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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 Apr 01 2025
Journal Name
Medical Journal Of Babylon
Response to Treatment in a sample of Iraqi Patients with Prolactinoma
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Abstract<sec> <title>Background:

Hyperprolactinemia is a common endocrine abnormality caused by physiological factors like pregnancy and lactation, drug-induced factors like antipsychotics, pituitary adenomas that secrete prolactin, or stalk compression or section that reduces dopamine inhibition. Dopamine agonists cure most prolactinomas.

Objectives:

To assess response to treatment in micro versus macroprolactinoma.

Materials and Methods: ... Show More
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Publication Date
Thu Jul 30 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Nurses’ Knowledge Concerning the Management of Bleeding in Patients with Leukemia
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To achieve the objectives of the study, a non –probability (purposive) sample of (50) nurses were selected those were working at the oncology wards at the above listed hospitals. The data selected according to the criteria of the study sample. The validity of the questionnaire was determined through an expert panel consists of (11) specialist expert and its reliability was determined through a pilot study by test – retest which was estimated as averages (R=0.89). Data was collected by direct interview technique using the questionnaire formal and data was analyzed by application of descriptive & inferential statistical methods (frequency, percentage, mean of score and Chi-Square). The resul

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Publication Date
Tue Oct 31 2023
Journal Name
Onkologia I Radioterapia
The prevalence of HSV1 expression in Iraqi patients with colorectal cancer
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Background: Colorectal Cancer (CRC) is one of the most serious health problems and Herpes viridae may hasten the progression of colon cancer. Aim: The purpose of conducting this research is to investigate the existence of Herpes Simplex Virus (HSV1) infection in samples of Colorectal Cancer (CRC) compared with normal tissue. Material and Methods: 40 samples of tissues (30 patients ) with CRC, and (10 samples) of normal tissue (without cancer) were obtained, for immunohistochemically analysis of Herpes Simplex Virus (HSV1) expression Results: The results showed no significant data to justify the link between both Herpes Simplex Virus (HSV1) and human colorectal cancer. Despite of presence of Herpes Simplex Virus (HSV1) found in

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Publication Date
Mon Mar 27 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Lipid Profile and Fasting Blood Sugar Analysis in Patients with Cholelithiasis
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Cholelithiasis is one of the commonest surgical problems and one of the most common gastrointestinal diseases throughout the world but its pathogenesis remains unclear. Many theories have been proposed forward to explain the mechanism of stone formation. It is not fully clear if symptomatic gallstone disease is associated with a specific pattern of some biochemical abnormalities, as lipid profile and fasting blood sugar in serum of patients.

This study was designed to estimate lipid profile and fasting blood sugar in the sera of patients with cholelithiasis in comparison with normal individuals (control).

In this study, 104(male=16, female=88) were symptomatic gallstone patients (aged 42.79± 12.18 years), and 38(male=6

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Publication Date
Mon Jan 23 2023
Journal Name
The Egyptian Journal Of Hospital Medicine
Estimation of SLC25A3 Gene Expression in Chronic Myelogenous Leukemia Iraqi Patients
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Background: Chronic myelogenous leukemia is a malignant hematological disease of hematopoietic stem cells. It is difficult to adapt treatment to each patient's risk level because there are currently few clinical tests and no molecular diagnostics that may predict a patient's clock for the advancement of CML at the time of chronic phase diagnosis. Biomarkers that can differentiate people based on the outcome at diagnosis are needed for blast crisis prevention and response improvement. Objective: This study is an effort to exploit the SLC25A3 gene as a potential biomarker for CML. Methods: RT-qPCR was applied to assess the expression levels of the SLC25A3 gene. Results: In comparison to the mean ΔCt of the control group, which was found to b

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Publication Date
Wed Jun 30 2010
Journal Name
Al-kindy College Medical Journal
Hypomagnesemia in Iraqi Diabetic Patients and Healthy Controls: An Exploratory study
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Background: Diabetes mellitus has been suggested
to be the most common metabolic disorder
associated with magnesium deficiency, and because
available data suggest that adverse outcomes are
associated with hypomagnesemia, it is prudent that
routine surveillance for hypomagnesemia be done
and the condition be treated whenever possible.
Aim of the study:To explore the serum Mg
concentrations of diabetic patients and healthy
controls in our locality.
Mehtods: One hundred and forty four diabetic
patients (22 with type I and 122 with type II diabetes
mellitus) recruited from the outpatient diabetes clinic
at the Specialized Center For Endocrine DiseasesBaghdad (62 patients), National Diabetes Center-Al

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Publication Date
Mon Aug 29 2016
Journal Name
Kufa Journal For Nursing Sciences
Atherogenic Index of Plasma Levels in Patients with Diabetic and Neurodiabetic
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Objectives: To determined the levels of lipid profile (TC, TG, HDL-c, LDL-C, VLDL) in diabetic and diabetic neuropathy patients and compare the results with control group. Also, to compare Atherogenic Index of Plasma (AIP) levels in these groups that may be predict prone of patients to cardiovascular disease. Methodology: Ninety subjects were enrolled in this study with aged ranged (40-65) years and BMI with (30-35) Kg/m2 that divided into three groups as follows: group one (G1) consists of 30 healthy individuals as a control group, group two (G2) consists of 30 patients with diabetes and group three (G3) consists of 30 patients with diabetes and neuropathy as complication. Electrochemical Skin Conductance (Feet Mean), Electrochemic

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Publication Date
Fri Apr 08 2022
Journal Name
International Journal Of Health Sciences
Infection frequency of Candida SP. in Iraqi patients suffering from UTI
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One of the most opportunistic mycosis globally is the Candida ssp., which is considered as the most agent that cause nosocomial urinary tract infections (UTIs), oral candidiasis and genitourinary candidiasis. This study included 100 samples of Iraqi subjects suffering from urinary tract infections. Identification of Candida have been done by different methods such as; characteristic of colony on culture, gram stain, and microscopically. This study aimed to isolation and identification of Candida spp from urine sample of UTI patients and find the relevance of ages and blood group of patients with the infections rate, also determine the effect of age on ESR and CRP levels in the patients. The results showed the higher frequency of

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Publication Date
Sun Nov 01 2015
Journal Name
Al-qadisiyah Medical Journal
A survey of dermatophytes isolated from Iraqi patients in Baghdad City
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SJ Mohammed, AA Noaimi, KE Sharquie, JM Karhoot, MS Jebur, JR Abood, A Al-Hamadani, Al-Qadisiyah Medical Journal, 2015 - Cited by 20

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Publication Date
Sun Sep 07 2008
Journal Name
Baghdad Science Journal
A Study of some biochemical parameters in patients with &#61538;- thalassemia
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Serum levels of iron,copper,ceruloplasmin and transferrine were estimated in three groups of patients with ?- thalassemia: 24 patients have splenectomy thalassemia major, 29 patients have non splenectomy thalassemia major and 19 patients have thalassemia intermedia , data were compared to normal and pathological controls (anemia and minor). There were significant increase in trace element levels in all studied groups of pateints as compared to normal and pathological controls. Also there were a significant increase in ceruloplasmin levels,While the result revealed that there were a significant decrease in transferrine levels in all groups of patients studied as compared to normal and pathological controls. The result also indicate that the

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