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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 Jan 13 2011
Journal Name
Tikrit Journal Of Agricultural Sciences
ESTIMATION OF GENE ACTION AND GENETIC PARAMETERS FOR SOME CHARACTERS OF YIELD AND ITS COMPONENTS IN SUMMER SQUASH (Cucurbita pepo L.) BY USING MEAN GENERATION ANALYSIS
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An experiment was carried out in the vegetables field of Horticulture Department / College of Agriculture / Baghdad University , for the three seasons : spring and Autumn of 2005 , and spring of 2007 , to study the type of gene action in some traits of yield and its components in summer squash crosses (4 x 3 = cross 1 , 3 x 7 = cross 2 , 3 x 4 = cross 3 , 3 x 5 = cross 4 , 5 x 1 = cross 5 , 5 x 2 = cross 6). The study followed generation mean analysis method which included to each cross (P1 , P2 , F1 , F2 , Bc1P1 , Bc1P2) , and those populations obtained by hybridization during the first and second seasons. Experimental comparison was performed in the second (Two crosses only) and third seasons , (four crosses) by using RCBD with three repl

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Publication Date
Fri Dec 01 2017
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST RECORD OF ADONTOMERUS AMYGDALI (BOUCEK, 1958) (HYMENOPTERA, TORYMIDAE): A PARASITOID OF THE ALMOND FRUIT WASP, EURYTOMA AMYGDALI ENDERLEIN, 1907 (HYMENOPTERA, EURYTOMIDAE) IN ERBIL PROVENCE, IRAQ
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    Adontomerus amygdali (Boucek, 1958) (Hymenoptera, Torymidae) is recorded for the first time in Iraq, parasitizing almond fruits wasp, Eurytoma amygdali Enderlein, 1907 (Hymenoptera, Eurytomidae) infesting fruits of almond trees Prunus dulcis (Mill.) D. A. Webb (=Amygdalus communis Linn.)   growing in Koysinjaq district, Erbil, Iraq. A short morphological description of this species is presented.

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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The role of leader-member exchange in the organizational citizenship behavior according to organizational trust Analytical research at the center of Ministry of Migration and Displaced
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This research aimed to examine the correlation and influence of leader-member exchange in the organizational citizenship behavior in the existence of organizational trust as mediator variable among workers in ministry of migration and displaced, has been collecting data and information relating to research by designing questionnaire was distributed to the stratified random sample included (56) member of the workers in the ministry mentioned, and through the use of several statistical method were the main findings of research was the existence of a correlation relationship and influence between leader- member exchange and organizational trust, while the results confirmed no correlation and influen

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Using the Balanced Performance Approach to Increase the Effectiveness of Strategic Planning in order to Maximize the Job Satisfaction Rates at the Faculties of Bisha University
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Purpose: To use the balanced measurement approach as a strategic link for increasing the effectiveness of strategic planning in the direction of achieving satisfaction rates at Bisha University in Saudi Arabia

Design / methodology / approach –The questionnaire survey was used to collect the data of the study from the faculty members at University of Bisha.

Findings –Prove the assumption that the use of the balanced measurement approach - as a strategic planning tool - leads to maximize the satisfaction rates among faculty members at the University of Bisha.

Research limitations/implications-  adopt effective strategic planning in order to achieve

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Publication Date
Tue Apr 18 2023
Journal Name
Al–bahith Al–a'alami
Public relations programs and its role to enhance the morale of employees in the Ministry of Transportation: A survey study on the State land Transport Company
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This research aims to learn about public relations programs and their role to enhance the morale of the State land Transport Company employees.The researcher relied on the survey method and use a questionnaire and scale tools to collect information from workers in the Department of Relations and Media and employees in all departments.
The research reached several conclusions, including:
1- Public relations seek to increase workers’ confidence in senior management and motivate them to improve their production, as well as their relentless endeavor to bring workers closer by following multiple and varied forms of communication with them.
2- The results of the study showed that there was a negative i

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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Integrated Framework for technologies to reduce costs and reengineering processes to develop strategies companyes An Empirical Study In some companies affiliated to the Ministry of Oil
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Began the process of re-engineering processes in the private sector as a way to assist organizations in re-thinking how to run the business in order to improve production processes and reduce operational cost, to get to compete on a global level. That was a major restructuring by further evolution in the use of technology to support innovative operations.

