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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 Sep 06 2009
Journal Name
Baghdad Science Journal
Biological and chemical Study to evaluate the types of water used for drinking in the Al-youssiffiyah area and its effect on public health
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Election study included four sites for the waters in area of Youssifiyah south of Baghdad (river water, tank water, liquefactions water, and water filtrate and seethed and purifier by alum and chloride), the samples were collected during the month of June in 2007. Temperature, electrical conductivity and acidity are measured. Also , the concentration of chloride , sulphate , carbonate , nitrate , sodium , calcium , magnesium , hard total and total dissolved substances are determined , as well as heavy metals assess environmental risk (such as Cu, Pb, Zn, Fe). It was also a study of bacterial totals included both total Bacteria (TB) and Total Coliform Bacteria (TC) and Fecal Coliform (FC) and Fecal Streptococci (FS). The stu

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Publication Date
Fri Sep 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Enamel Protective Agent on Shear and Tensile Bond Strength of Stainless Steel Brackets by Using Different Adhesive Agents (In Vitro Study)
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Background: Decalcification of surface enamel adjacent to fixed orthodontic appliances, in the form of white spot lesions, is a wide spread and familiar well-known side effect of orthodontic treatment. The present study was carried out to evaluate the effect of enamel protective agent (Clinpro white varnish) on shear and tensile bond strength of Dentaurum orthodontic stainless steel brackets by using 3M Unitek and Ormco as orthodontic adhesive agents. Materials and methods: Sixty-four extracted human upper first premolar teeth were selected and randomly divided into two groups with 32 teeth each, representing the shear and tensile bond strength testing groups. Then according to the type of bonding adhesive and the addition of Clinpro before

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Publication Date
Tue Jan 24 2023
Journal Name
Journal Of Advanced Biotechnology And Experimental Therapeutics
Influence of the high mobility group A1 genetic polymorphism on indices of metabolic syndrome and insulin resistance in the Iraqi population: Case-control study
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The high mobility group A1 gene (HMGA1) rs139876191 variant has been related to metabolic syndrome and type 2 diabetes, but data are lacking in Middle Eastern populations. The study aimed to assess whether the HMGA1 rs139876191 variant is associated with metabolic syndrome risk and whether this variant predicts the risk of insulin resistance. This case-control study was carried out at single center in Kirkuk city/ Iraq from February to August 2022. Polymorphisms in HMGA1 and genotyping were identified by Sanger sequencing of genomic DNA obtained from 91 Iraqi participants (61 patients with metabolic syndrome and 30 control). Lipid profile, serum (glucose and insulin), glycated hemoglobin, blood pressure, body mass index, and waist circumfer

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Publication Date
Sun Mar 10 2024
Journal Name
Journal Of Sport And Health Research
The effectiveness of a rehabilitation program with aqueous media on the egree of pain and balance for those suffering from sacroiliitis in football players
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Abstract in English  The aim of this study is to identify the effectiveness of rehabilitation exercises in conjunction with aquatic therapy for those suffering from sacroiliitis in football players. The researcher used the experimental approach, using the experimental design (pre-measurement, post-measurement). Similar to the objectives and procedures of the research, the researcher assumed the following: the existence of significant differences. Statistics between pre- and post-measurements in variables in favor of post-measurement for the following variables (degree of pain and level of balance). The experimental approach was used with a pre- and post-measurement design on one group of football players with sacroiliitis, nu

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
The construction of Complete (kn,n)-arcs in The Projective Plane PG(2,5) by Geometric Method, with the Related Blocking Sets and Projective Codes
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A (k,n)-arc is a set of k points of PG(2,q) for some n, but not n + 1 of them, are collinear. A (k,n)-arc is complete if it is not contained in a (k + 1,n)-arc. In this paper we construct complete (kn,n)-arcs in PG(2,5), n = 2,3,4,5, by geometric method, with the related blocking sets and projective codes.

