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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
Thu Dec 31 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Sudden Transition of Pharmacy Education from Traditional to Distance Learning in the Era of COVID-19: Action Steps of a Leading Pharmacy School in Iraq
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Education around the world has been negatively affected by the new coronavirus disease (COVID-19) pandemic. Many institutions had to transition to distance learning in compliance with the enforced safety measures. Distance learning might work well for settings with stable internet connections, professional technical teams, and basic implementation of technology in education. In contrast, distance learning faces serious challenges in less fortunate settings with inferior infrastructure. This report aims to shed light on the immediate action steps taken at a leading pharmacy school in Iraq to accommodate for the enforced changes in pharmacy education. The University of Baghdad College of Pharmacy went from less than minimal technology impl

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
The effect of teaching using the six thinking hats on academic achievement for students in the second grade average in the subject of family education
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Research problem:
Problem of current research can determine the dimensions to answer the following question: The effect of teaching using the six thinking hats on academic achievement for students in the second grade average in the subject of Family Education. The importance of research: research is gaining importance in terms of:
1. That this research is the first of its kind in the researcher's knowledge _ which deals with the teaching of Family Education by using the six hats, the researcher hopes to fill a gap in the educational field and serve in other studies serve the materials home economics. 2. Keep pace with the new field of modern education and strategies. 3. Highlight on the educational strategy in the field of creative

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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Article Sources mutual complaint among the Directorates of Education staff and directors of Secondary schools in the province of Baghdad in light of some variables
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A field study aimed at identifying the sources of mutual complaints among the Directorates of Education staff of their departments and management and run it in their daily dealings with principals in the province of Baghdad, and adopt approach. It was determined the research consists of (2357) male and female employees and 305 randomly stratified simple by the rate of (7%) from the research community as the number of sample reached (167) male and female employees, and selected sample was randomly stratified simple by the rate of (39.67%) of the research community, as the number of sample was (121) principals. It was constructed two questionnaires, the first included (28) items and the second contained (28) items. And the two researchers

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Publication Date
Thu Nov 21 2019
Journal Name
Al-kindy College Medical Journal
Magnetic Resonance Venography Findings In A Group Of Patients With Multiple Sclerosis
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Background: Multiple sclerosis is a chronic heterogeneous demyelinating axonal and inflammatory disease involving the Central Nervous System [CNS] white matter with a possibility of gray matter involvement in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to communicate, resulting in a wide range of signs and symptoms. Cerebral venous insufficiency theory was raised as a possible etiology for the disease at 2008 by Zamboni an Italian cardiothoracic surgeon. This theory was defeated by Multiple Sclerosis[ MS] researchers and scientists who thought that the disease is an autoimmune rather than vascular.

Obj

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Publication Date
Tue Jun 20 2023
Journal Name
Baghdad Science Journal
Estimation levels of CTHRC1and some cytokines in Iraqi patients with Rheumatoid Arthritis
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Collagen triple helix repeat containing-1 (CTHRC1) is an essential marker for Rheumatoid Arthritis (RA), but its relationship with pro-inflammatory, anti-inflammatory, and inflammatory markers has been scantily covered in extant literature. To evaluate the level of CTHRC1 protein in the sera of 100 RA patients and 25 control and compare levels of tumour necrosis factor alpha (TNF-α), interleukin 10 (IL-10), RA disease activity (DAS28), and inflammatory factors. Higher significant serum levels of CTHRC1 (29.367 ng/ml), TNF-α (63.488 pg/ml), and IL-10 (67.1 pg/ml) were found in patient sera as compared to that in control sera (CTHRC1 = 15.732 ng/ml, TNF-α = 33.788 pg/ml, and IL-10 = 25.122 pg/ml). There was no significant correlati

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Therapeutic Response of Serum Lipids to Atorvastatin in Type II Diabetic Patients
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Lipid disorders and cardiovascular disease (CVD) risk are known to be increased in patients with diabetes mellitus. The effects of statins on serum lipid levels are well known; however, previous studies did not compare the effects of statins on serum lipid levels in diabetic patients with non-diabetic patients. To investigate the effects of Atorvastatin on serum lipid profiles in hyperlipidemic patients with type 2 diabetes mellitus in comparison with hyperlipidemic patients without diabetes.This study was conducted on 33 type 2 diabetic patients & 34 non-diabetic patients; their age range was 40-80 years, all of them were hyperlipidemic, who had been administered 10, 20, & 40 mg daily of Atorvastatin and completed a 6-month foll

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Nutritional status of adult hemodialysis patients in Al-Najaf Al-Ashraf Governorate
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Objective: To assess the nutritional status of hemodialysis patients.
Methodology: A descriptive quantitative cross sectional study was effectuated in hemodialysis centers from
February 2011 to September 2011. A purposive "non-probability" sample of (70) male and female hemodialysis
patients in al-Najaf al-Ashraf Governorate from those who have spent more than six months on maintenance
hemodialysis schedule. Data collected through using of a well-designed questionnaire consist of five parts, part
one consists of sociodemographic contain (9) items, and part two consists of medical data contain (8) items, and
part three consists of health and nutrition behavior contain (12) items plus (8) items of anthropometric
measur

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Publication Date
Sat Apr 29 2023
Journal Name
Research Journal Of Pharmacy And Technology
Assessment of Serum Neopterin Levels in patients hospitalized with severe COVID-19
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Background: COVID-19 has caused a considerable number of hospital admissions in China since December 2019. Many COVID-19 patients experience signs of acute respiratory distress syndrome, and some are even in danger of dying. Objective: to measure the serum levels of D-dimer, Neutrophil-Lymphocyte count ratio (NLR), and neopterin in patients hospitalized with severe COVID-19 in Baghdad, Iraq. And to determine the cut-off values (critical values) of these markers for the distinction between the severe patients diagnosed with COVID‐19 and the controls. Materials and methods: In this case-control study, we collect blood from 89 subjects, 45 were severe patients hospitalized in many Baghdad medical centers who were diagnosed with COVID

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Publication Date
Tue Dec 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Nurses' Attitudes towards Patients’ End of life in Diyala Governorate
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Abstract:

Objectives: To assess nurses' attitude toward end of life phase. To find out  relationships between nurses attitude and socio demographic data (age, gender, level of education, years of experience).

Methodology: A descriptive cross-sectional study design is carried out to assess the attitude on nurses concerning patient at the end of life phase at critical care units, from the period of (1nd November 2021) to (1th February 2022). A probability sample random sampling technique used. Then, the number of participants in Baquba Teaching Hospital and general al khalis hospital were determined by using rando

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Correlating CT findings of stroke with hyperglycemia in acute ischemic stroke patients
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Background: Studies show that diabetic patients have a higher incidence of ischemic stroke than non-diabetic patients. In the Framingham study the incidence of thrombotic stroke was 25 times higher in diabetic men and 36 times higher in diabetic women than in those without diabetes

Objectives: aim of this study to analyze topography in diabetic patients.

Type of study:  Cross sectional study.

Methods: 48 patients with acute stroke were classified into 4 groups: euglycemic, stress hyperglycemia, newly diagnosed diabetics, and known diabetics.

Results:no significant differences were found in the type, site or size of st

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