile curved, oxidase and catalase positive,
gram negative rods similar in morphology to vibrios. The cells have polar flagella
and are often attached at their ends given pairs "S" shapes or seagull
appearance.
Object i ves: The present study was undertaken to estimate the serodiffusion of
H. pylori and hepatitis A virus (HAV) in 300 patients attending two centers in
Baghdad.
Metthods:: HAV was determined by the detection of HAV-IgM in the serum samples. Detection of H. pylori was by ELISA and endoscopic examination.
Resul t s: The serodiffusion of H. pylori was 40% (n=120). Out of the 120
patients infected with H. pylori, 50(41 .6%) patients were diagnosed clinically to
have g

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Publication Date
Sat Mar 02 2019
Journal Name
Iraqi Rjounal Of Science
The immunohistochemical assessment of Muc5ac in patients with gastric carcinoma (Gc) in Iraq
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The expression of MUC5AC has been associated with the loss of the differentiation, TNM system, and nodal metastasis, in many cancers including gastric carcinoma (GC).Objective: To evaluate whether the MUC5AC could be used as a predictor in patients with GC and to assess the correlation between the expression of MUC5AC& the clinicpathological parameters as age, sex, histopathological subtypes, grade and stage of the tumor. This is a retrospective study conducted on 60 randomly selected patients (30 normal vs 30 GC), at the Pathology Department of the Gastroenterology and Hepatology Teaching Hospital&some private laboratories. They were collected and diagnosed during the period 2014-2018. Histological sections were stained with H&E and IHC st

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Publication Date
Thu Apr 01 2021
Journal Name
Biochem. Cell. Arch
STUDY ON THE MUTATION OF ASXL1 IN ACUTE MYELOID LEUKEMIA IN IRAQI PATIENTS
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The present study was designed to shed light on the molecular effects caused by acute myeloid leukemia (AML). It was also aimed to investigate ASXL1 point mutations in newly AML patients as compared to healthy control. The study comprised of 43 AML Iraqi patients and their ages ranged between 16-75 years. It included 23 females and 20 males compared with 20 healthy controls. Results revealed that the extracted DNA from 30 AML patients and amplified by PCR to obtain ASXL1 gene from exon 12 showed larger bands (479). Among forty three patients, two of them displayed point mutations of deletion and substitution, while the others were normal since no mutations were detected. The total of mutations in two mutated patients was 27 mutations, the m

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Publication Date
Thu Nov 14 2019
Journal Name
Al-kindy College Medical Journal
Role Iron in Diabetes mellitus type 2 of the patients in province Diwaniya
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Background: Diabetes mellitus is a common health problem of the world. Iron may be a part of the cause of the disease and its Complications

Objectives: This study was designed to determine the relationship between the levels of iron indices  and diabetes mellitus type 2. Type 2

Type of the study: Cross –sectional study.

Methods: diabetes mellitus is clinical condition characterized by hyperglycemia due to the absolute or relative deficiency of insulin. It is also followed by pathological abnormalities like impaired insulin secretion, peripheral insulin resistance, and excessive hepatic glucose production. Although type 2 diabetes mellitus i

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