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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 Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of chemotherapy upon quality of life for patients with chronic myeloid leukemia
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Objective(s): To determine the impact of Chemotherapy upon the quality of life for patients with chronic myeloid
leukemia in Baghdad city.

Methodology: A descriptive study design was carried out The study was initiated from 30 January 2011 to October
2011.A purposive (non–probability) sample consisted of (130) patients with a chronic myeloid leukemia ,Who
attended to Baghdad Teaching Hospital and National Center for Research and Treatment of Hematology. The
sample criteria was the patients who were 18 years old and above, excluding the patients who suffered from
psychological problems and other chronic illnesses .A questionnaire was adopted and developed from European
Organization Research and treatment of Can

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Pharmaceutical Sciences & Research
Determination of Some Biochemical Parameters of Acromegalic Patients with Type 2 Diabetes Mellitus.
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Background: Because of the disturbance in the pituitary gland, growth hormone (GH) secretion will be increased and, as a result, insulin-like growth factor 1 (IGF-1) secretion will be increase as well, leading to a chronic and rare disease called acromegaly disease. One of the most serious complications of acromycaly is diabetes. Insulin resistance, which causes diabetes, occurs in the body because of increased growth hormone secretion Objective: The aim of this work is to estimate some biochemical parameters. These parameters were not studied extensively in the literature such as BALP and LOX and the possibility of using LOX as a new biomarker for acromyalgic patients with diabetic. Patients and Methods: The study was performed on (25) mal

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Baghdad City Seasonal Forecasts Of Monthly Chronic Diseases patients Numbers Using SARIMA Models
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    One of the most important problems of IRAQI HEALTH MINISTRY and all healthy instruments in IRAQ is Chronic Diseases because it  have a negative effects on IRAQI population, this is the aim of our study ,to specify the important Chronic diseases which make the population fell weakly, they are six diseases as the IRAQ ministry of health specified (  Diabetes, blood pressure diseases ,Brain diseases ,  Cardiology, Asthma, epilepsy) we got these data from IRAQI HEALTH MINISTRY ,bureau of planning and studies ,for the period 2009-2012,as monthly observations , represent sum of peoples have chronic diseases in Baghdad .

     Our research obj

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Publication Date
Sat Aug 03 2019
Journal Name
Current Research In Microbiology And Biotechnology
Seropositivity of Helicobacter pylori among Iraqi patients with Atherosclerosis and coronary artery disease
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The present study evaluated the anti- Helicobacter pylori IgG, IgA and the role of virulence factor of H. pylori Vacuolating associated cytotoxin gene (Vac A) as a risk factors for CAD. The levels of serum IgG and IgA was done by indirect immunofluorescent (IIF) whereas Vac A measured by enzyme linked immunosorbent assay (ELISA). Ibn Al-Bitar specialist center for cardiac surgery laboratory and Ministry of Health/ Baghdad/ Iraq, between May and October 2018. Seventy Iraqi patients with CAD were enrolled in this study, their ages ranged between 40-84 years ; and 20 individuals as a control group which was divided into 2 subgroups: 10 apparently healthy volunteers (negative control) and the other subgroup contained 10 with normal coronary art

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Publication Date
Sun Dec 22 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Belief about Medicines among a Sample of Iraqi Patients with Rheumatoid Arthritis
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Rheumatoid arthritis is a chronic, progressive, inflammatory autoimmune disease of unidentified etiology, associated with articular, extra-articular and systemic manifestation that require long-standing treatment. Taking patient’s beliefs about the prescribed medication in consideration had been shown to be an essential factor that affects adherence of the patient in whom having positive beliefs is an essential for better adherence. The purpose of the current study was to measure beliefs about medicines among a sample of Iraqi patients with Rheumatoid arthritis and to determine possible association between this belief and some patient-certain factors. This study is a cross-sectional study carried out on 250 already diagnosed rheumatoid

