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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 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 Dec 27 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
CYP2D6 Genotype in Relation to Liver Toxicity Due to Tetrabenazine in Iraqi Patients with Hyperkinetic Movement Disorders
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Abstract

The  common types of movement disorders are ; dystonia which is a syndrome  of  repetitive muscle contractions. While , Huntington disease is autosomal dominant progressive neurodegenerative disorder, which is characterized by involuntary movements (“chorea”).

Tetrabenazine therapy has been shown to effectively control this movements compared with placebo.

Design the proper dosing approach for patients treated with tetrabenazine with genotype polymorphisms and their hepatic effect on patients.

A prospective case controlled study was carried on 50 patients whom    divided into 2 groups :first group involved 25 patients who had cho

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Publication Date
Thu May 04 2023
Journal Name
Biomedicine
Relationship between cathepsin K and total oxidative state in diabetes mellitus female patients with osteoporosis in Iraq
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Introduction and Aim: Diabetes mellitus patients almost always struggle with a metabolic condition known as chronic hyperglycemia. According to the World Health Organization, osteoporosis is a progressive systemic skeletal disorder that is characterized by decreasing bone mass and microstructural breakdown of bone tissue that increases susceptibility to fracture and increased risk of breaking a bone. Here, we aimed to compare the levels of CatK and total oxidative state in patients with diabetes and osteoporosis among the female Iraqi population and study the possible relationship between them.   Materials and Methods: This study included 40 females with diabetes (Group G1), 40 with diabetes and osteoporosis (Group G2) and 40 norma

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Publication Date
Fri Dec 07 2018
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effects of Aldosterone, Osteoprotegerin and Fibroblast Growth Factor-23 and Some Biochemical Markers in Chronic Kidney Disease Patients (Stage II-IV) among Patients with or without Cardiovascular Events
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Chronic Kidney Disease (CKD) is a public health problem and many studies support the link between kidney dysfunction and cardiovascular events.  Aldosterone has been shown for decades that a plasma aldosterone concentration is elevated in CKD. Whilst, Osteoprotegerin (OPG), after its capacity to protect bone, also osteoprotegerin is elevated in patients with chronic kidney disease (CKD), where it could predict the deterioration of kidney function, cardiovascular, vascular events and all-cause mortality. On the other hand, fibroblast growth factors (FGFs), in patients with CKD, its levels seem to increase progressively as kidney function worsens. The aim of the present study is to assess the correlations between serum osteoprotegerin

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Publication Date
Sat Jun 06 2020
Journal Name
Journal Of The College Of Education For Women
Difficulties Facing the Teaching of Writing for Students at College of Education for Women, University of Baghdad
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This research paper attempts to explore problems facing the teaching of written expression among first-year female university students. The focal point behind conducting this research is to show the importance that writing is taking as a skill in learning the language. To achieve this goal, the researcher prepared a questionnaire consisting of 20 items. The sample, whose size is 60 participants, was selected randomly from the department of Arabic, College of Education for Women, University of Baghdad. Through the use of a set of statistical means including weighting means and percentage, the findings revealed that the students face many difficulties in learning writing. The researcher suggested some recommendations, mainly improving the

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Publication Date
Tue Jun 01 2021
Journal Name
International Journal Of Business And Technopreneurship
Assessment of Entrepreneurship Education on the Relationship Between Attitude, Subjective Norms, Perceived Behavioural Control and Entrepreneurial Intention
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Entrepreneurial events are understood to be imperious in accelerating the economic development of nations owing to a large number of jobs it creates. Thus, both developed and developing countries understand the importance of entrepreneurship education to instil student interest in entrepreneurial action. This study investigates the moderating effect of entrepreneurship education (EEP) on the relationship between attitude (ATT), subjective norms (SNMS), and perceived behavioural control (PBC) towards entrepreneurship intention (EINT) of university undergraduate students. The study population covered 794 students from all the four faculties of Northwest University Kano, that were taught a compulsory entrepreneurship education course in their

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Publication Date
Sat Dec 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
The impact of an Oral Health Education (OHE) program by teachers and mothers on adolescents' oral health
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Background: Adolescence is one of the most dynamic stages of human development. However, Oral health is an integral part of public health, significantly impacts on the quality of life. OHE program is an important issue that should be given to them. The aim of this study was to evaluate oral health outcomes on adolescents' oral health by teachers and mothers Materials and Methods: The study was carried out in seven schools of Diyala - Baquba city. This 14-weeks duration study assessed the effectiveness of school OHE program on oral hygiene status, gingival health, and halitosis assessment of 80, 12 year-old, both genders of school adolescents. From the selected schools, one group was supervised by the teachers and the other was supervised

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Publication Date
Wed Jun 14 2023
Journal Name
Al-academy
The effect of dramatizing characters within the social subject of the basic education stage on student achievement
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The researcher used the experimental approach due to its suitability and the nature of the research problem. The research community was represented by the eighth-grade students in the Rozak Elementary Mixed School affiliated with the General Directorate of Education in Erbil / the center, for the academic year (2021-2022), the number is (96) students, and the research sample consisted of (63) male and female students, with (31) in the experimental group, and (32) in the control group, and (11) students were excluded by (5) students from the experimental group, and (6) students from the control group, as the excluded, are students who failed and were absent from the lessons, and accordingly, the research sample became composed of (52) mal

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Publication Date
Fri Mar 20 2020
Journal Name
Journal Of Xi'an University Of Architecture & Technology
Academic Laboratory Skills For Chemistry Students at the College of Education For Pure Sciences -Ibn Al Haitham
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The current research aims to find out the extent to which students of the Faculty of Education for Pure Sciences\/Ibn al-Haitham have owned laboratory academic skills, the researcher adopted a descriptive research approach to conform to the goal of the research, the research sample the consisted of 140 students from the Department of Chemistry Phase II, The research tool, which consisted of a measure of laboratory academic skills, which consisted of seven skills and consisted of 28 paragraphs (four paragraphs per field), was prepared and the pent-up scale was chosen because the selected sample were university students, and the results showed the ownership of students' skills of laboratory academic skills other than skill The use of the libr

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Publication Date
Sun Jan 01 2012
Journal Name
Evidence-based Complementary And Alternative Medicine
Gelam Honey Inhibits the Production of Proinflammatory, Mediators NO,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mrow><mml:msub><mml:mrow><mml:mtext>PGE</mml:mtext></mml:mrow><mml:mtext>2</mml:mtext></mml:msub></mml:mrow></mml:math>, TNF-<b><i>α</i></b>, and IL-6 in Carrageenan-Induced Acute Paw Edema in Rats
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Natural honey is well known for its therapeutic value and has been used in traditional medicine of different cultures throughout the world. The aim of this study was to investigate the anti-inflammatory effect of Malaysian Gelam honey in inflammation-induced rats. Paw edema was induced by a subplantar injection of 1% carrageenan into the rat right hind paw. Rats were treated with the nonsteroidal anti-inflammatory drug (NSAID) Indomethacin (10 mg/kg, p.o.) or Gelam honey at different doses (1 or 2 g/kg, p.o.). The increase in footpad thickness was considered to be edema, which was measured using a dial caliper. Plasma and paw tissue were collected to analyze the production of inflammatory mediators, such as NO, PGE2

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