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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 Jun 21 2020
Journal Name
Baghdad Science Journal
Detection of Aflatoxin B1 among Early and Middle Childhood Iraqi Patients
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      The study was conducted for the detection of Aflatoxin B1(AFB1) in the serum and urine of 42 early and middle childhood patients (26 male and  16 female ) with renal function disease, liver function disease, in additional to atrophy in the growth and other symptoms depending on the information within consent obtained from each patient, in addition to 8 children, apparently healthy, as  the control. The technique of HPLC was used for the detection of AFB1 from all samples. The results showed that out of 42 patient children, 19 (45.2%) gave positive detection of AFB1 in the serum among all age groups patients with a mean of 0.88 ng/ml and a range of (0.12-3.04) ng/ml. This was compared with the cont

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Publication Date
Tue Sep 10 2024
Journal Name
Iraoi Academic Scientific Journals
The Psychological and Physical Life Difficulties of Patients with nerve fascicle
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Publication Date
Wed Jun 30 2021
Journal Name
Annals Of R.s.c.b.
Multidrug Resistant Enteric Bacteria Isolated From Patients With Urinary Tract Infections
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Background and Objectives: Urinary tract infections (UTIs), among a wide range of microbial infections, are of a double-edged worry with health-care and economic implications. They are serious diseases that can influence various parts of the urinary tract. The aim of this study was characterization of the enteric bacteria isolated from urine of human UTIs and studying their antimicrobial sensitivity. Materials and methods: A total of 50 urine samples were collected from patients with UTIs of both genders. The isolates identification was done using routine diagnostic methods and confirmed by Vitek2. Antimicrobial susceptibility was done against 10 antimicrobials. Results: Both genders of human were found to suffer from urinary tract problems

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Patients' Knowledge and adherence to Clopidogrel Therapy post Percutaneous Coronary Intervention
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Abstract

Objectives: To assess patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention, and to find out the relationship between patients’ knowledge and their adherence to Clopidogrel Therapy Post Percutaneous Coronary Intervention

Methodology: A descriptive design was carried out at Al- Nasiriyah Heart Center in Thi-Qar Governorate for the period between May 19th, 2022 to October 25th, 2022. A non-probability sampling was used among (50) patients after their Percutaneous Coronary Intervention. The study instrument that used to collect data was composed of three parts namely: sociodemographic charac

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Sexual Dysfunctions among Male Schizophrenic Patients Attending Al- Rashad Sex Clinic
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Background: Sexual dysfunction in patients with schizophrenia was reported as one of the most distressing antipsychotics drug adverse effects and it is directly related to treatment compliance, but the subject seldom touched in the field of psychiatry in Iraq previously.Objectives: To assess and find out the impact of schizophrenia on Sexuality of the patient, and illustrate effect of anti-schizophrenic on sexual activityMethods: using DSM4-TR and ASEX scale questionnaires for 104 male participants from out 155schizophrenic patient were studied in sex clinic in Al-Rashad teaching hospital for psychiatric disease in Baghdad. The study extended for 22 months from 1st of July 2010 to the 1st of April 2012, t test and chi square test were us

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Publication Date
Tue May 11 2021
Journal Name
Egyptian Journal Of Medical Human Genetics
Molecular analysis of CFTR gene mutations among Iraqi cystic fibrosis patients
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Abstract<sec> <title>Background

Cystic fibrosis (CF) is an autosomal recessive multisystem disease that results from mutation(s) of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. More than 2100 mutations and polymorphisms have been reported in this gene so far. Incidence and genotyping of CF are under-identified in Iraq. This study aims to determine the types and frequencies of certain CFTR mutations among a sample of Iraqi CF patients. Two groups of patients were included: 31 clinically confirmed CF patients in addition to 47 clinically suspected patients of CF. All confirmed pa

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Publication Date
Tue Nov 01 2011
Journal Name
Journal
Frequency of autoimmune diseases and estimation of P53 among vitiligo patients
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KE Sharquie, AA Noaimi, SY Mohsin, 2011 - Cited by 4

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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Rate of Schneiderian First Rank Symptoms among Newly Diagnosed Schizophrenic Patients
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Background: Schneiderian first rank symptoms are
considered highly valuable in the diagnosis of
schneideria.
They are more evident in the acute phase of the
disorder and fading gradually with time. Many studies
have shown that the rate of these symptoms are
variable in different countries and are colored by
cultural beliefs and values.
Objectives: To find out the rate of Schneiderian first
rank symptoms among newly diagnosed schizophrenic
patients, to assess which symptom(s) might
predominate in those patients, and to find out if there
is/are any correlation(s) between the occurrence of
these symptoms and the sex of the patients.
Methods: Out of twenty-four patients with no past
psychiatric hi

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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Evaluation of Patients with Liver Injuries Treated by Perihepatic Gauze Packing
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Background: The liver is one of the most common organs
injured after blunt abdominal trauma. The control of severe
hemorrhage remains a problem.
Methods: One-hundred thirty-eight patients diagnosed as
liver injury between 09/2003 and 08/2006 had been evaluated
prospectively in Al- Kindy Teaching Hospital.
A distinction was made between hemodynamically stable and
unstable patients. Different modalities of surgical procedures
were done concentrating on perihepatic gauze packing.
Results: (60 out of 138) patients included in the study were
clinically evaluated as hemodynamically stable. The average
abbreviated injury severity score (ISS) was 25. Twenty
patients underwent abdominal surgery. In 12 of them

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Publication Date
Sun Apr 01 2007
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Isolation of some microorganisms from Iraqi patients with chronic maxillary sinusitis.
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