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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 30 2023
Journal Name
Al-kindy College Medical Journal
Pharmacist Intervention to Address Drug Related Problems in Patients with Decompensated Liver Cirrhosis
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Background: Patients with decompensated cirrhosis are often given therapeutic and prophylactic drugs. Polypharmacy raises both the likelihood of prescription errors and the complications associated with drugs. Clinical pharmacists are excellent at recognizing, addressing, and preventing clinically significant drug-related problems.

Objectives: Identification types of pharmacist interventions to address drug-related problems in patients with decompensated cirrhosis and assess the acceptance/implementation of these recommendations. And identify patient factors associated with accepting pharmacist recommend

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Psychiatric Squele of Sodium Valproate Versus Carbamazipine in Patients with Primary Generalized Epilepsy
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Background: psychiatric and behavioral side effects are
common in patients with epilepsy and it may represent an
intrinsic feature of the disease itself or a side effect of the
antiepileptic use. Our aim in the present study is to assess
the psychiatric side effects of Sodium Valproate and
Carbamazipine .as these drugs are the most commonly
used antiepileptic drugs in Iraq.
Methods: 80 patients with primary generalized epilepsy
on Carbamazipine and 50 patients on Sodium Valproate
were enrolled in the present study; all the patients were
assessed for any psychological disturbances using semistructural interview based on the tenth edition of the
international classification of the diseases(ICD 10)
adopte

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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
Sun Sep 20 2020
Journal Name
Biochemical And Cellular Archives
MOLECULAR INVESTIGATION OF EPSTEIN-BARR VIRUS IN IRAQI PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA
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Chronic lymphocytic leukemia (CLL) is one type of leukemia that arises from lymphocytes' progenitor cell in the Bone marrow, it affects individuals over the age of 50 years in both genders. In Iraq, leukemia affected 1532 (847 males and 683 females) according to the latest announced statistics of the Iraqi Cancer Registry Center in 2012. Chronic lymphocytic leukemia may occur due to several genetic causes, such as chromosomal aberrations and gene mutations, or exposure to carcinogens and mutagens (radiation, chemicals, and oncogenic viruses). The most famous virus is the Epstein-Barr virus (EBV), which is a gamma herpesvirus that infects more than 90% of individuals. Its infection is mostly a latent infection, and EBV remains latent in memo

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Publication Date
Fri Apr 12 2024
Journal Name
Cureus
Assessing the Hepatotoxic Effects of Fluoropyrimidine Chemotherapy in Male Iraqi Colorectal Cancer Patients
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Publication Date
Sun Jun 07 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Oral manifestations, microbial study and salivary IgA study in asthmatic patients receiving prednisolone
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Background: Asthma is a disease of the airways characterized by chronic inflammation associated with airway hyper-responsiveness and airway wall remodeling. Aims of the study: The aims of this study was to determine the prevalence of oral manifestations , identify different microorganism from oral micro flora and determination of salivary IgA and salivary flow rate in asthmatic patients taking different dose of Prednisolone in comparison with control group. Subjects, materials and methods: The study included 17 patients under treatment with Prednisolone (10-20 mg),15 patients take (20-30 mg) of Prednisolone and other 18 patients take (30 – 40mg) of Prednisolone, and 25 healthy control group (10 male and 15 female). Results : The mo

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Publication Date
Mon Jul 01 2024
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Evaluation of some Biochemical and Hematological Parameters in Patients with Chronic Kidney Disease
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Background: Chronic kidney disease is a condition that results from an indefinite change in the structure and function of the kidneys. A slow, steady progression characterizes it and is irreversible.  Objectives: This study aims to evaluate the findings of certain biochemical and hematological tests in samples from Iraqi CKD patients.  Methods: This study included 90 subjects, where 70 patients with chronic kidney disease and 20 healthy individuals. Blood samples were collected from the patients during their visits to Ghazi Al-Hariri Surgical Specialties' Hospital- Medical City, Baghdad, Iraq. Age, sex and body mass index were assessed for each participant followed by renal function tests [serum blood urea, creatinine, uric acid a

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Publication Date
Sun Jun 30 2024
Journal Name
Iraqi Journal Of Science
Assessment of Malondialdehyde and Soluble α-Klotho Serum Levels in Iraqi Acromegaly Patients
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     Acromegaly has been associated with several metabolic health conditions that can increase risks of death and illness. These include heart disease, diabetes, and problems with how the body regulates insulin levels. Multiple studies have found that people living with acromegaly are two to four times more likely to pass away than others of the same age and sex in the general population. Research also suggests a link between acromegaly and higher levels of malondialdehyde (MDA) in the body. MDA is a byproduct formed during natural processes like prostaglandin and lipid peroxidation production that is able to damage genes and has been connected to cancer development. The transmembrane protein known as soluble a-Klotho (SAKL) is

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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
Wed Jun 30 2010
Journal Name
Al-kindy College Medical Journal
Prevalence of bacterial infection and their sensitivity in patients undergoing an infertility eval
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Background: Infection with sexually
transmitted diseases is broad and includes
bacterial, viral and protozoa infection.
Large number of infected people goes
untreated because of symptomatic or
unrecognized infections.
Patients and methods: Forty five
patients was complaining from infertility
(primary or secondary), consulting
Kammal El-Sammari Hospital for
infertility from May - 2008 to February -
2009. Control group consisted of twenty
fertile women that consulting private clinic
for checking. Four swabs were taken from
each woman in two groups. Two swabs
were taken from posterior fornix of the
vagina (High vaginal swab) and the last
two were taken from endocervical canal.
First swab

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