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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
Fri Aug 01 2014
Journal Name
2014 36th Annual International Conference Of The Ieee Engineering In Medicine And Biology Society
Spectral analysis of resting state magnetoencephalogram activity in patients with bipolar disorder
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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
Tue Nov 06 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Lipid Profile and Insulin Resistance in Patients with Type-ΙΙ Diabetes Mellitus
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Objective: To investigate the relation between dyslipidemia and insulin resistance where it is one of the metabolic
disorders in patients with type-ΙΙ diabetes mellitus and compare the results with the control group.
Methodology: Blood samples were collected from (35) patients with type-ΙΙ diabetes mellitus, besides (35) healthy
individuals as a control group were enrolled in this study. The age of all subjects range from (20-50). Serum was
used in determination of glucose, insulin, lipid profile (cholesterol (Ch), triglyceride (TG), high-density lipoprotein
(HDL-Ch), low-density lipoprotein (LDL-Ch) and very low-density lipoprotein (VLDL), for patients and control
groups. Insulin resistance (IR) was calculated acco

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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
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
Fri Jan 19 2024
Journal Name
Baghdad Science Journal
GRHPR gene variations in Iraqi patients infected with calcium oxalate kidney stones
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      The alterations in glyoxylate reductase and hydroxy-pyruvate reductase concentrations in the sera and the genetic alterations associated with calcium oxalate kidney stones in Iraqi patients were not studied previously so this study aimed to focus on these points. This study included 80 subjects; they were 50 patients with calcium oxalate stones compared to 30 apparently healthy controls. Biochemical investigations for kidney functions (creatinine, urea, and uric acid), were performed on the sera of both groups. Also, complete blood count, random blood sugar, and blood group tests. Furthermore, urine had been collected for General Urine Examination to visualize oxalate crystals in the urine of the patient. Also, the GRHPR

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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
Sat Dec 01 2018
Journal Name
Annals Of Medicine And Surgery
Plasma d-dimer level correlated with advanced breast carcinoma in female patients
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Publication Date
Sun Jun 03 2012
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Baghdad Science Journal
Staphylococcal infections among leukemic patients
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Staphylococcus are cause hospital community acquired infection and they are an important cause of health –care associated infection.The Coagulase positive Staphylococcus are Staphylococcus aureus which can implicated in toxic shock syndrome. Methicillin and Vancomycin Staphylococcus aureus resistant (MRSA, VRSA) become major cause of hospital- acquired infection and community acquired infection.Coagulase negative staphylococcus emerged as major cause of infection in immunocompromised patients.The main objective of this study was to evaluate the distribution of Staphylococci among leukemic patients since it is well known that leukemic patients are prone to be infected easily due to their immunosuppressed status.This study was undertaken b

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Publication Date
Sun Apr 02 2017
Journal Name
Journal Of Educational And Psychological Researches
Article Sources mutual complaint among the Directorates of Education staff and directors of Secondary schools in the province of Baghdad in light of some variables
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A field study aimed at identifying the sources of mutual complaints among the Directorates of Education staff of their departments and management and run it in their daily dealings with principals in the province of Baghdad, and adopt approach. It was determined the research consists of (2357) male and female employees and 305 randomly stratified simple by the rate of (7%) from the research community as the number of sample reached (167) male and female employees, and selected sample was randomly stratified simple by the rate of (39.67%) of the research community, as the number of sample was (121) principals. It was constructed two questionnaires, the first included (28) items and the second contained (28) items. And the two researchers

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