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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
Sun Apr 02 2017
Journal Name
Research Journal Of Pharmaceutical, Biological And Chemical Sciences
GLP-1, GPCR Levels and their Relationshipwith Some Parameters in Nondiabetic Dyslipidaemia in Iraqi Patients
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Abnormalities in the Lipid and lipoprotein levels are common in the general population and are considered as very important risk- factors for cardiovascular disease .In this context the effect of cholesterol, which is one of the most clinically relevant lipids is very important. Aim of the present study was to determine the levels of GLP-1 and GPCR in non- diabetic dyslipidaemic patients and compare the results with the control group, which may be used as a novel biomarker to predict heart disease in these patients. The study was also aimed to find the relationship between GLP-1 and GPCR with lipid profile and glucagon in the patient group. The study involved 90 non-diabetic dyslipidaemia patients, with 90 healthy controls. The subjects wer

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Taste Detection Thresholds in Relation to Salivary and Serum Zinc in Patients on Simvastatin Treatment
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Background: Hyperlipidemia is an elevated fat (lipids), mostly cholesterol and triglycerides, in the blood. These lipids usually bind to proteins to remain circulated so-called lipoprotein. Aims of the study: To determine taste detection threshold and estimate the trace elements (zinc) in serum and saliva of those patients and compare all of these with healthy control subjects. Methods: Eighty subjects were incorporated in this study, thy were divided into two groups: forty patients on simvastatin treatment age between (35-60) years, and forty healthy control of age range between (35-60) years. Saliva was collected by non-stimulated technique within 10 minutes. Serum was obtained from each subject. Zinc was estimated in serum and saliva

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The frequency of IgM-anti HAV in the sera of patients with hepatitis in Iraq
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Three hundred and fifty five patients with hepatitis were investigated in this study all cases gave negative result with HBs Ag , IgM-anti HCV , IgM-anti HEV, IgM-anti HDV and anti-HIV tests . The frequency of IgM-anti HAV was 113 and the percentage was 32 % in all ages but when these patients divided into five groups dependent on ages. The highest percentage of IgM-anti HAV was (45%) in age <10 and the percentage declined with age increase till to 9% in age >41 year.

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Publication Date
Sun Apr 30 2023
Journal Name
Al-kindy College Medical Journal
Estimation of Salivary IL-6 Level in relation of Periodontal Status in Patients with Hyperthyroidism
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Background: The overproduction of thyroid hormones is known as hyperthyroidism. Increased susceptibility to caries and periodontal disease are two potential oral symptoms. The interleukin-6 (IL-6) was observed to significantly increased in the hyperthyroid group. According to multiple research, IL-6 dysregulation has been linked to a number of oral disorders, including periodontal diseases. The study aimed to evaluate periodontal health status in relation to IL6 among hyperthyroidism patients.

Subjects and Methods: The sample was composed of 90 female patients aged 25-45 years attending endocrine disorder

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Publication Date
Sun Dec 03 2017
Journal Name
Baghdad Science Journal
Determination of the Level of some Adipokines in Hypo-and Hyperthyroids Patients in Baghdad City
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Determination of the level of adipokines (obestatin, vaspin, tumor necrosis factor-? and interleukin-6)in hypo-and hyperthyroid patients from Educational Baghdad Hospital in Baghdad City was investigated. Fifty patients with hypothyroidism and Fifty patients with hyperthyroidism were selected. A control group of thirty euthyroid persons was included. Blood was collected by vein puncture and serum was separated and stored at –20C. Adipokines (obestatin, vaspin, tumor necrosis factor-? and interleukin-6) were estimated using ELISA method. The findings show a significant (p<0.05) increase in obestatin level in hypothyroid patients, while there is no significant difference in hyperthyroid patientsas compared with the euthyroid subjects.

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Publication Date
Tue Mar 30 2021
Journal Name
Iraqi Journal Of Science
Changes in Serum Levels of Lipid Profile Parameters and Proteins in Toxoplasma gondii Seropositive Patients
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The influence of Toxoplasma gondii on some biochemical parameters has lately gained an increasing attention. The aim of this study was to assess the levels of some biochemical parameters in Toxoplasma positive and negative subjects. An analytical case–control study was achieved in Baghdad for the period from October 2018 until March 2019. Forty nine females participated in this study, with an age range of 18-55 years. The participants were separated into two groups, namely Toxoplasma positive subjects (n=21) and Toxoplasma negative subjects (n=28), based on enzyme-linked immunosorbent assay (ELISA). Blood and serum samples were collected from all subjects to evaluate the serum levels of cholesterol, triglycerides, high density lip

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Publication Date
Mon Jan 01 2024
Journal Name
Scripta Medica
Effect of proteolytic enzymes and insulin sensitiser in treatment of joint osteoarthritis in diabetic patients
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Background/Aim: Knee osteoarthritis is a frequently crippling chronic condition. Numerous pharmacological medications have been successfully utilised to treat knee osteoarthritis. This research aimed to compare the efficiency of metformin and serratiopeptidase in treating and preventing osteoarthritis development via distinct mechanisms. Methods: Between 1 January and 30 May 2019, a randomised-clinical-trial was done at Al-Kindy Hospital on 80 osteoarthritis patients, divided in two groups. Group I was given metformin 850 mg orally, whereas Group II was given serratiopeptidase 20 mg and metformin 850 mg orally. Parameters in these groups were compared with forty healthy normal controls. Results: Following treatment, patients in Grou

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Innovation, Creativity And Change
The role of the Classroom Google Educational platform in E-learning from the viewpoint of students of the College of Basic Education
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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
Sun Dec 16 2018
Journal Name
Al-academy
The Effect of 3DS Max in Developing the Skill of Designing Theatrical Decoration among the Students of the Department of Art Education
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The research aims at benefiting from the technological development and the technical progress. This development necessitated that the educational process take advantage of this progress, and the development of special computer software, especially the design programs, made the two researchers think about how to benefit from these design programs in teaching students the skills of theatrical design.

The current search aims at:

Identifying the effect of 3Ds Max in developing the skill of theatrical decoration design among the students of the Department of Art Education "Third stage / Department of Art Education / Faculty of Fine Arts / University of Diyala for the academic year 2014-2015.

The researchers used the ex

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