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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 Jul 01 2012
Journal Name
Journal Of Educational And Psychological Researches
A comparative study between the emotional responses in patients with blood pressure on a scale of music types characteristics compared with responses to some Healthy patients
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The problem of the study and its significance:

           Due to the increasing pressures of life continually, and constant quest behind materialism necessary and frustrations that confront us daily in general, the greater the emergence of a number of cases of disease organic roots psychological causing them because of severity of a lack of response to conventional treatments (drugs), and this is creating in patients a number of emotional disorders resulting from concern the risk of disease

 

     That is interested psychologists and doctors searchin

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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
EFFECT OF EUCALYPTUS AND MYRTUS EXTRACTS IDENTIFICATION BY GAS CHROMATOGRAPHY-MASS SPECTROMETRY ON SOME SPECIES OF CANDIDA AS A MODEL OF MEDICAL PLANTS
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Publication Date
Wed Jun 10 2020
Journal Name
Annals Of Tropical Medicine & Public Health
EFFECT OF EUCALYPTUS AND MYRTUS EXTRACTS IDENTIFICATION BY GAS CHROMATOGRAPHY-MASS SPECTROMETRY ON SOME SPECIES OF CANDIDA AS A MODEL OF MEDICAL PLANTS
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The study showed that all extracts (aqueous, ethanolic and acetonic) of the leaves of Eucalyptus and Myrtus plants had a inhibitory effect on the growth of all types of yeasts studied, acetone extract recorded the highest inhibition of yeastat 100ppm concentration,The inhibition was 35mm, 34mm, 24mm and 20mm for Candida parapsilosis, Candida glabrata, Candida tropicalis and Candida albicans respectively, The experiments above showed the least significant differences at 0.05 level.The results ofE. Cammldulensis ethanolic tincture analysis has shown the presence of 44 biologically active substances. The main Eucalyptus leaves component was: 2-Bicyclo (2-2.1) heptanol (12.37%), Ledol (8.23%),1,2,4- Benzenetriol (8.45%) and that contain spathul

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Publication Date
Sun Jun 07 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Nutritional status in relation to oral health status among patients attending dental hospital
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Background: Good Nutrition is essential for oral and dental health in children. Good eating habits and food preferences are established early in childhood. Oral health problems can effect dietary quality and nutrient intake in another side increase the risk of several systemic diseases., The aim of the present study was to investigate the relation or the effect the of nutritional status in children at age of 5 to16 on the oral health status and dental caries . Materials and Methods: the total sample composed of 153 patients attending the Pedodontic and Preventive Department/College of Dentistry/University of Baghdad, the assessment of nutritional status was performed by using Body Mass Index specific for age and gender according to Chronic

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Publication Date
Tue May 01 2018
Journal Name
International Journal Of Medical Research & Health Sciences
Estimation of Serum Matrix Metalloproteinases-1 Levels in Iraqi Female Patients with Osteoarthritis
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This study was established to investigate the correlation between the expression of matrix metalloproteinases (MMP-1) and the pathogenesis of osteoarthritis (OA). Blood samples were collected from 55 female patients with inflammatory OA and controls for estimation of serum (MMP-1) levels. In the current study, there is significant increase (p<0.001) in the mean of serum MMP-1 levels in osteoarthritis females (4027.73 ± 1345.28 pg/ml) than that in control females (798.76 ± 136.79 pg/ml). It was concluded that MMP-1 may be associated with the pathogenesis of osteoarthritis.

Publication Date
Sat Aug 30 2025
Journal Name
Iraqi Journal Of Science
Seroprevalence and Molecular Detection of Human Parvovirus B19 in Beta Thalassemia Major Patients
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Beta thalassemia major (BTM) is a genetic disorder that has been linked to an increased risk of contracting blood-borne viral infections, primarily due to the frequent blood transfusions required to manage the condition. One such virus that can be transmitted through blood is the Human Parvovirus B19 (B19V). The aim of this study was to investigate the frequency and molecular detection of B19V. This study included 60 blood donors as controls and 120 BTM patients. B19V was identified by serology, which measured B19-IgG and B19-IgM antibodies. Nested Polymerase Chain Reaction (nPCR) was employed to target the VP1/VP2 structural proteins. The results showed that B19V seropositivity represents 27.5% (33 out of 120) in BTM patients, and

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Publication Date
Mon Feb 01 2010
Journal Name
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, And Endodontology
Oral Candida flora in a group of Jordanian patients with β-thalassemia major
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Objective Thalassemic patients present with multiple immune abnormalities that may predispose them to oral Candida, however this has not been investigated. The aim of this study was to assess oral candidal colonization in a group of patients with β-thalassemia major both qualitatively and quantitatively. Study design The oral mycologic flora of 50 β-thalassemia major patients and 50 age- and sex-matched control subjects was assessed using the concentrated oral rinse technique. Candida species were identified using the germ tube test and the Vitek yeast identification system. Results Oral Candida was isolated from 37 patients (74%) and 28 healthy subjects (56%; P = .04). The mean candidal count was significantly higher in thalassemic patie

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Publication Date
Mon Apr 01 2019
Journal Name
Biochemical And Cellular Archives
Association Of Human Cytomegalovirus With Her2 Protooncogene Overexpression In Iraqi Breast Cancer Patients
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Human cytomegalovirus (HCMV) has a worldwide distribution and common infections. The presence of HCMV genome and antigens has been detected in many kinds of human cancers. The proto-oncogene Her2/neu is overexpressed in 25% to 30% of human breast cancers and frequently associated with tumor aggressiveness and worse prognosis. Examination was applied to detect different HCMV antigens and to demonstrate their correlation with Her2/neu overexpression in breast cancer. The present study includes samples from 70 women of 60 breast cancer patients and 10 normal breast tissues. Formalin-fixed paraffin embedded tissue blocks were obtained from each woman according to ethical approval. Human cytomegalovirus early antigen expression was detected in 5

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Publication Date
Tue Jan 01 2013
Journal Name
Medical Journal Of Babylon
Interleukin-33(IL-33)in Iraq's R Patients Rheumatoid Arthritis Prone to Atherosclerosis
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Publication Date
Fri Aug 19 2022
Journal Name
International Journal Of Health Sciences
Interleukin-32, interleukin-33 and acid phosphatase levels in patients with Helicobacter Pylori
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The study was carried out to detection of H. pylori in (218) patients who attended two teaching hospitals in Baghdad. The diagnosis was done by Immunochromatography methods. Stools and blood samples were taken from each patient as well as other (30) healthy control matching in age. The study included measurement the Levels of Interleukin-32, Interleukin-33, and Acid phosphatase   in sera of patients and control .The result indicated  presence  of H pylori antigen in 115 cases 59 cases  of males and 51 of females , Also, the result indicated  increasing levels of IL-32 and IL-33 and Acid phosphatase  in patients sera  in comparison with healthy control.

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