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Publication Date
Mon Sep 30 2024
Journal Name
Iraqi Journal Of Science
Study of Some Hormonal and Biochemical Parameters among Patients with Chronic Liver Diseases
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It has been revealed previously that chronic liver disease (CLD) may be associated to hormonal fluctuations. The current study, therefore, aimed to evaluate some hormones in CLD patients compared with non-CLD individuals. This case control study was conducted at Gastroenterology and Hepatology Teaching Hospital, Medical city, Baghdad, Iraq during December 2021 to May 2022. One hundred and twenty male patients with CLD (age:14-75 years) and 120 control males (age: 24-70 years) were involved in this study. Serum samples were taken from all individuals and were then analysed for many tests which included hormones (Cortisol, testosterone, prolactin, insulin  and thyroid stimulating hormone TSH); biochemical analysis (Prothrombin time

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Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Orbital Hydatid Disease: A case study of young patients with primary orbital lesion
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Background:This is a prospective study of three children presented to us in the Orbital clinic in AL ShahidGazi Al Hariri Hospital with painless proptosiswith suspension of Hydatid disease.Objectives: : Orbital hydatid disease is a rare lesion accounting for less than 1% of the total lesions of the body (1, 2). Orbital cysts presented as a primary lesion in our study which is rare to have such lesion without involvement of other organs (3). Humans represent the intermediate host where the commonly affected organ are liver and the lung (10-15%) (4). Methods:This is a prospective study of three Children presented to us in the Orbital clinic in Al Shahid Ghazi Alhariri Hospital with painless proptosis with suspension of Hydatid disease, dep

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Publication Date
Tue Nov 06 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Patients' Knowledge about Chronic Diseases towards Risk Factors and Warning Signs of Stroke
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Objectives: to assess chronic diseases patients’ knowledge toward stroke risk factors and warning signs, besides
determining the relationship between chronic diseases patients’ knowledge and their sociodemographical
characteristics.
Methodology: A descriptive study was carried out at public medical clinics which has started from December
2
nd, 2008 to August 8th, 2009. A purposive "non-probability" sample of (300) chronic diseases individuals who
were clients of Public Medical Clinics who have one or more of the following chronic diseases (hypertension,
diabetes mellitus, heart diseases, and previous stroke), in Baghdad city. The data were collected through the use
of a constructed questionnaire which consists

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Publication Date
Sun Jul 29 2018
Journal Name
Iraqi Journal Of Science
Incidence of Ciprofloxacin-Resistant of Methicillin Resistant Staphylococcus aureus isolated from Iraqi patients
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The resistance of Staphylococcus aureus to ciprofloxacin has complicated the problem of treating staphylococcal associated infections in which MRSA is the causative agent since ciprofloxacin was the drug of choice to treat such infections. Our study investigated the incidence of Ciprofloxacin resistant S. aureus isolates that were also methicillin resistant among Iraqi patients. The obtained bacterial isolates were tested for Ciprofloxacin resistance using agar dilution method and the sequence of gyrA and parC. The results revealed that about 8% of the isolated MRSA strains were Ciprofloxacin resistant and the resistance was due to mutation in gyrA rather than parC.

Publication Date
Mon May 30 2022
Journal Name
The Journal Of Infection In Developing Countries
SARS-CoV-2 viral shedding and susceptibility: perspectives on gender and asymptomatic patients
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Despite efforts to contain and manage the SARS-CoV-2 outbreak which was declared a public health emergency of international concern in January 2020 by the World Health Organization (WHO), the COVID-19 pandemic still remains a major global challenge. Patients who display the classical symptoms of the infection are easily identified, tested, isolated and monitored. However, many cases of infected asymptomatic patients have been documented. These patients are not easily identified even though many evidences suggest that they can spread the virus to others. How and why these COVID-19 asymptomatic presentations occur remain unclear. The many theories and views are conjectural, and supporting evidences are still needed. In this review, we

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