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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
Sat Dec 28 2024
Journal Name
Dental Hypotheses
Assessment of Color Change of Artificial White Spot Lesions after Sandblasting with Bioactive Glass, Resin Infiltration, or Microabrasion Followed by Color Stability Test by pH Cycling: An in Vitro Study
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Introduction: This study aimed to assess the color change of human teeth with artificial enamel white spot lesions (WSLs) after sandblasting with bioactive glass, resin infiltration, and microabrasion and to test color stability after pH cycling. Methods: Fifty extracted human mandibular first molars were randomly assigned into five groups: Sound, WSLs (untreated), and WSLs sandblasted with bioactive glass (Sylc), WSLs treated by resin infiltration (ICON), and WSLs treated by microabrasion (Opalustre), respectively. All specimens underwent a pH cycling procedure. The color parameters for each specimen were assessed using an Easyshade dental spectrophotometer at different time stages then the color changes (ΔE) were calculated. Results: The

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Office managers skills and it's impact on the effectiveness of time management A survey of a sample of departments managers in the institutes and faculties at the middle technical university
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The objective of this study is to highlight the skills of office managers and it's impact on the effectiveness of time management in the institutes and faculties of middle technical university and a group of cognitive and practical aims. The managers skills forms mthe modern trend and the main source to provide organizations with highly skilled managers with distinctive performance and because of the sharp changes in the environment which today's organizations works in it , business organizations generally and managers especially realise the importance of time management and it's role in achieving competitive advantage . The problem of this study raised from this point which reflect the extent of departments managers realisation

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Publication Date
Tue Sep 01 2020
Journal Name
Al-nahrain Journal Of Science
Spectrophotometric Determination of Co(II) in Vitamin B12 Using2-(biphenyl-4-yl)-3-((2-(2,4-dinitrophenyl) hydrazono)methyl) imidazo [1,2-a]pyridine as Ligand by Flow Injection–Merging Zone Analysis
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Publication Date
Wed Jan 11 2023
Journal Name
College Of Islamic Sciences
The jurisprudential aspects of Imam Abu al-Fayyadh al-Basri And its impact on the Shafi’i school of thought, In the provisions of transactions, personal status, felonies, borders, and others
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Summary of the discussion of the jurisprudential aspects of Imam Abu Al-Fayyad Al-Basri, and their impact on the Shafi’i school, on the provisions of transactions, personal status, janaabah, limits, and others

      Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of the Messengers, our master Muhammad, and upon his pure family, and his ignorant and ignorant companions, and those who followed them in goodness until the Day of Judgment.

     Then:

     The many jurisprudential aspects that the Shafi’i imams said are of great importance, because these aspects are nothing but the opinions of venerable jurists who have reached a high degree of knowledge unti

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Publication Date
Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The use of the methods of the lower squares and the smaller squares weighted in the estimation of the parameters and design of the sample acceptance schemesFor general exponential distribution
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The acceptance sampling plans for generalized exponential distribution, when life time experiment is truncated at a pre-determined time are provided in this article. The two parameters (α, λ), (Scale parameters and Shape parameters) are estimated by LSE, WLSE and the Best Estimator’s for various samples sizes are used to find the ratio of true mean time to a pre-determined, and are used to find the smallest possible sample size required to ensure the producer’s risks, with a pre-fixed probability (1 - P*). The result of estimations and of sampling plans is provided in tables.

Key words: Generalized Exponential Distribution, Acceptance Sampling Plan, and Consumer’s and Producer Risks

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Publication Date
Sun Oct 01 2023
Journal Name
Baghdad Science Journal
Detecting DNA of multispecies dinoflagellate cysts in the sediment from three estuaries of Makassar strait and fishing port using CO1 primer: Is it CO1 primer suitable for detecting DNA dinoflagellate?
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Most dinoflagellate had a resting cyst in their life cycle.  This cyst was developed in unfavorable environmental condition. The conventional method for identifying dinoflagellate cyst in natural sediment requires morphological observation, isolating, germinating and cultivating the cysts.  PCR is a highly sensitive method for detecting dinoflagellate cyst in the sediment.  The aim of this study is to examine whether CO1 primer could detect DNA of multispecies dinoflagellate cysts in the sediment from our sampling sites. Dinoflagellate cyst DNA was extracted from 16 sediment samples. PCR method using COI primer was running. The sequencing of dinoflagellate cyst DNA was using BLAST. Results showed that there were two clades of dinoflag

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Publication Date
Mon Sep 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Supervisory oversight role for the central bank to raise awareness of the banking supervisory: Applied Research in the Central Bank of Iraq and a sample of the Iraqi private banks
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Representing banking supervision An important function performed by the Iraqi Central Bank, in order to achieve stability in the financial and banking system, and safeguard the rights of depositors, investors and other targets, and to realize the Iraqi Central Bank banking supervision actors on banks, there must be an awareness of regulatory bank's existing control and subject them, as well as the role of banking oversight interested in spreading this awareness.
So sought search to find out the role played by the Iraqi Central Bank in raising awareness of the regulatory banking between the parties to the regulatory process, through the presentation and analysis of the legal framework for banking supervision and awareness supervisory

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of tax techniques on the quality of services provided to income taxpayers: An exploratory study in a sample of the branches of the General Tax Authority / Baghdad Governorate
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The research aims to demonstrate the impact of tax techniques on the quality of services provided to income taxpayers by studying the correlational and influencing relationships between the exploited variable (tax techniques) and the dependent variable (the quality of services provided to income taxpayers), and in line with the research objectives, the main hypothesis of the research was formulated (there is a relationship Significance between tax techniques and the quality of services provided to income taxpayers) a number of sub-hypotheses emerged from this hypothesis that were stated in the research methodology, and a number of conclusions were reached, the most important of which were (through the use of the correlation coeff

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Publication Date
Sat Apr 29 2023
Journal Name
International Journal Of Biomaterials
The Influence of the Hyaluronic Acid Gel on the Postoperative Sequelae following Surgical Removal of the Impacted Mandibular Third Molar in Comparison with the A-PRF: A Randomized Controlled Trial
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One of the most common procedures in oral surgery is the removal of impacted mandibular third molars, often followed by pain, swelling, alveolitis, and trismus. Purpose. To compare the outcomes of the intrasocket application of 1% hyaluronic acid oral gel (HA) and advanced platelet-rich fibrin (A-PRF) on the expected postoperative complications, pain, swelling, and trismus follow the surgical extraction of the impacted mandibular third molar. Material and Methods. A randomized controlled trial was conducted at the Oral and Maxillofacial Surgery Unit, Dental Teaching Hospital. Healthy patients who required surgical removal of the impacted mandibular third molar were divided randomly into three groups. The extraction site of the group

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Organizational commitment and its role in enhancing the performance of employees : exploratory search of the views of a sample of managers and employees of the General Company for Dairy Products
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Expected to The organizational commitment by employees increases their loyalty towards their organization and thus contribute to enhancing their performance , therefore this study aimed to discover the relationship and the impact between the organizational commitment (emotional commitment, standard commitment, continuous commitment) and the performance of employees in the company researched, additional to know the available organizational commitment levels of employees in the company researched and its impact on the performance of employees, Research was conducted at the General Company for products in the dairy to achieve the goals of research has been developed questionnaire conation (22 ) items to collect data from the study s

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