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Publication Date
Sat Oct 20 2018
Journal Name
Journal Of Economics And Administrative Sciences
Fluctuations of global crude oil prices and their effect on inflation and economic growth in Iraq " A standard study for the period 1988– 2015
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Abstract

That Iraq's dependence on the revenues of the oil product in financing its development programs and growth rates , Making the economy affected by external forces represented by fluctuations in crude oil prices in the global market, Which is directly reflected on the performance and efficiency of the Iraqi economy.

The study adopted its objectives to analyze the time series for the period (1988 - 2015) through the use of standard and statistical methods, Four standard models were estimated to reach those targets, Where the results of the stability test showed instability of most variables at their original level, But to achieve stability when taking the first differences, While the result

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Publication Date
Fri May 01 2020
Journal Name
Journal Of Engineering
Numerical investigation on heat transfer enhancement and turbulent flow characteristics in a high aspect ratio rectangular duct roughened by intersecting ribs with inclined ribs
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In this study, the effect of intersecting ribs with inclined ribs on the heat transfer and flow characteristics of a high aspect ratio duct has been numerically investigated. The Relative roughness pitch (P/e) is 10 and the Reynolds number range from 35,700 to 72,800. ANSYS (Fluent-Workbench 18.0) software has been utilized to solve the Reynolds averaged Navier-Stokes (RANS) equations with the Standard k-ε turbulence model. Three ribbed models have been used in this study. Model 1 which is a just inclined ribs, Model 2 which has a single longitudinal rib at the center with inclined ribs and Model 3 which has two longitudinal ribs at the sides. The results showed that the heat transfer rate has been enhanced when the int

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Publication Date
Tue Aug 01 2023
Journal Name
Nauchforum
COGNITIVE ELEMENTS AND CRITERIA OF THE INFLECTIONAL SYSTEM OF RUSSIAN AND ARABIC LANGUAGUES IN THE PROCCES OF VERBAL COMMUNICATION (COGNUTIVE ANALYSIS OF LANGUAGE STRUCTURE)
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In this paper we study the selection of cognitive elements and criteria of the inflectional structure of the Russian and Arabic languages in the process of speech communication. Phonetic-physiological principle is the main parameter by which the elements and criteria of cognitive activity in the presented study are distinguished. On the basis of the above mentioned parameter, we select the investigated criteria and elements. The first criterion is semantic, reflects the accordance of the elements of thinking to sound combinations in the studied languages, and allows us to distinguish the second criterion – morphonological. The second criterion depends on the phonetic changes of these combinations occurring in the process of speech activit

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Publication Date
Thu Aug 01 2013
Journal Name
Desalination And Water Treatment
Competitive biosorption of Pb(II), Cr(III), and Cd (II) from synthetic wastewater onto heterogeneous anaerobic biomass in single, binary, and ternary batch systems
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Biosorption of lead, chromium, and cadmium ions from aqueous solution by dead anaerobic biomass (DAB) was studied in single, binary, and ternary systems with initial concentration of 50 mg/l. The metal-DAB affinity was the same for all systems. The main biosorption mechanisms were complexation and physical adsorption of metallic cations onto natural active functional groups on the cell wall matrix of the DAB. It was found that biosorption of the metallic cations onto DAB cell wall component was a surface process. The main functional groups involved in the metallic cation biosorption were apparently carboxyl, amino, hydroxyle, sulfhydryl, and sulfonate. These groups were part of the DAB cell wall structural polymers. Hydroxyle groups (–O

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Crossref (13)
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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Management Representations Effect on Auditor Responsibility: Applied Research in a sample of Companies under Control and Audit of BSA and private sector auditing offices
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Management Representations Letter plays a significant role as an evidence to get conclusions the Auditor is looking for. These conclusions could show the professional opinion of auditor over the fairness and integrity of financial statements for many issues and numbers that management claims, Hereby, the research aims at highlighting the importance of Management Representations Letter and the way of using as an evidence with expressing its meaning and means of application in addition to identify the Responsibility of Auditor on that Letter, This research discusses also the effect of Management Representations Letter on the credibility of financial statement and enhancing the credibility of the submitted reports, From other side, in the t

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