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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
Fri Sep 09 2022
Journal Name
Revista Mexicana De Oftalmología (english Edition)
Posterior subtenon triamcinolone acetonide combined with phacoemulsification for patients with diabetic maculopathy
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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Poly Acrylamide Gel Electrophoresis of Serum Protein, Application to Kala-azar Patients
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         Sera samples were collected from 60 children aged 4-60 months, all were clinically and serologically proven cases of visceral leishmaniasis, as well as  from 10 healthy children, all were seronegative with no history of parasitic infection who serve as a control during the study. Serum total protein and albumin were measured and compared between the control and visceral leishmaniasis patients. Serum protein profiles have been investigated using the conventional sodium dodecyl sulphate – polyacrylamide gel electrophoresis (SDS-PAGE).  Serum of control group showed the specific protein pattern with five protein bands, while serum protein profile in visceral leishmaniasis pat

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Publication Date
Tue Jan 01 2019
Journal Name
Biochemical And Cellular Archives
Phenotypic and molecular detection of Escherichia coli efflux pumps from UTI patients
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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Patients' awareness about Cardiovascular Disease and the Causes of Coronary Artery Disease
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Objective: This study aims to assess the awareness of patients suffering from cardiovascular
diseases.
Methodology: A descriptive design was applied in this study. A purposive sample consisted of
(100) patients with cardiovascular disease in the Mosul's hospitals were interviewed to achieve study
objectives. A questionnaire was used for data collection after tested for validity and reliability by pilot
study.
Results: The study results showed the mean of patients awareness are (1.78) cut point of (3) and
the majority of patients84% were aged more than 50 years or above. Slightly increase proportion of
male more than females. Most of them are married81%, retired, smokers, and a period of developing
the disease a

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of International Dental And Medical Research
Evaluation of selection criteria for patients indicated for fixed orthodontic appliance treatment
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Publication Date
Wed Oct 16 2019
Journal Name
International Journal Of Research In Pharmaceutical Sciences
Assessing quality of life among sample of iraqi patients with rheumatoid arthritis
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Rheumatoid arthritis is one of the common chronic disease, which lead to great disability and chronic pain, and has a main adverse economic and social effect upon patients. The reason for the addition of quality of life as a pointer for health outcome result is attributed to the affectability of this measure for the evaluation of patient's health status after taken treatment and its health outcome. The purpose of the current study was to assess quality of life among a sample of Iraqi patients with rheumatoid arthritis and to determine the possible association between health’s related quality of life and some patient-certain factors. This study is a cross-sectional study carried out on 250 already diagnosed rheumatoid arthritis pat

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Publication Date
Mon Jul 01 2024
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Serum CXCL 9 as a Potential Biomarker for Patients with Ulcerative Colitis
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Background: Ulcerative colitis (UC) is an inflammatory bowel disease restricted to the large intestine, characterized by superficial ulceration. It is a progressive and chronic disease requiring long-term treatment. Although its etiology remains unknown, it is suggested that environmental factors influence genetically susceptible individuals, leading to the onset of the disease. (C-X-C) ligand 9 is a chemokine that belongs to the CXC chemokine family, it plays a role in the differentiation of immune cells such as cytotoxic lymphocytes, natural killer T cells, and macrophages. Its interaction with its corresponding receptor CXCR3 which is expressed by a variety of cells such as effector T cells, CD8+ cytotoxic T cells, and macrophage

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Publication Date
Thu Dec 06 2018
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Belief about Medications among Sample of Iraqi Patients with Inflammatory Bowel Disease
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 Inflammatory bowel disease includes both Crohn’s disease and ulcerative colitis, is a chronic, progressive relapsing disease of gastrointestinal tract that require long-term treatment or maintenance therapy. Taking patient’s beliefs about the prescribed medication in consideration had been shown to be an important factor that affects compliance of the patient in whom having positive beliefs is a prerequisite for better compliance. The aim of the current study was to investigate and assess beliefs about medicines among a sample of Iraqi patients with inflammatory bowel disease and to determine possible association between these beliefs and some patient-specific factors.

This study is a cross-sectional study carried out o

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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of An Instructional Program on Pulmonary Tuberculosis Patients Quality of Life Concerning General Health-Related among sample in Baghdad City
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Objective(s): This research aims at evaluating the quality of pulmonary tuberculosis patients life before and after applying the suggested instructional program, and to find out relationships among distribution of an overall assessment quality of life improvement and socio-demographic characteristics variables. Methodology: Self controlled design studying effectiveness of applying instructional program on quality of life for pulmonary tuberculosis patients among sample size (65) patients from primary health care centers/AL-Sadur City sector-the consultation clinic of chest and respiratory diseases at AL

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Publication Date
Sun Sep 01 2019
Journal Name
Meta Gene
Association of HLA-G + 3142G &gt; C gene polymorphism and toll-like receptor-9 serum level in systemic lupus erythematosus patients
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Background: Human leukocyte antigen-G (HLA-G)and Toll-like receptor-9 (TLR-9)play a role in the regulation of autoimmune diseases and inflammatory processes. Aim of the study: To detect the HLA-G + 3142G > C gene polymorphism that associated with the susceptibility to SLE patients and associated with Hepatitis B infection and TLR-9 serum level. Patients and methods: This study was done on 75 SLE patients and 75 healthy control groups. Genotyping of HLA-G + 3142G > C were detected by PCR and PCR-RFLP methods. In addition to the estimation of Hepatitis B surface (HBs)antigen status by immunochromatography technique and TLR-9 serum level by ELISA technique. Results: The HLA-G + 3142G > C gene polymorphism between the SLE patients and controls

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