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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 Jan 01 2021
Journal Name
International Journal Of Nursing Education Scholarship
Incivility among Arabic-speaking nursing faculty: testing the psychometric properties of the Arabic version of incivility in nursing education-revised
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Abstract<sec id="j_ijnes-2021-0020_abs_001"> <title>Objectives

Civil environment in nursing education enhances achieving learning outcomes. Addressing incivility can be crucial to improve academic achievements. The purpose of this study was examining the psychometric properties of the Arabic version of the Incivility in Nursing Education-Revised scale regarding nursing faculty.

Methods

This cross-sectional study conducted in five Arab countries using a convenience sampling st

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Publication Date
Tue Jul 09 2024
Journal Name
Diagnostics
A Novel Hybrid Machine Learning-Based System Using Deep Learning Techniques and Meta-Heuristic Algorithms for Various Medical Datatypes Classification
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Medicine is one of the fields where the advancement of computer science is making significant progress. Some diseases require an immediate diagnosis in order to improve patient outcomes. The usage of computers in medicine improves precision and accelerates data processing and diagnosis. In order to categorize biological images, hybrid machine learning, a combination of various deep learning approaches, was utilized, and a meta-heuristic algorithm was provided in this research. In addition, two different medical datasets were introduced, one covering the magnetic resonance imaging (MRI) of brain tumors and the other dealing with chest X-rays (CXRs) of COVID-19. These datasets were introduced to the combination network that contained deep lea

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Publication Date
Sun Jan 01 2023
Journal Name
The Egyptian Journal Of Hospital Medicine
Training of Skilled Force with The Different Medical Ball and Their Effect on Developing Some Special Physical Abilities and the Accuracy of Long Shooting Performance in Handball
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Publication Date
Thu Jan 23 2020
Journal Name
Iraqi Journal Of Laser
Fractional CO2 Laser Treatment of Mild Periorbital Wrinkles in Iraqi Patients
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Background and Objective: Public demand for procedures to rejuvenate photodamaged facial skin have stimulated the use of fractional CO2 laser as a precise and predictable treatment modality. The purpose of this study was to assess the effect of fractional CO2 laser system for reducing periorbital rhytids.

Materials and Methods: twenty seven subjects with mild periocular wrinkles, and photoaged skin of the face were prospectively treated two to three times (according to clinical response) in the periorbital area with a fractional CO2 laser device equipped with a scanning hand piece. Improvements in eyelid wrinkles was evaluated clinically and photographically. Subjects also scored satisfaction and

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Publication Date
Wed Dec 30 2015
Journal Name
Al-kindy College Medical Journal
Evaluation Study of Patients Infected with Chronic Hepatitis C in Iraq
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Background: ;Hepatitis C virus (HCV) is a major cause of chronic liver disease. Approximately 85% of patients acutely infected with HCV progress to chronic liver disease with persistence of HCV-RNA for more than 6 months Among patients with chronic HCV infection , 15-20% progress to end-stage liver disease main transmission methods of the virus is by : blood and blood products ; sharing needles and acupuncture .Objective: To evaluate Iraqi patients infected with chronic HCV, including their treatment, and factors that affect their response to treatment .Methods :This study was performed at Gastroenterology and Hepatology hospital in Baghdad from January 2011 to March 2012.The study enrolled 90 patients with HCV Antibody positive (Ab +ve)

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Publication Date
Wed Dec 01 2021
Journal Name
Baghdad Science Journal
Study of Certain Biomarkers in Iraqi Female Patients with Breast Cancer
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The prospective study has been designed to determine some biomarkers in Iraqi female patients with
breast cancer. The current study contained 30 patients whose tissue samples have been collected from
hospitals in Medical City in Baghdad after consent patients themselves and used immunohistochemical
technique to determine these markers. The results showed a significant correlation between ER and PR tissue
markers (Sig = 0.000) and a significant correlation between cyclin E phenotype and cyclin E intensity (Sig =
0.001).

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Mitral Valve Prolapse In Patients With Benign Joint Hypermobility Syndrome (BJHS)
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Background: Joint hypermobility  was first mentioned by Hippocrates as an isolated feature, when he described the Celts' Incapacity to Pull a Bowstring or Throw a Dart, Due to The Slackness of Their Limbs

Objective: to determine the prevalence of mitral valve prolapse(MVP)in patients with benign hypermobility syndrome (BJHS).

Type of the study: Cross –sectional study.

Methods: Ninety patients with BJHS were included in this study. Full cardiological assessment was done for all of them,  which  include clinical examination, electrocardiography and echocardiography. Cardiac assessment was done for another sixty age and sex matched (

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Publication Date
Sun Mar 01 2015
Journal Name
Baghdad Science Journal
Assessment of Serum Prolactin Level in Patients Women with Rheumatoid Arthritis
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The prolactin hormone played role in the many autoimmune disorders. To determine the importance of high levels of prolactin in triggering rheumatoid arthritis, thirty patient's women with hyperprolactinemia aged (20-45) years old have been investigated and compared with twenty five healthy individuals. All the studied groups were carried out to measure the concentration of citrulinated peptide(CCP) by enzyme linked immunosorbent assay( ELISA), antikeratin antibodies (AKA)and antinuclear antibodies(ANA) by indirect fluorescent assay IFAT. There was a significant elevation of CCP concentration compared with control groups (P< 0.05). The percentage of antikeratin antibodies and antinuclear antibodies was (20%, 10%) respectively, and

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Publication Date
Wed Mar 15 2023
Journal Name
Bionatura
Evaluation of serum Interleukin 36 in Iraqi patients with Rheumatoid arthritis
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Rheumatoid arthritis is a worldwide inflammatory chronic autoimmune disease with varying severity. Due to no definitive cure for this disease, current therapies aim to decrease the pain and slow further damage. The interleukin (IL)‐36 cytokine was little known for its role in rheumatoid arthritis; this research aimed to evaluate the serum IL36 levels in RA patients compared to healthy controls. This study included 80 patients with rheumatoid arthritis registered at the Rheumatology Clinic in Baghdad teaching hospital. The patients were divided into three groups based on the treatments received. Group 1 included patients treated with biological therapy (etanercept, adalimumab), Group2 patients with non-biological treatment (methotr

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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Evaluation of the Potential Role of Serum Selenium in Diabetic Patients
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Background: The altered status of some essential trace elements observed in diabetes could have deleterious influences on the health of the diabetics. Objectives: To estimate and study the potential role of serum Selenium in type 1, type 2 diabetics and healthy subjects; and its relation with lipid profile and glycemic index. Methods: A case control designed study was carried out at the National Diabetes Center (NDC) / Al-Mustansiria University; on a total of 94 participants formed of 32 type 1 diabetics, 32 type 2 diabetics and 30 healthy control participants. Data collected about age, sex and BMI; also, blood samples examined for FPG, HbA1C, serum total cholesterol, HDL cholesterol, non-HDL cholesterol, serum triglyceride and sera were

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