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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
Sun Sep 22 2019
Journal Name
Baghdad Science Journal
Kinetic Studies of Na+/K+-ATPase in Tissue Aerobic Thyroid Patients
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Na+/K+-ATPase is a prevalent enzyme that maintains the Na+ and K+ gradients across the cell membrane by transporting three Na+ out and two K+ into the cell, the aim of this study  is to provide detailed mechanistic insights, potentially with important effects on physiological regulation of active Na and K transport in tissues of Aerobic Thyroid Patient. Thyroid tissues were obtained from a 35 year old patients, the operation was carried out at the Al-Hadi Specialist Hospital in Samarra city, the sample was stored at -20ºC until used. The purification protocol included Salt Precipitation, Ion Exchange Chromatography, Gel Filtration and E

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Publication Date
Fri Jun 02 2017
Journal Name
International Journal Of Medical Research & Health Sciences
Analysis of HLA-DQB1 Alleles Frequency in Patients with Chronic Periodontitis
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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Clinical Evaluation of Some Biochemical Parameters from Patients in Heamodialysis Room
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As a marker of systemic inflammation, raised (C-reactive protein (CRP)) concentrations which are still within the normal range have been associated with an increased inflammation of chronic renal diseases (CRD). The current study aimed to establish potential determinats of raised CRP concentrations in patients who treated in Heamodialysis room,then study the relationship between CRP& some biochemical parameters related CRD We used a CRP latex reagents Kit which is based on an immunological reaction between CRP antisera bounded to the biologically inert latex particles or with CRP in the test specimens of 19 patients with (CRD) mean age 48 years ,range = 30?65 & in 21 healthy subjects as control group their age range = 30 ?45 years. The

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Publication Date
Thu Apr 13 2023
Journal Name
Journal Of Survey In Fisheries Sciences
The Elevation of Serum Subfatin Levels in Patients with Double Diabetes
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Background: Hybrid diabetes (or double diabetes, DD) occur when the patient which exhibits characteristics that combine type 1 diabetes (T1DM) and type 2 diabetes (T2DM). Formerly epidemiological studies found that quarter of people with T1D also had the metabolic syndrome. Subfatin, Also called cometin, it is a small (~27kDa) cytokine secreted by protein encoded by a gene called METRNL (simeler of meteorin). is much expressed in skin in the mucosal tissues and activated macrophages. Subfatin has also been described as a hormone that effected in some diseases such as metabolic diseases (including dyslipidemia), type 2 diabetes and obesity. Objectives: The current study objective is evaluating the subfatin in the blood serum of double diabet

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Publication Date
Sat Sep 01 2018
Journal Name
Saudi Medical Journal
Relationship between human leukocyte antigen DRB1 and psoriasis in Iraqi patients
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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Detection of Granulocyte Chemotactic Protein 2 in Serum of Periodontitis Patients
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Background: Chronic periodontitis defined as “an infectious inflammatory disease within supporting tissues of the teeth, progressive attachment loss and bone loss". Aggressive periodontitis is rare which in most cases manifest themselves clinically during youth. It characterized by rapid rate of disease progression .Pro-inflammatory chemokines organized inflammatory responses. Granulocyte chemotactic protein 2 is involved in neutrophil gathering and movement. The purpose of the study is to detect serum of Granulocyte Chemotactic Protein 2 and correlate to periodontal condition in patients with chronic periodontitis, Aggressive periodontitis and Healthy Control subjects and measurement the count of neutrophils for the studied groups. S

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Publication Date
Wed Sep 02 2020
Journal Name
International Journal Of Pharmaceutical Research
Prevalence of Bacterial Species Associated With Infants Meningitis Patients in Iraq
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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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Publication Date
Sun Mar 04 2012
Journal Name
Baghdad Science Journal
Frequency of HLA Antigens in a Sample of Iraqi Brucellosis Patients
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Fifty one patients with serologically confirmed brucellosis and 70 healthy controls were phenotyped for HLA-A, -B, -DR and -DQ antigens by using standard microlympho-cytotoxicity method, and lymphocytes defined by their CD markers (CD3, CD4, CD8 and CD19). The results revealed a significant (Pc = 0.001) increased frequency of HLA-DR8 (41.18 vs. 10.0%) in the patients . A significant increased percentage of CD8+ lymphocytes was also increased in the patients (25.15 vs. 22.0%; P = 0.006), while CD3+ lymphocytes were significantly decreased (75.1 vs. 79.4%; P = 0.02).

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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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