 Entered the technology in all areas of life and different regulations, This led to use as a change in all aspects The companies achieved success and progress today through the use of resources so as to ensure the wishes of the customers and their needs, and the requirements of the market primarily, Which is reflected on the basis of building strate

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Publication Date
Thu Jun 27 2024
Journal Name
Iraqi Journal Of Pharmaceutical Sciences
Synthesis, Characterization and Anticancer Activity of Chitosan Schiff Base / PEG Blend Doped with Gold and Silver Nanoparticles in Treatment of Breast Cancer Cell Line MCF-7
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In the present study, chitosan Schiff base has been prepared from chitosan reaction with p-chloro benzaldehyde. The AuNPs and AgNPs were manufactured by extract of onion peels as a reducing agent. The AuNPs and AgNPs that have been synthesized were characterized through UV-vis spectroscopy, XRD analyses and SEM microscopy. The polymer blends of the chitosan / PEG has been prepared by using the approach of solution casting. Chitosan Schiff base / PEG Au and Ag nanocomposites were synthesized, nanocomposites and polymer blends have been characterized by FTIR which confirm the formation of Schiff base by revealing a new band of absorption at 1693 cm-1 as a result of the (C=N) imine group. FESEM, DSC and TGA confirm the thermal stability

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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Immunohistochemical Expression of MMP2, VEGF and D2-40 as Biological Markers of Local Invasion Potential, Angiogenesis and Lymphangiogenesis in Oral Squamous Cell Carcinoma and Verrucous Carcinoma
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Background: Verrucous carcinoma (VSCC) is considered as a rare well differentiated carcinoma variant of SCC with no metastatic potential. The aim of this study is to evaluate the Immunohistochemical expression MMP-2, VEGF and D2-40 expression in OSCC and VSCC. Materials and methods: Thirty formalin fixed paraffin embedded tissue blocks of OSCC and another twelve VSCC were collected and Four micrometer thick sections were cut from each block and mounted on positively charged slides and stained immunohistochemically with monoclonal antibodies to MMP-2, VEGF and D2-40. Results: there is no statistical difference between SCC and VSCC regarding the immunoexpression of MMP-2 and VEGF. While the lymphatic vessels density were higher in SCC than V

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Publication Date
Tue Jul 01 2025
Journal Name
The International Journal Of Advanced Manufacturing Technology
Impact of tool geometry on void evolution, stress non-uniformity, and thermomechanical interaction in friction stir welding of T-joints using CEL simulation and experimental validation
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Although Friction Stir Welding (FSW) is broadly invested in joining aluminum alloys, welding T-joint configurations display revealing challenges due to the interface’s intricate material flow and stress development. Defect formation, including voids and lack of fusion, as well as sudden response forces and residual stresses, can substantially undermine joint performance. This study presents an innovative three-dimensional finite element model to predict the coupled thermomechanical conditions experienced during the friction stir welding (FSW) of AA 6061-T6 lap T-joint design. The study identifies the geometrical parameters of the FSW tool, including shoulder and pin diameters, as well as pin form (cylindrical and tapered), as critical var

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of The College Of Languages (jcl)
فارسی Practical application of Jean René Ladmiral's model in translation from Arabic to Persian: کاربست عملی الگوی ژان رنه لادمیرال در ترجمه از عربی به فارسی
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Translation is a dynamic and living process that cannot be considered equal to the original text and requires the appropriate structure, language, thought and culture of the target language, and the translator's intellectual, linguistic and cultural influences inadvertently penetrate into the translated text. It causes heterogeneity of the destination text with the source text.

Admiral's theory is trying to help by providing components and suggested approaches to resolve these inconsistencies. In the meantime, in addition to the mission of putting words together, the translator must sometimes sit in the position of the reader and judge and evaluate the translated text in order to understand its shortcomings and try to correct it a

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