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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 Sep 15 2022
Journal Name
Bionatura
Assessment of lipid profile with HbA1c in type 2 diabetic Iraqi patients
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Insulin-induced hyperglycemia is the hallmark of diabetes mellitus (DM), including various metabolic disorders. Diabetic people are more likely to develop dyslipidemia, hypertension, and obesity. Type 2 diabetes ‎(T2DM), the most common illness, is generally asymptomatic in its early stages and can go misdiagnosed for years. Diabetes screening may be beneficial in some cases since early identification and treatment can lessen the burden of diabetes and its consequences.‎ This study aimed to find the relationship between Glycated hemoglobin (HbA1c) ‎and lipid profile components in T2DM‎ patients. This descriptive-analytical and cross-sectional study was performed on the control group and T2DM patients in ‎Medical City in Ba

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Publication Date
Wed Apr 02 2014
Journal Name
Iraqi Journal Of Physics
The evaluation of left ventricle stiffness index in patients suffering from hypertension
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Many diseases can produce cardiac overload, of these disease hypertension, valve disease congenital anomaly in addition to many other disease. One of the most common diseases causing left ventricle overload is hypertension. A long term hypertension can cause myocardium hypertrophy leading to changes in the cardiac contractility and reduced efficiency. The investigations were carried out using conventional echocardiography techniques in addition to the tissue Doppler imaging (TDI) from which many noninvasive measurements can be readily obtained. The study has involved the effect of hypertension on the myocardium stiffness index through the measurement of early diastolic filling (E) and the early velocity of lateral mitral annulus (E

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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
Mon Jul 01 2024
Journal Name
Indian Journal Of Clinical Biochemistry
Evaluation of Bone Turnover Markers in Patients with Acute and Chronic Leukemia
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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
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
Mon Apr 20 2026
Journal Name
Global Journal Of Health Science
Serum Vitamin and Mineral Profiles in Patients with Hypothyroidism-Associated Hair Loss
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Background: Hair loss is a frequent and distressing manifestation among patients with hypothyroidism. In addition to thyroid hormone imbalance, deficiencies in vitamins and minerals may contribute to impaired hair follicle function. Objective: This study aimed to assess serum vitamin and mineral profiles in patients with hypothyroidism-associated hair loss and to explore their relationship with thyroid hormone status. Methods: the study was conducted on a total of 90 participants, including 65 patients diagnosed with hypothyroidism-associated hair loss, 25 control - and sex-matched apparently healthy control subjects, groups aged 30 and over. Serum levels of vitamin D3, vitamin B12, zinc, iron, ferritin, calcium, magnesium, th

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
Prevalence of polypharmacy among older adult patients in Baghdad: A descriptive study
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Publication Date
Thu Sep 15 2022
Journal Name
Bionatura
Assessment of lipid profile with HbA1c in type 2 diabetic Iraqi patients
...Show More Authors

Insulin-induced hyperglycemia is the hallmark of diabetes mellitus (DM), including various metabolic disorders. Diabetic people are more likely to develop dyslipidemia, hypertension, and obesity. Type 2 diabetes ‎(T2DM), the most common illness, is generally asymptomatic in its early stages and can go misdiagnosed for years. Diabetes screening may be beneficial in some cases since early identification and treatment can lessen the burden of diabetes and its consequences.‎ This study aimed to find the relationship between Glycated hemoglobin (HbA1c) ‎and lipid profile components in T2DM‎ patients. This descriptive-analytical and cross-sectional study was performed on the control group and T2DM patients in ‎Medical City in Baghdad be

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Scopus (6)
Crossref (4)
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Publication Date
Thu Nov 21 2019
Journal Name
Al-kindy College Medical Journal
Urinary Tract Infection Risk Assessment By Non- Thermal Plasma In Iraqis Patients
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Background: In the present study used device jet plasma needle with atmospheric pressure which  generates non thermal plasma jet to measure treatment potent with plasma against pathogenic bacteria  founded  in UTI  was inactivated with plasma at 10 sec,

Objective:. This work included the application of the plasma produced from the system in the field of bacterial sterilization , where sample of Gram- negative bacteria (Escherichia coli) were exposed to intervals (1-10)second . Midstream Urine samples swabs were obtained from patients with urinary tract infections.

Type of the study: Cross -sectional study.

Methods: The work were used i

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