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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
Wed Mar 02 2022
Journal Name
International Journal Of Early Childhood Special Education
Understanding the life applications of green chemistry among students of the College of Education for Pure Sciences, Ibn al-Haytham in Iraq
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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Women's Knowledge about Risk Factors and Early Detection of Breast Cancer at Ibn Rushd College of Education in Baghdad University
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Objective: Evaluation of women's knowledge about risk factors and early detection of breast cancer at
Ibn Rushd college of education in Baghdad University.
Methodology: The study sample included (184) women in the Ibn Rushd College / University of
Baghdad, whose age ranged between (17-58) years. Data were collected through a structured
questionnaire prepared by the National Cancer Research Center which were answered during a scientific
symposium about breast cancer. The score was calculated by correcting the results of the answer, giving
one score for each correct answer and then estimating the level of knowledge and inputting all data in a
statistical program.
Results: The results showed limited level of women's

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Publication Date
Mon Mar 31 2025
Journal Name
Romanian Medical Journal
Amylase and lipase roles as prognostic indicators in patients with diabetic foot
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Background. Diabetes mellitus (DM) is a prevalent disease that, if not appropriately managed, can lead to a variety of problems, including diabetic foot. Glycated hemoglobin A1c (HbA1c), FBS, amylase, and lipase are important diabetic management indicators now employed as diagnostic tests. Objective. This study aimed to evaluate the value of amylase and lipase as predictive markers in patients with diabetic foot. Patients and methods. This study included 50 patients who reported to Baghdad Hospital with diabetic feet between November 2023 and February 2025. All patients had their HbA1c, amylase, lipase, and FBS levels tested. Means, independent t-tests, and the F-test were used in the statistical analysis. Results. The study evaluat

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Publication Date
Sun Mar 04 2012
Journal Name
Baghdad Science Journal
C-Reactive Protein and Cholesterol level In Male Type 2 Diabetic Patients.
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Elevated C-Reactive Protein (CRP) level in serum is a risk factor for type 2 diabetes ,this relationship is likely to be the cause it means elevated CRP leads to T2D in future . Our objective was to examine CRP in male Type 2 Diabetes(T2D) patients in different age ,we studied 120 male subjects divided to two groups according to their age. First group A age (31 - 40) year old ,60 person )30 control & 30 T2D patients(,3 person for each same age: second group B age (41 – 50) years old ,60 person )30 control & 30 T2D patients(,3 person for each same age. We examined blood sugar ,cholesterol and CRP in each group. and we toke the mean of samples in the same age in each data in all the 4 groups. Our data shows that CRP

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Publication Date
Wed May 01 2019
Journal Name
Annals Of Medicine And Surgery
Assessment of the difficulties in laparoscopic cholecystectomy among patients at Baghdad province
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Scopus
Publication Date
Sun Sep 25 2022
Journal Name
Research Journal Of Biotechnology
Evaluation of Interlukein-6 and Vitamin D in Patients with COVID-19
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COVID-19 is a unique viral infectious illness that causes a variety of symptoms and health hazards, particularly to the respiratory system and has been declared a worldwide pandemic. The disease is characterized by a cytokine release in severe conditions. Interleukin-6 (IL-6), a proinflammatory cytokine, mediates an important immunomodulatory process. Also, vitamin D was identified to have a role in the innate immunity of individuals. Our study was designed to find the role of IL-6 and vitamin D in COVID-19 patients, as well as, to see whether there is a link between vitamin D deficiency and cytokine syndrome development. The study included 90 COVID-19 patients and 30 control people from Baghdad, Iraq. The age of the participants was non-s

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Publication Date
Sun Dec 07 2014
Journal Name
Baghdad Science Journal
Studying Association between Thyroid Disorders and Helicobacter pylori infection in Iraqi Patients
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This study was aimed to investigate the association between thyroid disorder and Helicobacter pylori infection in 122 patients (100 females and 22 males )and for comparison, 60 healthy individuals (31females and 29 males),who had no thyroid disorder, were also included in the study. Blood samples were collected from both patients and the healthier individuals. Enzyme Linked Fluorescent Assay (ELFA) technique through using Vitek Immuno Diagnostic Assay System (VIDAS) was applied to measure levels of the thyroid hormones (tri-iodothyronine T3, tetra-iodothyroxine T4) and thyroid stimulating hormone (TSH). From the results obtained, patients were classified into three groups: 40 were

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Immunohistochemical Assessment of SOX2 Expression in Iraqi Patients with Gastric Carcinoma (GC)
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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Immunoglobulins Levels and Complements in Patients with Brain Tumour (Meningioma and Glioma)
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Objective(s): The present study aims at studying the relationship between immunoglobulin IgG, IgA,
IgM , as well as to C-3 and C-4 in brain tumours patients immunity (meningioms and gliomas).
Methodology: Forty sera of brain tumour patients were included 20 glioma and 20 meningioma was
tested to determine the levels of IgM, IgG IgA, C-3 and C-4 by using single radial immune-diffusion
technique and compared with 20 apparently healthy blood donors.
Results: The study revealed a significant decreasing in IgG levels in glioma as compare to meningioma
and control. The concentration of two other serum immunoglobulins and complement in both
meningioma and glioma show no significant differences with those in control group.

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Publication Date
Wed Jun 22 2022
Journal Name
Pakistan Journal Of Medical & Health Sciences
Macrophage Colony Stimulating Factor as Predictive Marker of Osteoporosis in T2DM Patients
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Background: Diabetes mellitus and osteoporosis are two common medical disorders that are becoming more common as the population ages. T2DM patients have a higher fracture hazard, having a high BMD, which is primarily due to the raise hazard of falling. Macrophage colony-stimulating factor (M-CSF) is one of the hematopoietic growth factor family, and It plays an important function in fracture repair by attracting stem cells to the fracture site and influencing the production of hard calluses by promoting osteoclast genesis.Aims of study: The purpose of this research was to assess the blood level of macrophage colony-stimulating factor in Iraqi osteoporotic patients with and without type 2 diabetes. in addition, that M-CSF may be a predictiv

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