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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
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Swine Flu 2009, Morbidity and Mortality in a Sample of patients Admitted in Al-kindy Teaching Hospital
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Objective; swine flu is known to be caused by influenza A subtypes H1N1,H1N2, H2N3, H3N1, and H3N2, was first proposed to be a disease related to human flu during the 1918 flu pandemic, Iraq face the epidemic of 2009, many patients admitted to the medical word of alkindy teaching hospital, the clinical features were observed and managed according to WHO protocols.
The aim of the study; is to asses some features of morbidity and mortality of swine flu epidemic admitted patients in 2009 in alkindy teaching hospital.
Methods; A total 131 patients with suspected influenza
admitted to Alkindy Teaching Hospital all complain of
fever more than 38c, sore throat with or without cough.
The admitted patients are of two main
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Publication Date
Tue Apr 01 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Serological and Molecular Detection of Prevalence of Human Parvovirus (B19) in Beta Thalassemia Major Patients in Baghdad
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Background: Beta thalassemia major (β-TM) is an inheritable condition with many complications, especially in children. The blood-borne viral infection was proposed as a risk factor due to the recurrent blood transfusion regimen (hemotherapy) as human parvovirus B19 (B19V). Objective: This study investigated the B19V seroprevalence, DNA presence, B19V viral load, and B19V genotypes in β-TM patients and blood donors. Methods: This is a cross-sectional study incorporating 180 subjects, segregated into three distinct groups each of 60 patients, namely control, β-TM, and β-TM infected with Hepatitis C Virus (HCV).  For the B19V prevalence in the studied group, the ELISA technique and real-time PCR were used. The genotyping was follo

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Correlation Between Hyperglycemia and Rheumatoid Factor in Type 2 Diabetic Patients in Al- Risafa Area, Baghdad
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Diabetes mellitus type 2 (T2DM) formerly called non-insulin dependent diabetes mellitus (NIDDM) or adult-onset diabetes is a common disease. Rheumatoid factor is a well-established test used in the diagnosis and follows the prognosis of rheumatoid arthritis (RA). Rheumatoid factor is sometimes found in serum of patients with other diseases including diabetes mellitus (DM), due to the presence of pro-inflammatory cytokines such as TNF- α which play an important role in chronic inflammatory and autoimmune diseases like rheumatoid arthritis (RA). The aim of the study is to investigate the associations between type 2 diabetes mellitus (T2DM) and rheumatoid arthritis (RA) in scope of rheumatoid factor (RF), hyperglycemia a

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Publication Date
Sun Oct 29 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Nurses' Practices in Intensive Care Units Following Coronary Artery Bypass Grafting Patients in Baghdad City
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Objective: To evaluate nurses' practices toward coronary artery bypass grafting (CABG) patients in the
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Methodology: A purposive sample of (50) staff nurses was selected out of three hospitals for cardiac surgery.
The study instmment consisted of two major sections was constructed. It is based on the review of literature.
First it is concerned with demographic data for nurses; and the second section is observationaL tool (checklist) is
composed of six parts in which there mere (78) items. Reliability and validity of the observational checklist were
determined through the analysis of a pilot study.
Data were collected through the use of the

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Publication Date
Sat Apr 25 2020
Journal Name
Open Access Macedonian Journal Of Medical Sciences
The Efficacy and Prevalence of Montelukast Therapy in Cough-Variant Asthma Patients in Al-Kindy Teaching Hospital
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Mon Dec 30 2013
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Estimation of immunoglobulins levels in the sera of patients infected with liver hydatid cysts
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This study included 46 patients with liver hydatid cyst diagnosed clinically and surgically, control group consist of 22 were naïve from infection had been confirmed by specialist. The patients were divided according to the size of the cysts into more and less than 5 cm diameter size, were 33 and 13 respectively. Also it divided into primary and secondary hydatid cyst infection which were 30 and 16 respectively. The role of immunological response against hydatid cyst parasite, showed a significant increased in humoral immunoglobulins (IgG, IgA, IgM and IgE) which were significantly higher in the hydatid cyst infection than control. Also significant increased in immunoglobulins in secondary infection than primary infection, beside significa

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Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
The extent of UMOD gene polymorphism and its level in type 2 diabetes patients
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Sun Dec 06 2015
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The Study of Serum Complement C3, C4 and Immunoglobulin E IgE in Psoriasis Patients
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The present study was aimed to find out the role of humoral immunity in the pathogenesis of psoriasis. Complements C3, C4 and immunoglobulin IgE .The study included 55 Iraqi patients with psoriasis 30 (15 females ,15 males) were untreated with any drugs. The other patient group consisted of 25 (9 female and 16 male) treated with a biological treatment (infliximab) ,and 30 (13 males ,12 females) healthy control group. Blood sample were withdrawn (5) ml of venous blood for both patients and members of the control ,to conduct the Immunological tests to determine the quantitative for each of total IgE by using (ELISA) and C3,C4 by Single Radial Immunodiffuse (SIRD). The results showed significant increase in the level of probability (P <0.0

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Publication Date
Fri Jul 24 2020
Journal Name
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Speculations of Immunotherapy in COVID-19 Patients with Practical Applications During Childhood and Pregnancy
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Publication Date
Sun Mar 01 2009
Journal Name
Baghdad Science Journal
The Relationship Between Hyperglycemia and the Rheumatoid Factor in the Serum of Diabetic Patients
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This study was conducted to determine the relationship between two most common diseases in Iraqis patients , which are Diabetic mellitus (DM) and Rheumatoid Arthritis (RA); seeking rheumatoid factor in hyperglycemic sera. The results revealed that ; 62.5% of hyperglycemic (HG) patients had positive rheumatoid factor (RF) . No difference in number between both gender of HG patients (20 males and 20 females ) , RF reaction was nearly similar in males and females of HG patients ( 12 &13 respectively ) . Only 40% out of patient controls had positive RF . None of the apparently healthy subjects had positive RF .

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