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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
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
The current research aims to identify the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham
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  • Identifying the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham.
  • Identifying the statistically significant differences in the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham according to the gender variable.
  • And the descriptive approach was used, due to its relevance to the nature of the research objective.

    To verify this, the visual culture skills test consisted of (22) items of the multiple choice type, where the (Koder Richardson 20) equation was applied to calculate the stability of the visual culture skills test. For the skill of writing

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Publication Date
Fri Dec 31 2021
Journal Name
Journal Of Communicable Diseases
The Relation between RT-PCR and Chest CT Scan Sensitivity as Tools in the Diagnosis of COVID-19 Patients in Al-Najaf Province, Iraq
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The typical test for diagnosis of severe acute respiratory syndrome coronavirus 2 is a reverse transcription-polymerase chain reaction (RT-PCR) technique, but the chest CT scan might play a complementary role at the first detection of Coronavirus Disease 2019 (COVID-19) pneumonia. Objectives: To determine the sensitivity of CT scan on patients with COVID-19 in Al-Najaf, Iraq, and to compare the accuracy of CT scan with that of RT-PCR technique. Material and Method: This is a prospective study. The patients suspicious of having COVID-19 infection and respiratory symptoms were registered. All patients were diagnosed by RT-PCR and chest CT. Diagnostic performance of CT was intended using RT-PCR as the reference sta

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Publication Date
Wed Jan 20 2010
Journal Name
Mustansiria Dental Journal
Traumatic dental injuries of the permanent incisors and its relation to malocclusion in patients attending the pedodontic clinic in College of Dentistry, Baghdad University
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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Pharmaceutical Negative Results
The Effect of Ferric Citrate in Controlling Iron Deficiency Anemia and its Tolerability in a Sample of Iraqi Hemodialysis Patients: Randomized Controlled Clinical Trial
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Background: The iron deficiency anemia along with hyperphosphatemia are the main complications of dialysis patients. Traditional iron supplement has been failed to correct iron deficiency anemia, therefore, the current study aimed to investigate the efficacy and tolerability of new phosphate binder, ferric citrate, in a sample of Iraqi patients with end stage renal disease on maintenance hemodialysis. Method: Prospective, randomized, open label, active controlled trial was conducted in one center for dialysis in Babylon governance. Patients were randomized to receive ferric citrate with dose of 6 g/d and calcium carbonate with dose of 3 g/d for eight weeks. Hemoglobin concentration, mean corpuscular hemoglobin concentration and count o

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Publication Date
Sun Jan 01 2017
Journal Name
Indian Journal Of Pathology And Microbiology
Assessment of topoisomerase II-alpha gene status by dual color chromogenic in situ hybridization in a set of Iraqi patients with invasive breast carcinoma
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Abstract Background: The human epidermal growth factor receptor 2(HER2) proto-oncogene is overexpressed or amplified in approximately 15%-25% of invasive breast cancers. Approximately 35% of HER2-amplified breast cancers have coamplification of the topoisomerase II-alpha (TOP2A) gene encoding an enzyme that is a major target of anthracyclines. Hence, the determination of genetic alteration (amplification or deletion) of both genes is considered as an important predictive factor that determines the response of breast cancer patients to treatment. The aims of this study are to determinate TOP2A status gene amplification in a set of Iraqi patients with breast cancer that have had an equivocal (2+) and positive HER2/neu by immunohistochemistry

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Publication Date
Tue Jan 01 2019
Journal Name
Iraqi Journal Of Agricultural Sciences
Role of calcium-regulating hormones, adipocytokines and renal function test in the progress of type 2 diabetes mellitus in a sample of Iraqi patients
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A cross-sectional study was conducted on 80 type 2 diabetic patients aged 20-60 years in Baghdad and 20 non diabetic persons as controls. Laboratory assessment of glucose related parameters; Fasting blood sugar (FBS), Glycated hemoglobin (HbA1c), Insulin and Insulin resistance (IR), renal function test; Blood urea, serum creatinine, Calcium (Ca) and Phosphorus (P), Calcium regulating hormones; Parathyroid hormone (PTH), calcitonin and vitamin D, cytokines, Adiponectin and Tumor necrosis factor (TNF-α) and comparison these parameters between patients and controls. The results: a high significant (p˂0.01) increase in FBG level in the patients (211.34 ± 11.20 mg/dl) as compared with control (85.89 ± 3.07 mg/dl). A high significant (p˂0.01

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Publication Date
Sat Dec 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
The relation of maxillary root apices and the maxillary sinus floor among patients with different skeletal patterns in Iraqi samples
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Background: Understanding the morphological characteristics between the floor of the maxillary sinus and the tips of the maxillary posterior roots is crucial in orthodontics involving diagnosis and treatment planning. The aim of this study was to evaluate the distances from the maxillary posterior root apices to the inferior wall of the maxillary sinus, thickness and density of maxillary sinus floor using cone-beam computed tomography images and the relationships between roots and maxillary sinus according to gonial angle and skeletal pattern. Materials and methods: Three-dimensional images of each root were checked, and the distances were measured along the true vertical axis from the apex of the root to the sinus floor, and the thickne

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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
Efficiency and Safety of Desferioxamine Chelation Therapy in Paediatric Patients with Transfusion-Dependent Anaemia: Experience of two Centres from Sudan
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Background: Repeated blood transfusion   is   the main   therapeutic option for transfusion-dependent anaemias with consequent iron overload and organ damage .Therefore iron chelating agents are important protective measures for these patients. The aim of this study was  to investigate  the efficiency and safety of Desferroxamine  in paediatrics population subjected  to iron overload as a consequence  of repeated transfusion in a group of  Sudanese children  

Subjects & Methods: This was a descriptive cross-sectional hospital based study.  Conducted in two main paediatric reference hospitals   in, Su

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Publication Date
Mon Dec 07 2020
Journal Name
Iranian Journal Of Parasitology
Serum levels of il-12 and il-23 in breast cancer patients infected with toxoplasma gondii: A case-control study
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Scopus
Publication Date
Sun Jan 01 2023
Journal Name
Medical Journal Of Babylon
Evaluation of the Salivary Levels of Interleukin-17 and Galectin-3 in Patients with Periodontitis and Type 2 Diabetes Mellitus
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Background: Periodontitis and type 2 diabetes mellitus are both considered as a chronic disease that affect many people and have an interrelationship in their pathogenesis. Objective: The aim is to evaluate the salivary levels of interleukin-17 (IL-17) and galectin-3 in patients with periodontitis and type-2 diabetes mellitus. Materials and Methods: The samples were gathered from 13 healthy (control group) and 75 patients split into 3 groups, 25 patients with type 2 diabetes mellitus and healthy periodontium (T2DM group), 25 patients with generalized periodontitis (P group), and 25 patients with generalized periodontitis and type 2 diabetes mellitus (P-T2DM group). Clinical periodontal parameters were documented. The concentration of IL-17

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