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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
Thu Aug 14 2025
Journal Name
International Journal Of Latest Technology In Engineering, Management & Applied Science (ijltemas)
Temporal Trend of Congenital Heart Diseases in Iraqi Patients: An Analytic Study from Two Cardiac Institutions
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Publication Date
Sun Apr 30 2023
Journal Name
Al-kindy College Medical Journal
Interleukin 6 Levels and their Correlation with Various Hematological and Biochemical Parameters in Covid-19 Patients
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Background: coronavirus 19 is a beta-coronavirus, enveloped and roughly spherical with approximately 60 to 140 nm in diameter with positive-sense single-stranded RNA genome.

Objectives: Measurement of interleukin 6 (IL6) level in a group of patients with confirmed Covid19 infection and its correlation with many hematological and  biochemical parameters , mainly lymphocyte , neutrophil  count and their ratio , platelet count , serum ferritin , C reactive protein as well as D-dimer level

Subjects and Methods: This study was conducted on 60 PCR positive patients variably affected by COVID-19 , cases collected sequentially from June till November 20

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Publication Date
Sat Sep 05 2020
Journal Name
Al-kindy College Medical Journal
Prevalence of Oral Manifestations of Inflammatory Bowel Disease in Patients Admitted to Sulaymaniyah teaching hospital – Iraq
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The aim of this study is to evaluate the association between IBD and oral symptom and mucosal lesions in patients with Crohn’s disease and ulcerative colitis

Methods: This is a cross-sectional study that has been done in (Kurdistan center for Gastroenterology and hepatology) of Teaching Hospital in Sulaymaniyah-Iraq, which included 101 patients previously diagnosed with Inflammatory Bowel Disease who were interviewed regarding manifestations of inflammatory bowel disease especially oral manifestations. Required data were collected through a specially designed questionnaire,

Results: The patients’ mean age was 45.74±12.58 years. Patients with ulcerative colitis and Crohn’s disease w

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Publication Date
Mon Apr 04 2022
Journal Name
Neuroquantology
The Role of Adropin as a Novel Biomarker in Iraqi Patients with Parkinson's Disease and Osteoporosis
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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
None anticipated bacterial urinary tract infections in type 2 diabetic patients relative to duration and angiopathies
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Background: Diabetes mellitus is a well
known metabolic and vascular illness associated
with high incidence of bacterial urinary tract
infections especially in diabetic complications
including both micro and macro-vascular types.
Objective: To study the incidence of bacterial
urinary tract infections in type 2 diabetic
patients, the type of micro-organism responsible
in relation to age, sex of patients, duration of the
disease & related micro & macrovascular
diabetic complications.
Methods: A prospective study of the diabetic
patients including 40 males with mean age of
54(±9) years and 50 females, mean age of 51(±7)
years and duration of the and sex matched
controls (27 males and 33

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
Patient Satisfaction and its Relationship to Dental anxiety among patients of Dental Clinics in Baghdad city
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Patient satisfaction and dental anxiety considered as an important factors in dental health care and treatment because they greatly affect the patient's cooperation with the dentist and the extent to which follows the guidelines, treatment and preventive instruction. The present study investigates the relationship between patient satisfaction and dental anxiety, as well as their relation to demographic variables such as gender, age, number of visits, and cultural level. The study was applied on a random sample of dental clinics in Baghdad city with total of (200) patient (108 male and 92 female). Two scales were used in this study, patient satisfaction scale PSS (included 9 aspects, constructed by authors) and Iraqi dental anxiety scale

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Publication Date
Tue Dec 02 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Effects of light smoking on salivary levels of alkaline phosphatase and osteocalcin in chronic periodontitis patients
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Background: Chronic periodontitis is an inflammatory disease that affects the supporting tissues of the teeth and it’s common among adults. Smoking is an important risk factor for periodontitis induces alveolar bone loss. Alkaline phosphatase enzyme is involved in the destruction of the human periodontium. It is produced by many cells such as polymorphonuclear leukocytes, osteoblasts, macrophages and fibroblasts within the area of the periodontium and gingival crevice. Osteocalcin is one of the most abundant matrix proteins found in bones and the only matrix protein synthesized exclusively there. Smaller Osteocalcin fragments are found in areas of bone remodeling and are actually degradation products of the bone matrix.The purpose of

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Publication Date
Mon Jun 26 2023
Journal Name
Journal Of Contemporary Medical Sciences
Molecular detection of mononucleotide biomarkers of microsatellite instability in sporadic colorectal carcinoma patients with clinicopathological correlation
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Objectives: To identify the frequency and types of microsatellite instability among a group of sporadic CRC patients and to correlate the findings with clinicopathological characteristics. Methods: During an 8-month period, all patients with sporadic CRC who attended to two teaching hospitals in Baghdad, Iraq were recruited to this cross-sectional study regardless of age, sex, ethnicity, or tumor characteristics. Demographic, clinical, and histopathological features were recorded. DNA was extracted from FFPE-blocks of the resected tumors and normal tissues. PCR amplification of five microsatellite mononucleotide repeat loci (BAT25, BAT26, NR-21, NR-24, and MONO-27) and 2 pentanucleotide repeat control markers (Penta C and Pent

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Publication Date
Wed Aug 30 2023
Journal Name
Baghdad Science Journal
Studying the Effect of COVID-19 on Liver Enzymes and Lipid Profile in Iraqi Recovering Patients
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  The Covid-19 virus disease has been shown to affect numerous organs and systems including the liver. The study aimed to compare lipid profiles and liver enzyme levels in individuals who had recovered from Covid-19 infection. To achieve the study objectives, liver Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline phosphatase (ALP),  Random Blood Sugar (RBS) and Lipid profile which include cholesterol, High-Density Lipoprotein (HDL), Triglycerides (T.G), Low-Density Lipoprotein (LDL), and Very low-density Lipoprotein (VLDL) were determined.

One hundred twenty serum samples were obtained, of which fifty samples were utilized as the control healthy persons (not affected by COVID) and seventy samples came f

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Publication Date
Thu Sep 04 2025
Journal Name
The Open Dentistry Journal
Clinical and Salivary Antioxidant Effects of Matcha Tea in Patients with Gingivitis: A Randomized Controlled Trial
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Introduction

Gingivitis, the initial stage of periodontal disease, is characterised by inflammation driven by dental biofilm and associated with oxidative stress. Matcha tea, a powdered green tea rich in antioxidants, has shown potential health benefits. This study aimed to investigate the effect of Matcha tea consumption on clinical periodontal parameters and salivary antioxidant levels in patients with gingivitis.

Methods

A randomised controlled clinical trial was conducted with 41 participants diagnosed with gingivitis.

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