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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 01 2019
Journal Name
Annals Of Tropical Medicine And Public Health
Arlyesterase activity of Paraoxonase-1 enzyme in Iraqi patients with β-thalassemia minor
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Background: Arylesterase activity of Paraoxonase-1 (ARE-PON-1) exhibits an antioxidant role which protects lipoprotein from oxidation. It is known that ARE-PON-1 antioxidant activity associated with high density lipoprotein cholesterol (HDL-C) reduces the oxidative damage mediated by low density lipoprotein cholesterol (LDL-C). The present study was aimed to examine the level of serum ARE-PON1 in Iraqi patients with β-thalassemia minor and its relationship with lipid profile (total cholesterol (TC), HDL-C, very low density lipoprotein (VLDL-C), and LDL-C) and hematologic changes as a part of antioxidant system action. Methods: In the present study, the ARE-PON-1 activity was investigated in serum of patients with β-thalassemia minor. Resu

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Publication Date
Sat Oct 01 2022
Journal Name
The Egyptian Rheumatologist
Interleukin-22 is up-regulated in serum of male patients with ankylosing spondylitis
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Publication Date
Tue Aug 15 2023
Journal Name
Journal Of Economics And Administrative Sciences
Machine Learning Techniques for Analyzing Survival Data of Breast Cancer Patients in Baghdad
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The Machine learning methods, which are one of the most important branches of promising artificial intelligence, have great importance in all sciences such as engineering, medical, and also recently involved widely in statistical sciences and its various branches, including analysis of survival, as it can be considered a new branch used to estimate the survival and was parallel with parametric, nonparametric and semi-parametric methods that are widely used to estimate survival in statistical research. In this paper, the estimate of survival based on medical images of patients with breast cancer who receive their treatment in Iraqi hospitals was discussed. Three algorithms for feature extraction were explained: The first principal compone

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Publication Date
Thu Jul 01 2010
Journal Name
Clinical And Experimental Rheumatology
RE-EVALUATION OF PATHERGY TEST IN IRAQI PATIENTS WITH BEHCET&#39;S DISEASE
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KE Sharquie, R Hayani, J Al-Rawi, A Noaimi, SH Radhy, CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 2010

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Publication Date
Mon Jun 01 2020
Journal Name
P J M H S
The influence of Breast Cancer Molecular Subtypes on Metastatic pattern in Iraqi patients
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Publication Date
Thu Mar 07 2024
Journal Name
Problems Of Endocrinology
KI-67 as a predictive indicator of papillary thyroid cancer in Iraqi patients
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BACKGROUND. KI-67 (MKI-67 in humans) is a protein able to bind to DNA which contributes to cell growth and cell proliferation. KI-67 is currently considered as a biomarker that is widely utilized as prognostic indicator for evaluating cell proliferation, diagnosing diseases, and conducting research. Several different kinds of cancer have high Ki-67 expression, which simplifying the choice of treatment for individuals with various cancer types.AIM. The objective was to evaluate the expression of KI67 in patients suffering papillary thyroid cancer (PTC) also the association between patients age and gender and KI67 expression.MATERIALS AND METHODS. To undertake an in-

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Publication Date
Mon Apr 01 2024
Journal Name
Iraqi Postgraduate Medical Journal
Estimation of Prevalence rate of Sjogren’s syndrome among Rheumatology clinic patients in Iraq
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Publication Date
Mon Jan 01 2018
Journal Name
Ibn Al-haitham Jour.for Pure & Appl.sci.
Determination of Osteocalcin, Bone Alkaline Phosphatase, and Lysyl Oxidase in Iraqi Acromegalic Patients
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This study was aimed to determine bone formation markers (OST and BALP) and lysyl oxidase in diabetes and non-diabetes Iraqi acromegaly patients in addition to find the relationship among these parameters. The present study conducted 60 acromegalic patients (30 diabetes & 30 non diabetes) attending National Diabetes Center / AL-Mustansiriya University/Baghdad, and 30 healthy individuals as a control group aged (35-60) years. All patients were administrated Sandostatin drug, and they were diagnosed by physician in the hospital.FBG, GH, IGF-1, OST, BALP, and LOX were determined in all groups. The results showed a highly significant rise in all parameters (GH, IGF-1, FBG, OST, BALP, and LOX values in serum of all patients when compared with n

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Publication Date
Sat Aug 20 2022
Journal Name
International Journal Of Health Sciences
Study the efficacy of intralesional pentoxifylline versus triamcinolone acetonide in keloid scars patients
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Keloids are prevalent fibro-proliferative tumors, and treating them is still a challenge although intralesional injections of triamcinolone acetonide (TAC) are effective, they have frequently linked adverse effects. Pentoxifylline (PTX) is an anti-fibrotic and anti-inflammatory, and vasodilator. It has not yet been tested for intralesional injection in keloids. The aim of the study is to study the efficacy of intralesional pentoxifylline versus triamcinolone acetonide in keloid scars of 40 patients. In this study, 40 patients with keloid scars regardless of the cause of keloid born, 20 patients have injected with intralesional triamcinolone acetonide, and 20 patients with intralesional pentoxifylline every two weeks until the lesi

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Free Fatty Acids and Biochemical Changes in Iraqi patients with Chronic Renal Failure
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Chronic renal failure (CRF) is progressive irreversible destruction of kidney tissue by disease which, if not treated by dialysis or transplant, will result in patient's death. This study was carried out on 30 patients (17 male and 13 female) with chronic renal failure. The aim of this research was studied the changes in the level of total protein ,albumin, calcium ,ionized calcium, phosphorous , iron ,ALP, LDH ,CK and FFA in patients with CRF before and after hemodialysis .The obtained results have been compared with 30 healthy subjects as control group (18male and 12 female). The results showed that there was significant increase in the level of calcium ,ionized calcium, phosphorous ,iron ,ALP,LDH,CK and FFA ,while there was a signifi

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