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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
Tue Jan 21 2025
Journal Name
Procedia Environmental Science, Engineering And Management
Optimizing Radiofrequency Parameters for Effective Lesion Formation in Patients with Supraventricular Tachycardia
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Radiofrequency catheter ablation is now widely recognized as a primary treatment for a range of arrhythmias and serves as the first-line therapy fo...

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Scopus
Publication Date
Fri Nov 01 2024
Journal Name
Human Antibodies
The potential role of dyslipidemia in COVID-19 severity among Iraqi patients
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BACKGROUND:

The correlation between dyslipidemia and the severity of coronavirus disease 2019 has been widely categorized. Dyslipidemia is one of the most dominant disorders among these patients. Systemic inflammation accompanied by cytokine storm hemostasis modifications and severe vasculitis have all been reported to occur among COVID-19 patients, and these may contribute to some severe complications.

OBJECTIVE:

The aim of this study is to assess the possible relationship between dyslipidemia and the severity of coronavirus disease 2019.

METHODS:

This work encompassed 200

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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
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
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Using of Laser Therapy in the Treatment of Patients With Plantar Fasciitis
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Background: planter fasciitis is a common condition
seen in adults and sport men, it is characterized by dull
pain in the heel, especially when getting up and
standing on the foot in the morning or after sitting for a
long time.
Recently low level laser therapy is used as a method of
treatment.
Objective: to evaluate the benefit of laser therapy in
treatment of planter fasciitis.
Methods: Out of twenty five patients with planter
fasciitis exposed to laser therapy. Laser used is (diode
type) given in two cessions per week for four weeks,
time for each cession is about (12 minutes).
Results: complete recovery seen in (32%) of patients,
moderate improvement in (16%), mild improvement in
(24%), no

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of Dental Calculus, Plaque and GingivalInflammation in Patients with Urinary Stone
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Background: Dental calculus is mineralized dental plaque formed on teeth and dental prosthesis surfaces in the oral cavity. Urinary stone is a crystal aggregation formed in urinary system due to minerals saturation present in urine. The structure of dental calculus is similar to that of urinary stone. Objective: To assess oral hygiene and gingival status in patients with urinary stone. And compared with healthy subjects. Patients and Methods: Sixty participants, 25-40 years, were involved in this study who were divided into study and control group. The study group involved patients with urinary stone while the control group involved healthy subjects. Clinical parameters including plaque, calculus and gingival indices were recorded for al

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Publication Date
Thu Jun 30 2011
Journal Name
Al-kindy College Medical Journal
Results of Kidney Biopsies among Adult Iraqi Patients in a Single Center
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Background: Patients requiring renal biopsies have various glomerular diseases according to their demographic characteristics.
Objective: To study types of glomerular disease among adult Iraqi patients in a single center in Baghdad/Iraq
Material and Methods: A total of 120 native kidney biopsies were studied. All biopsies were adequate and were processed for Light Microscopy.
The age range of the study patients was 17-67 years, with a mean of 38.5 years. The mean follow up period was 28 weeks (4-52 weeks)
Indication for biopsy included: Nephrotic syndrome (N=72; 60%), Asymptomatic proteinuria (N=21; 17.5%), acute nephritic presentation (N=17; 14.16%), asymptomatic haematuria (N=10; 8.33%).
Results: Primary glomerulonephrit

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Publication Date
Tue Oct 20 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of serum and salivary malondialdehyde in patients with oral lichen planus
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Background: The aim of this study was to evaluate the expression of fibroblast growth factor-2 and Heparanase in salivary pleomorphic adenoma, and to correlate the two studied markers with each other and with clinicopathological parameters including: age, sex, tumor site and histopathological presentation. Methods: Sections of twenty five formalin-fixed paraffin embedded tissue blocks specimens of salivary pleomorphic adenoma were immunostained using monoclonal antibodies (Fibroblast growth factor-2 and Heparanase) to assess their expression in this tumor. Results: The expression of fibroblast growth factor-2 and Heparanase were positive in all pleomorphic adenoma cases (100%). The positive expression of fibroblast growth factor-2 was signi

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