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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 Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effect of Atorvastatin on Bone biochemical markers in dyslipidemic patients, Basra, Iraq
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Objective: The aim of the study was to estimate the action atorvastatin(20mg/day) on bone biochemical markers dyslipidemic men. Methodology: This study was conducted between May 2015 and November 2015 in Al-Basrah General hospital in Basra, Iraq, to evaluate important role of atorvastatin (20mg/day)(Lipitor® Pfizer Pharma GmbH.Germany) on bone biochemical markers. Thirty men patients who had been admitted for a variety of medical problems included in the study. All the patients had previously been diagnosed with Dyslipidemia by specialist physician in internal medicine and all patients age below 55 yea

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Publication Date
Mon Jul 01 2024
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Study of Adhesion Molecules in Diabetes Mellitus Type2 Iraqi Patients with Dyslipidemia
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Background: Cell adhesion molecules are protein entities that are located on the cell surface. The vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) expression is related to type 2 diabetes mellitus (T2DM) with dyslipidemia. Objectives: To determine the levels of VCAM-1 and ICAM-1 in T2DM patients with dyslipidemia and to explore the relationship between VCAM-1 and ICAM-1 and the development of dyslipidemia in T2DM patients. Patients and methods: The study included 150 individuals with an age range of (35-55) years. Patients with diabetes for more than 5 years were excluded. Fifty healthy individuals constituted Group 1 (G1), fifty patients with T2DM constituted Group 2 (G2), and fifty T2DM p

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Publication Date
Sat Nov 30 2024
Journal Name
Iraqi Journal Of Science
Evaluation of Syndecan-1 Expression in Iraqi Patients with Papillary Thyroid Carcinoma
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Papillary thyroid carcinoma (PTC) represents the most prevalent kind of thyroid gland cancer, making up around 80% of all occurrences of thyroid cancer. Evidence shows that Syndecan-1 (SDC-1) expression is lost in a number of benign and malignant epithelial neoplasms, although its expression profile in thyroid gland neoplasms is yet unknown. Therefore, the aim of this study was to assess SDC-1 expression in papillary thyroid carcinoma patients, as well as the relationship between age and gender and SDC-1 expression. To undertake a detailed investigation of SDC-1 in normal and malignant tissues, tissue sections were used to examine SDC-1 expression in 70 tissue samples, 50 distinct PTC (6 males and 44 females) and 20 normal tissue ty

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Awareness Regarding Diabetes Mellitus and Its' Complications in Type 2 Diabetic Patients
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Background: Various studies conducted in many parts of the world suggest that there is lack of public awareness and knowledge of various aspects related to diabetes. With proper education, awareness, earlier detection and better care, many complications and co-morbidities can be reduced in diabetic population.Objectives: to evaluate the level of awareness of diabetes mellitus type 2 patients regarding their disease and its' complications.Methods: Cross – sectional survey was conducted during November and December 2011, in the Medical centers of Al Baladiat, Mustansyria and Zuafranya, including 145 type 2 diabetic patients (58.6 % males, 41.4% females) who were subjected to self–structured questionnaires regarding different aspects of

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Clinical And Diagnostic Research
Thiopurine S-Methyltransferase Polymorphism in Iraqi Paediatric Patients with Acute Lymphoblastic Leukaemia
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Publication Date
Tue May 01 2007
Journal Name
Saudi Medical Journal
Invasive squamous cell carcinoma of the eyes in patients with epidermodysplasia verruciformis.
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KE Sharquie, SA Al-Meshhadani, AA Al-Nuaimy, Saudi medical journal, 2007 - Cited by 9

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Publication Date
Fri May 25 2018
Journal Name
Journal Of Physics: Conference Series
Partial purification of Leucine aminopeptidase (LAP) in Acromegalic Sample of Iraqi Patients
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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Clinical And Diagnostic Research
Immunohistochemical Expression of HER2/neu Receptors in Iraqi Patients with Endometrioid Carcinoma
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Introduction: With the advent of era of targeted cancer therapy, the serious side effects of chemoradiotherapy have been minimised. Considering the success story of anti-HER2/neu drugs in breast cancer oncology, the present study was conducted. The study evaluates the immunohistochemical expression of HER2/neu in endometrioid cancer among Iraqi patients. Aim: To assess the immunohistochemical expression of HER2/neu in endometrioid carcinoma of uterus and to find the relationship of this expression with FIGO stage and grade and with patient age. Materials and Methods: In this cross sectional study, formalin-fixed, paraffin-embedded tissue blocks of 62 hysterectomy specimens that were diagnosed as endometrioid carcinoma in the teaching labora

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Publication Date
Thu Jun 30 2011
Journal Name
Al-kindy College Medical Journal
The Role of Aspirin as Otoprotective Agent in Patients Receiving Amikacin Therapy
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Objective: To investigate and prove that aspirin
protects, or at least attenuates amikacin ototoxicity in
humans.
Method: This study was conducted in 60 patients that
completed all
requirements .The patients were divided into two
groups:
• Control group: receive placebo treatment.
• Drug–treated group: They receive aspirin
coated tablets (1.5gm/ day), 500mg 8 hourly.
Both groups had similar aspects regarding the gender,
age and weight. The duration of therapy was 7 days
and dosage of amikacin was 1gm/day (500mg 12
hourly).
Results: Comparison of Audiometry test in
Ear/Nose/Throat (E.N.T.) Department (Pure Tone
Audiometry) at 1000 Hertz (Hz), 2000 Hz, 4000 Hz,
and 8000 Hz showed sig

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Publication Date
Wed Jul 05 2017
Journal Name
International Journal Of Science And Research (ijsr)
Hyperglycosylated hCG in a Group of Iraqi Patients with Gestational Trophoblastic Disease
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Background : Hyperglycosylated hCG a newly discovered variant of hCG which can be used as a predictor of invasion of trophoblastic cells in patient with gestational trophoblastic disease. Objectives : To measure hyperglycosylated human chorionic gonadotrophin and to assess how far it can be used as predictor of invasion in invasive mole and choriocarcinoma. Study design control study. Setting: : Case Gynecological department in Baghdad Teaching Hospital from January 2016 to January 2017. Patient and Methods : 60 women were enrolled in this study 30 of them were with gestational trophoblastic disease (no.= 30 ) the remainder were normal pregnancy (no. =30) , hCG –H level was measured in both groups. Results : Mean serum hCG-H le

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