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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 Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Practices regarding Patients Discharge Planning post Cardiac Surgery at Cardiac Centers in Baghdad city
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Objective (s): to assess nurses' practices regarding discharge planning post-cardiac surgery and to find out the relationship between nurse practices and demographic characteristic (age, gander, level of education, years of experiences, and years of experiences in surgical ward).
Methodology: A descriptive study was carried out at cardiac centers and hospitals in Baghdad (Ibn Al- Bitar specialized center for cardiac surgery; Iraqi center for heart disease and Ibn al Nafees hospital). For the period of 6th February 2017 up to 1st of June 2018. A non-probability (purposive) sample of (58) nurses (male & female) who were working in surgical wards. The data was collected, by using of a questionnaire, which consists of two parts, part

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Publication Date
Sat Aug 17 2013
Journal Name
American Journal Of Pharmacological Sciences
Pentoxifylline as Adjuvant Therapy to Etanercept in Patients with Moderately to Highly Active Rheumatoid Arthritis
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Publication Date
Sun Dec 01 2002
Journal Name
Iraqi Journal Of Physics
The Role of Plasm Lipid Profile on RBC Aggregation and Sedimentation Changes in Diabetic Patients
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The aggregation capacity of human reb blood cells lies between that of the non- aggregated arythrocyte and the remarkably full sedimentation. As the ability to aggregate is atributed to many factors such as the availability of macromolecules and plasma lipids, the role of plasm lipid profile on RBC aggregation and sedimentation changes in normal and diabetic patients is studied.Also serum lipid profile measurement (Total cholesterol, Triglyceride, HDL, LDL, VLDL) in normal and diabetic subjects were made. The principle of measurement includes detecting the transmitted laser light through a suspension of 10% diluted red blood cells in plasma. In all diabetics, the raulux formation and sedimentation rate is enhanced.

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Pharmaceutical Sciences & Research
Evaluation of Oxidative Stress and Some Vitamins as Antioxidants in Type2 Diabetic and Nephropathic Patients.
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Background: The present study involved the following parts, the first part is evaluation of the levels of glycated hemoglobin(HbA1c), creatinine, uric acid(UA) and albumin in patients with diabetic nephropathy comparison with the group of healthy as a control group. The second part is the measurement and evaluation of oxidative stress represented in the malondihydehyde(MDA) as a biomarker of oxidative stress as well as the identification of vitamins C and E as an antioxidant in patients with diabetic nephropathy(DN) compared with the healthy group. Objective: The objective of this study is to estimate oxidative stress by calculate malondialdehyd as biomarker and evaluate some vitamins such as vit C and vit E as antioxidants in diabetic neph

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Publication Date
Tue Dec 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Belief about Medications Among Type 2 Diabetic Patients Attending the National Diabetes Center in Iraq.
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Diabetes mellitus is a common health problem worldwide counting about 1.2 million cases in Iraq in 2015. Taking in account of the patient’s beliefs about the prescribed medication had been reported to be one of the most important factors that affects adherence where holding positive beliefs about medications is a prerequisite for intentional adherence. The aim of the current study was to investigate and assess beliefs about medicines among type 2 diabetic patients and to determine possible association between this belief and glycemic control as well as some patient-specific factors. This study is a cross-sectional study carried out on 380 (mean age 56.58± 10.06 years) already diagnosed T2DM patients who attended the National Diabetes

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Publication Date
Mon Aug 15 2022
Journal Name
Revis Bionatura
ND2 Gene Sequencing of Sub fertile Patients Recovered from COVID-19 in Association with Toxoplasmosis
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A total of (90) blood samples were collected from male patients infected with Toxoplasmosis who recovered from COVID- 19 and attended Kamal Alsamiraai Hospital from 15 January to 15 September 2021. We measured anti-Toxoplasma antibodies (IgG and IgM) detected by ELISA, whereas Anti-COVID-19 antibodies (IgG and IgM) were estimated using Elisa and Afilias. The semen characteristics were also studied among fertile, healthy individuals (control group) and sub-fertile patients. Results showed that the mean sperm count was high among the control group (40.5±1.3x 106/ml) compared with that of the sub-fertile patients (10.3±1.75 and 8.8±1.9 x 106/ml for oligozoospermia, and oligoasthenozoospermia respectively), and it was the highest (44.7±1.4

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Publication Date
Thu Dec 10 2009
Journal Name
Iraqi Journal Of Laser
Diagnosis and Treatment of Cervical Intraepithelial Neoplasia with Carbon Dioxide Laser Therapy in Selected Patients
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Female infection with HPV (human papilla virus) has been established as an essential cause of CIN (cervical intraepithelial neoplasia). The danger of transformation from CIN to frank malignancy should be considered. Objective: The goal of this study is to evaluate the effectiveness of CO2 laser vaporization of ectocervical lesion high grade squamous intraepithelial lesion (HGSIL). Patients and Methods: Four Female out of 150 affected with HGSIL lesions were submitted to CO2 laser vaporization and followed up in 4 months later, and 10 women with HGSIL lesion submitted to electrocautery diathermy for the comparison. Results: Among women treated by CO2 laser vaporization, 3 women had negative results (clear cervix), at 4 months follow up; o

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Publication Date
Sun Apr 03 2011
Journal Name
لمؤتمر العلمي الرابع لكلية التربية/ جامعة سامراء
A comparison between alanine aminopeptidase (AAP) activity in type 2 diabetes and diabetic cardiac patients.
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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Functional Performance For Patients Post Heart's Valves Replacement at Cardiac Surgery Centers in Baghdad City
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Abstract
Objectives: The study is carried out to assess functional performance for heart's valve replacement patients and find out relationship with sociodemographic data and clinical data
Methodology: Descriptive design is carried out at cardiac surgery centers in Baghdad ; Ibn -Al Betar Specialized for cardiac surgery center and Al-Iraqi center for cardiac disease. its initiation from December28the 2013 to September 1st 2014,A non- probability (purposive) sample of 50 adults patients are attended cardiac surgery centers at Baghdad city and who have heart valves replacement. The data collection through development of questionnaire which is composed from three parts(socio demographic data, clinical information, functional performa

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Publication Date
Thu Dec 31 2009
Journal Name
The Iraqi Journal Of Veterinary Medicine
Possible beneficial effects of amlodipine, lisinopril, and their Combination on lipid profile in hypertensive patients
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It is well known that monotherapy does not provide therapeutic response in all hypertensive. Somepatients show an excellent response, while in others there is a poor response. Combinationantihypertensive therapy is administered when blood pressure is inadequately controlled bymonotherapy to achieve a balanced and additive antihypertensive effect with minimum adverse effects.Both angiotensin converting enzyme (ACE) inhibitors and dihydropyridine type of calcium antagonistsare well established and widely used in monotherapy. An understanding of differences in themechanism of action of these agents allows a logical approach for the use of these agents as acombination therapy. This study was designed to evaluate the possible beneficial

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