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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 Apr 29 2025
Journal Name
Modern Sport
A Comparative Study on the Results of the Administrative Performance Skills Scale Among Heads of Sports Talent Departments in the Ministry of Youth and Sports
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Sports management is a fundamental pillar that supports sports institutions and plays a pivotal role in achieving advanced levels of success in talent development. The Talent Development Project is one of the key strategic initiatives of the Ministry of Youth and Sports. This study compares department heads with effective managerial competence to those with ineffective competence to highlight differences in performance quality. Through this comparison, the urgent need to assess the administrative performance skills of the heads of sports talent departments becomes evident, particularly their ability to lead and manage the Sports Talent Development Project. The objective is to identify strengths and weaknesses, establish a clear framework fo

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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of Physical Education
The Effect of Competitive Exercises Using Physical Performance Tracking Technology (GPS Playertek Plus and Polar H9) on Developing Speed in Iraqi Premier League Football Players
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Football is one of the most important team sports, practiced by men and women, young and old, across various age groups. The physical development in this sport can be attributed to athletic training and modern technology, which have contributed significantly to advancing the sports field in general. Outstanding performance in football requires precise and quick physical abilities, closely tied to the competitive nature of the game. Speed is fundamental in football, making the use of technologies such as GPS tracking devices and heart rate monitors essential in both training and matches. This study aims to develop the speed of Al-Talaba SC players in Baghdad using a scientifically-based approach to improve their performance. The impo

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Publication Date
Sat Jul 01 2023
Journal Name
Heliyon
Effect of plasma surface treatment of three different CAD/CAM materials on the micro shear bond strength with resin cement (A comparative in vitro study)
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Objectives: This study aimed to evaluate and compare the effect of plasma treatment versus conventional treatment on the micro shear bond strength (μSBS), surface roughness, and wettability of three different CAD/CAM materials. Materials and methods: Sixty cylindrical specimens (5 mm diameter ×3 mm height) were prepared from three different CAD/CAM materials: Group A: Zirconia, Group B: Lithium disilicate, and Group C: Resin nano-ceramic. Each group was subdivided into two subgroups according to surface treatment used: Subgroup I: Conventional treatment, zirconia was sandblasted with Al2O3, while lithium disilicate and resin nano-ceramic were etched with hydrofluoric acid. Subgroup II: Plasma treatment, the surface of each material was tr

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Publication Date
Thu Feb 01 2024
Journal Name
Baghdad Science Journal
Studying the Effect of Curcumin (Standard & Supplements) and Zinc on the Concentrations of Glucose, Insulin, HOMA-IR, and Anti-Mullerian Hormone in PCOS-Model Rats
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The goal of the current study was to investigate the effects of curcumin in both formulas (supplement and standard), zinc, and then use them together to show their effect on the levels of glucose, insulin, insulin resistance (IR), and anti-mullerian hormone (AMH) in the model of female rats with induced polycystic ovary syndrome (PCOS) using 1mg/kg/day of letrozole for 21 days followed by a treatment period of 14 days including different treatments of zinc 30 mg/kg, curcumin standard 200 mg/kg, curcumin supplement 200 mg/kg, (curcumin standard plus zinc), (curcumin Supplement plus zinc) and metformin as a standard treatment. After the treatment, all female rats were sacrificed, and blood samples were collected from the inferior vena cava

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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The role of the green human resources management practices in a achieving requirements of environmental citizenship- Field research at the General Company for Vegetable Oils.
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The research aims to determine the role of the practices of green human resources management in achieving requirements of environmental citizenship in the workplace, the General Company for Vegetable Oils was chosen for the application of field-side of research which represent one of the important industrial companies in Iraq, which suffers from poor Green human resources management applications, which reflected negatively on the development Environmental citizenship among Employees. The questionnaire use as a tool to collect data and information as well as field presence of the researcher, The research sample included (30) managers of departments and Division ,and through using statistical program (SPSS) the data has been analys

