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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 31 2023
Journal Name
Journal Of Molecular Modeling
Ab initio study of structural, mechanical and electronic properties of 3d transitional metal carbide in cubic rocksalt (rs), zincblende (zb), and cesium chloride (cc) structures by using LDA and GGA Approximation
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This study rigorously investigates three 3d transition metal carbide (TMC) structures via LDA and GGA approximations. It examines cohesive energy (Ecoh), Vickers hardness (Hv), mechanical stability, and electronic properties. Notably, most 3d TMCs exhibit higher cohesive energy than nitrides, and rs-TiC demonstrates a Vickers hardness of 25.66 GPa, outperforming its nitride counterpart. The study employs theoretical calculations to expedite research, revealing mechanical stability in CrC and MnC (GGA) and CrC (LDA in cc structure), while all 3d TMCs in rs and seven in zb structures show stability. Charge transfer and bonding analysis reveal enhanced covalency along the series, influenced by the interplay between p orbitals of carbon and d o

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of The College Of Languages (jcl)
(comparative analysis of phraseological units in the lexical-semantic field "on the material of Arabic and Russian languages"): (сопоставительный анализ фразеологических единиц лексико-семантического поля " на материале арабского и русского языков")
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Establishing the systemic character of vocabulary, its relationship with other language systems, their interdependence creates the possibility of a comprehensive scientific study and description of the lexical system of each language, as well as contrastive comparative studies of several languages, including their phraseological composition.

It is known that not all words-components of phraseological units are equivalent in their role in the formation of the semantic content of phraseological units. In this regard, it is necessary to introduce the concept of a lexical dominant. To this we include words, which are kind of centers around which the entire semantic complex of phraseological units, the entire set of its words-componen

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Publication Date
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
A study to compare the internal fitness and marginal gap between single crowns and crowns within three-unite bridge of zirconia substructure fabricated by CAD-CAM system. (An In vitro study)
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ABSTRACT Purpose: the aim of this in vitro study was to compare the marginal gap and internal fitness between single crowns and the crowns within three-unit bridges of zirconium fabricated by CAD-CAM system. Materials and methods: A standard model from ivoclar company was used as a pattern to simulate three-units bridge (upper first molar and upper first premolar) as abutments used to fabricate stone models, eight single crowns for premolar and eight of three units bridges. Crowns and bridges fabricated by CAD-CAM system were cemented on their respective stone models then sectioned at the mid-point buccolingaully and misiodistaly and examined under stereomicroscope. Result: the marginal gap in premolar crowns and premolar within bridge we

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Publication Date
Wed Jun 24 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Shear bond strength of stainless steel brackets bonded to porcelain surface treated with 1.23% acidulated phosphate fluoride gel compared to hydro fluoric acid with silane coupling agent (In vitro comparative study)
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Background: With the increasing demands for adult orthodontics, a growing need arises to bond attachments to porcelain surfaces. Optimal adhesion to porcelain surface should allow orthodontic treatment without bond failure but not jeopardize porcelain integrity after debonding.The present study was carried out to compare the shear bond strength of metal bracket bonded to porcelain surface prepared by two mechanical treatments and by using different etching systems (Hydrofluoric acid 9% and acidulated phosphate fluoride 1.23%). Materials and Methods: The samples were comprised of 60 models (28mm *15mm*28mm) of metal fused to porcelain (feldspathic porcelain). They were divided as the following: group I (control): the porcelain surface left u

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
Psychological social conflict and its relation with family parental style for adolescences from the intermediate stage student at governmental Hail school, in the light of economical levels and sex variables .KSA
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The current research attempts to examine the relationship between social-psychological conflict and their relation to family upbringing approaches among the adolescents of intermediate stage according to sex and economical level. To do this, the researcher prepared a questionnaire to measure social-psychological conflict that consisted of (32) item divided on four dimensions, and also she prepared a questionnaire to measure family upbringing approaches which composed of (28) item divided on four dimensions. The sample was (260) male and female student from intermediate stage chosen randomly. The results revealed that there were significant differences between social-psychological conflict which went to male, there was a negative correlat

