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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
Tue Jun 11 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Serum Aldosterone Levels in Patients With Diabetic Nephropathy in Relation to Vascular Calcification
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Diabetic Nephropathy(DN) is a complex disease manifested by persistence microalbuminuria   occurring due to the interaction between hemodynamic and metabolic pathway that activates the local renin-angiotensin-aldosterone system resulting in a decline in renal functions.

This study aimed to quantify the associations between serum aldosterone concentration and fetuin- A as a marker of calcification in type 2 diabetic patients with and without microalbuminuria from one side, and study the possible relationship between aldosterone and fetuin-A with glycemic indices, serum electrolyte, renal function and microalbuminuria and body mass index from the other side.

A case-control study involved eighty-six adult subjects

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Publication Date
Fri Mar 03 2023
Journal Name
World Journal Of Biology Pharmacy &health Science
Ventricular septal defect in children and adults by echocardiography study in Iraqi patients
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A ventricular septal defect (VSD) is defined as a communication between the left and right ventricles or between the left ventricle and the right atrium. VSDs are amongst the most common abnormalities of the heart. They can be present in isolation or in association with other congenital cardiac abnormalities. This is study done with the aim to evaluate the types, size, associated CHD with ventricular septal defect in children and adolescent in two cardiac centers (Medical City Complex cardiac clinics, Ibn Al Nafaes teaching hospital) in Baghdad - Iraq

Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Clinical Pharmacist in Reducing Drug Related Problems in Hemodialysis Patients
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Abstract

Prescribing drugs to patients to treat ailments or reducing their morbidity may not be enough, even if the drugs were all indicated and in the right dose. Clinical pharmacists play a pivotal role in conducting information and instruction to patients and conveying feedback to treating physician when appropriate, and the final goal is in the interest of the patient.  Identification and classification of drug related problems and discussing them with the health care providers.  Prospective, interventional, clinical study for 180 hemodialysis patients, and was designed as two phases, an observational phase to identify drug related problems and classifying them according to the latest Pharmaceutical

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Publication Date
Mon Jul 01 2024
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Immunohistochemical Expression and Histopathological Role of CD47 in Colorectal Cancer in Iraqi Patients
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Background: Bowel cancer is the most prevalent digestive system cancer and is the 4th largest cause of cancer-related death worldwide. In Iraq, colon and rectal cancer (CRC) is the 6th most common malignancy in males and the 5th in females. This cancer is sluggish in growth, which gives a window of opportunity to screen for both precursor lesions and early cancer. The Cluster of Differentiation 47 (CD47) protein is a type of transmembrane glycoproteins found on nearly all human cells, including non-hematopoietic and hematopoietic cells. CD47 promotes CRC growth by triggering angiogenesis and apoptosis of tumor cell. Objectives: To evaluate the immunohistochemical expression of (CD47) in various colorectal samples from Iraqi patients

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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
Tue Jan 01 2019
Journal Name
Journal Of Southwest Jiaotong University
Recognizing Job Apathy Patterns of Iraqi Higher Education Employees Using Data Mining Techniques
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Psychological research centers help indirectly contact professionals from the fields of human life, job environment, family life, and psychological infrastructure for psychiatric patients. This research aims to detect job apathy patterns from the behavior of employee groups in the University of Baghdad and the Iraqi Ministry of Higher Education and Scientific Research. This investigation presents an approach using data mining techniques to acquire new knowledge and differs from statistical studies in terms of supporting the researchers’ evolving needs. These techniques manipulate redundant or irrelevant attributes to discover interesting patterns. The principal issue identifies several important and affective questions taken from

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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Economics And Administrative Sciences
“The Strategic Partnership to Strategic Leadership of Upgrade Higher Education Quality (Global Perspective)”
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The higher education has become an enterprise integrate system that described as knowledge society, the essential part in its electronic and virtual format in the shadow of globalization challenges with its various dimensions . Until the logical ryles aboat a strategic partnership between the Iraqi higher education establishments and their international equivalent ones Strategic windows should be invested for the purpose of enhancing the quality of higher education in a sustainable way. This forms a challenge before the international education leaders on the social, operational and establishment's level to determinte knowledge gap, observing, diagnosing and processing in the present and future, e

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Publication Date
Mon Dec 25 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Knowledge, Attitudes and Barriers Towards Breast Cancer Health Education Among Iraqi Community Pharmacists
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With the increasing prevalence of breast cancer among female internationally, occupies about 25% of all cases of cancer, with a measured 1.57 million up to date cases in 2012. Breast cancer has turn a most warning to health of female in Iraq, where it is the major cause of death among women after cardiovascular diseases, with a mortality rate of 23% related cancer. Recently there is a crucial requirement to include community pharmacists in health elevation activities to support awareness and early diagnosis of cancer, specially breast cancer. The aim of this study is to assess knowledge, attitude and perceived barriers amongst Iraqi community pharmacists towards health promotion of breast cancer. This study is cross sectional research. A

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Publication Date
Thu Mar 31 2022
Journal Name
Journal Of The College Of Education For Women
Evaluating Teacher Preparation Programs in Scientific Disciplines at the Faculty of Education in Al-Aqsa University in Light of the Requirements of the Labor Market
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The current study seeks to evaluate teacher preparation programs in the scientific disciplines at the College of Education in Al-Aqsa University in the light of the requirements of the labor market. It further aims to reveal the significance of the differences in the sample members’ response averages of to the availability of labor market requirements in the program that prepares the teacher of scientific disciplines at the Faculty of Education in Al-Aqsa University taking into account the (gender, program) variables. The study followed the descriptive analytical approach, and so a questionnaire was distributed to a sample of scientific discipline students in the teacher preparation program adopted in Al-Aqsa University, (200) male and

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Artificial intelligence in accounting education and its role in achieving sustainable development goals in the Kingdom of Bahrain/University of Applied Sciences as a model
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The research aims to show the relationship between artificial intelligence in accounting education and its role in achieving sustainable development goals in the Kingdom of Bahrain. The research dealt with the role of artificial intelligence applications in accounting education at the University of Applied Sciences as a model for Bahraini universities to achieve sustainable development goals. The application of artificial intelligence in accounting education achieves seven of the seventeen sustainable development goals. It also concludes that there is an artificial intelligence infrastructure in the Kingdom of Bahrain, as it occupies a leading regional position in digital transformation, as Bahrain ranks first in the Arab world i

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