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Publication Date
Fri Jan 01 2021
Journal Name
Macromolecular Characterization Of Hydrocarbons For Sustainable Future
Feasibility of the Gas and Downhole Water Sink-Assisted Gravity Drainage (GDWS-AGD) Process to Enhance the Recovery of Oil in Reservoirs with Strong Aquifer
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Gas and Downhole Water Sink, Gravity Drainage, GDWS-AGD, Enhance the Recovery of Oil

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Publication Date
Wed Nov 07 2018
Journal Name
Asian Journal Of Pharmaceutical And Clinical Research
INVESTIGATING THE EFFECT OF DIFFERENT GRADES AND CONCENTRATIONS OF PH‑SENSITIVE POLYMER ON PREPARATION AND CHARACTERIZATION OF LIDOCAINE HYDROCHLORIDE AS IN SITU GEL BUCCAL SPRAY
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Objective: The present study was aimed to develop a pH-triggered in situ gel for local release of lidocaine hydrochloride (lidocaine HCL) in the buccal cavity to improve the anesthetic effect of this amino amide drug which has very high water solubility. The formulations were introduced to the oral cavity as a spray to improve compliance and for easier administration.Methods: In this work, two grades of carbopol (934 and 940)-based in situ gel spray were designed. The formulations containing lidocaine HCl 5% were prepared by mixing different concentrations of carbopol with xanthan gum. Eight formulations were investigated and evaluated for gelation capacity, spray angle, volume of solution delivered per each actuation, rheological p

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of effect of local exogenous application of Myrrh oil on healing of wound incisions of facial skin (Histochemical, Histological and Histomorphometrical study in rabbits)
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Aim of the study: Is to evaluate the effect of myrrh oil local application on the healing process of skin wounds histologically , histomorphometrically and , histochemically. Materials and methods:Twenty male white New Zealand rabbits were used in this study. An incisional wounds with full thickness depth and of 2 cm length were done on both sides of the cheek skin of each rabbit. The left sided incisions (the control group) were irrigated with distilled water (10µL). The right sided incisions (the experimental groups) were treated with myrrh oil (10µL). Each group was subdivided into 4 subgroups according to the healing interval into 1,3,7 and 14 days(5 rabbits for each group). Results: Histological findings of our current study s

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Publication Date
Sat Jan 02 2021
Journal Name
Journal Of The College Of Languages (jcl)
The psychological structure of Simha Bin Zion, in the story of A Broken Soul: המבנה הפסיכולוגי של הסופר שמחה בן ציון בסיפורו נפש רצוצה כדוגמה
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The present paper sheds light on the psychological structure of  Simha Bin Zion’s A Broken Soul. After reviewing the biography of the storyteller, it is clear that the hero of the rebellious character in the story of (A Broken Soul) is the writer himself. The storyteller directly begins to depict his psychological sufferings in his childhood days. He tells a story full of sadness and refusal of the neglect he suffered in his childhood. It is obvious that the early five years of Samha bin Zion’s life is considered a period of conflict that participated in the formation of his individual identity. The story represents an outlet for a hidden secret world buried under the layers of his consciousness. It deals with

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Publication Date
Sat Sep 30 2023
Journal Name
Industrial Engineering &amp; Management Systems
Empirically Measuring the Impact of Corporate Social Responsibility on Earnings Management in Listed Banks of the Iraqi Stock Exchange: The Mediating Role of Corporate Governance
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The current study is based on previous findings, where corporate governance (CG) significantly increased corporate social responsibility (CSR) to enhance transparency while reducing the tendency of corporate management to engage in earnings management (EM). A sample of 11 Iraqi banks listed on the Iraq Stock Exchange from 2010 to 2020 was selected. The CG was included in the board size and board independence apart from the variables of Chief Executive Officer (CEOs) gender, majority shareholder ownership, foreign ownership, and institutional ownership. The CSR included the wage growth rate, bank contribution growth rate for social security, training programmes, subsidies, environmental protection, and bank compliance with the law. Specifica

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