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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 Jun 01 2023
Journal Name
Neurology Asia
Integrin alpha-4 gene polymorphism in relation to natalizumab response in multiple sclerosis patients
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Objectives: The aim of this study was to assess the possible the association between +3061 (G>A, rs1143676) missense mutation in exon 24 of the integrin α-4 subunit (ITGA-4) gene and the response to natalizumab in a sample of Iraqi multiple sclerosis patients. Methods: A sample of 59 patients with multiple sclerosis (16 males and 43 females; mean age of 32 years; age range of 15 to 52 years) receiving natalizumab for at least 12 consecutive months were involved in the study between March and August/ 2022. The sample was categorized into two groups according to their response to natalizumab treatment (responders and non-responders). Polymerase chain reaction and Sanger’s sequencing for the extracted deoxyribonucleic acid was pe

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Publication Date
Tue Feb 14 2017
Journal Name
مجلة كلية التربية للعلوم الصرفة ابن الهيثم
synthesis and characterization of New Bidentate schiff base Ligand Type(NO)Donor Atoms Derived from isatin and 3-Amino benzoic acid and Its complexes with Co(||),Cu(||),Cd(||)and Hg(||)Ions
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synthesis and characterization of New Bidentate schiff base Ligand Type(NO)Donor Atoms Derived from isatin and 3-Amino benzoic acid and Its complexes with Co(||),Cu(||),Cd(||)and Hg(||)Ions

Publication Date
Thu Sep 01 2022
Journal Name
Res Militaris
Patterns of thinking about chemical identity among students of the College of Education for Pure Sciences - Ibn Al-Haytham in Iraq
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Publication Date
Wed Mar 23 2022
Journal Name
World Economics & Finance Bulletin (wefb)
ANALYSIS OF THE CAUSALITY RELATIONSHIP BETWEEN SPENDING ON HIGHER EDUCATION AND SOME ECONOMIC VARIABLES IN IRAQ FOR THE PERIOD 1990-2020
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Higher education is important because it creates and develops human capital and provides qualified human cadres, which requires restructuring government spending so that an increase in funding allocated to education is brought about. During the period 1990-2020, government spending was weak on educational institutions in Iraq, which led to a decline in The role of these institutions in the economic development of the country. The highest percentage of spending on higher education of GDP was 0.47% in 2007 and the lowest was 0.01% in 2005. The number of public universities reached 35, and the number of private universities and colleges reached 64 universities and private colleges in 2020. This was accompanied by an increase in the number of s

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Influence of Teacher and Students Errors Correction Techniques on Students’ Achievement in English at College of Physical Education for Women
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The research is an attempt to investigate experimentally the influence of teacher’s errors correction and students’ errors correction on teaching English at the College of Physical Education for Women. Errors are seen as a natural way for developing any language but teachers are puzzled the way they can correct these errors. So, this research gives some idea of using two types of errors correction. The sample of the research is female students of the first year stage at the College of Physical Education for Women of the academic year 2009-2010. The whole population of the research is (94) students while the sample is (64). Thus, the sample represents 68% from the population of the research. The sample represents It is hypothesized th

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Education Program on Nurses- Midwives' knowledge toward Postpartum Hemorrhage at Delivery Room of Maternity Hospitals in Baghdad City
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 Objectives: To find out the effectiveness of education program application on nurses-midwives' knowledge toward prevention and management of postpartum hemorrhage in delivery room and some socio demographic characteristics Methodology: a quasi -experimental "test-retest"design has carried throughout the present study with the application of a pre –test and post- test for nurses-midwives' knowledge toward postpartum hemorrhage. The study was conducted in six hospitals in Baghdad: Fatima Al – Zahra for Maternity and Pediatric, Al -Elwia maternity, Baghdad Teaching, AL-Imamine Al - Kadhimin Teaching, Al-Karckh maternity and Al-Yarmouk Teaching hospital for the period from 27th May 

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an education program for Caregivers Knowledge Related to Management of Children with Growth Hormone Deficiency in Outpatient Endocrine Clinics
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Objectives: The study aims to assess and evaluate the caregivers  knowledge  about management of the children with growth hormone deficiency and to find out the relationship between caregivers kowledge and caregivers age, gender, number of individual in house hold, Date of treatment started ,Caregivers level education and economic status Methodology: Quazi expermental study design was carried out at (Child's Central Teaching Hospital, Medical City of Al Imamian Al Khadhmain Teaching Hospital, and National Centre for Treatment and Research of Diabetes,Specialized Center for Endocrine Diseases and Diabetes, and Department of Medical City Children Welfare Teaching Hospital started  from 

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Publication Date
Mon Dec 30 2024
Journal Name
Cumhuriyet Üniversitesi Fen-edebiyat Fakültesi Sosyal Bilimler Dergisi
French Language in Iraq: Study of the Relationship between University Education and Social Activities (The Case of the University of Baghdad)
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Cumhuriyet Üniversitesi Fen-Edebiyat Fakültesi Sosyal Bilimler Dergisi | Volume: 48 Issue: 2

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Publication Date
Thu Jan 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Educational Program on Female Students’ Practices toward Premenstrual Syndrome at Secondary Schools in Third Al- Rusafa Education Directorate
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Objective: Determination the effectiveness of educational program on female students’ practices toward premenstrual.

Methodology: A quasi-experimental design study was conducted involving (140) student purposely in four secondary schools at Al-sadder city (70) student for study group and (70) for control group. The prevalence of PMS selected through American College of Obstetricians and Gynecologists (ACOG) (2015) criteria to select PMS students before program. The education program were set in four steps, the first step (pre-test) is to assess the practices, before the implementation of the program, the second step is implementing the program, following two steps post-test  I and II betwe

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Publication Date
Wed Jun 29 2022
Journal Name
Journal Of The College Of Education For Women
The Degree to which Islamic Education Teachers Employ the Strategy of Directed Discovery in Teaching to Develop Higher-Order Thinking Skills
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The study aimed to know the degree to which Islamic education teachers employ the strategy of directed discovery in teaching to develop higher thinking skills (analysis, synthesis, and evaluation) among sixth-grade students at the basic stage in East Nile Province, Khartoum State - Sudan. The researcher used the descriptive-analytical method, and adopted a questionnaire that consisted of (15) indicators representing the skills of analysis, synthesis, and evaluation as a tool of the study. A random sample of (175) Islamic education teachers was selected, from the Department of Basic Education. The data were analyzed according to the Statistical Packages for Social Sciences (SPSS) program, and the results of the study have shown that the u

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