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Publication Date
Mon Dec 30 2019
Journal Name
College Of Islamic Sciences
The mother of the believers, the mother of Salamah and her narrators of jurisprudence In attaining the goal of the rulings evidence Ibn Hajar al-Asqalani (d. 852 AH)      (prayer book)
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The Muslim woman actively participated in narrating, preserving, controlling and maintaining the hadith, along with her brother, the man who later became an inexhaustible representative of the effort to preserve, control, and narrate the Sunnah. Undoubtedly, the mothers of the believers, may God be pleased with them, had a great advantage in communicating Islam and spreading the Sunnah of the Prophet Especially among women, all of them heard from him, may God’s prayers and peace be upon him, and lived with him in the details of his life on the disparity between them in memorizing and narrating and publishing them. It narrated (378) recently, and it is considered the second narrator after the mother of the believers Aisha, may God be pl

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Publication Date
Tue Dec 13 2022
Journal Name
Dental Hypotheses
Comparative Evaluation of Marginal Microleakage Between Bulk-Fill, Preheated Bulk-Fill, and Bulk-Fill Flowable Composite Resins Above and Below Cemento-Enamel Junction Using Micro-Computed Tomography: An In Vitro Study
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Objective: The aim of this study was to compare the marginal microleakage between bulk-fill, preheated bulk-fill, and bulk-fill flowable composite resins above and below cemento-enamel junction (CEJ) using micro-computed tomography. Methods: Sixty freshly extracted premolar teeth were prepared with a slot shaped cavities of a total of 120 Class II: 3mm (bucco-lingual), 2mm (mesio-distal) with mesial-gingival margin located 1mm coronal to CEJ, and distal gingival margin located 1mm apical to the CEJ. The samples were randomly divided into two main groups according to the restorative material (Tetric EvoCeram and 3M Filtek), and each group was further sub-divided into three subgroups according to the consistency (bulk fill, preheated bulk fil

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Publication Date
Sun Apr 30 2017
Journal Name
Journal Of Engineering
Experimental Study on Heat Transfer and Friction Factor Characteristics of Single Layer Graphene Based DI-water Nanofluid in a Circular Tube under Laminar Flow and Different Heat Fluxes as Boundary Conditions
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An experimental study was performed to estimate the forced convection heat transfer performance and the pressure drop of a single layer graphene (GNPs) based DI-water nanofluid in a circular tube under a laminar flow and a uniform heat flux boundary conditions. The viscosity and thermal conductivity of nanofluid at weight concentrations of (0.1 to 1 wt%) were measured. The effects of the velocity of flow, heat flux and nanoparticle weight concentrations on the  enhancement of the heat transfer are examined. The Nusselt number of the GNPs nanofluid was enhanced as the heat flux and the velocity of flow rate  increased, and the maximum Nusselt number  ratio (Nu nanofluid/ Nu base fluid)   and thermal performance factor

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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Extent of Organizational Dynamic Capabilities' Contribution to Human Talent Management: An Analytical Study of the Opinions of a Sample of Administrative Leaders in the Presidency of the University of Mosul.
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The recognition of the dynamic organizational capabilities in their actual and influential extent in the work environment achieves a set of positive data that can fall under the addition axes, particularly with regard to the organization's ability to manage human talents in them, so the researchers sought to identify the level of contribution of dynamic organizational capabilities in the management of human talents in terms of Keep them away in the research organization by indicating the level of relationship and impact between them. The presidency of Mosul University was chosen as a field for the current study, and data were collected by adopting the questionnaire form as the main tool for the study. The study used a deliberate

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Banking Governance According to the principles of the Basel Committee and its impact on the achievement of the strategic objectives of banks Study in a sample of private commercial banks Iraqi
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     This study aims to impact statement played by banking governance according to the decisions of the Basel Committee in achieving the strategic objectives of the banks, But order to achieve the this goal has been the adoption of two hypotheses in addition to the two main hypotheses as sub answered preliminary The study seeks to verify their health and two (no correlation relationship and impact between Banking  governance and achieve strategic objectives), has been tested hypotheses. Study has reached

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