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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
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Academic Accreditation From The point Of view The Teaching Staff Of Iraqi Expatriates And Its Impact On Strategic Performance Of Institutions Of Higher Education - Field Research
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Abstract

       The Research Includes Two Variables : First , Academic Accreditation with his dimensions ( Educational Context , Educational Inputs , Educational Process , Educational Outputs , Feedback ) , And The Second : Strategic Performance With His dimensions ( Financing , Satisfaction Stakeholders , Internal Processes , Learning And Growth ) , The Research Highlights On The Academic Accreditation System Which Is Considered A Major And Important Systems Can Through Which Administration Of Activities And Programs Institutions Of Higher Education , As This research aims to determine his relationship And The Extent Of Its Effect In The Strategic Performance , And It Includes The Research C

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Publication Date
Tue Dec 02 2025
Journal Name
Journal Mustansiriyah Of Sports Science
A comparative study of mental abilities and athletic achievement motivation among students of the College of Physical Education and Sports Sciences at the University of Baghdad
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Publication Date
Thu Feb 28 2019
Journal Name
The Open Rheumatology Journal
The Value of Soluble Transferrin Receptor and Soluble Transferrin Receptor-ferritin Index in Discriminating Iron Deficiency Anaemia from Anaemia of Chronic Disease in Patients With Rheumatoid Arthritis
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Background:

Anaemia is a common extra-articular manifestation of rheumatoid arthritis (RA) where anaemia of chronic disease (ACD) and iron deficiency anaemia (IDA) are the two most frequent types. The distinction between these two types of anaemia has always been challenging requiring sophisticated techniques. Serum transferrin receptor (sTfR) a truncated soluble form of the transferrin receptor is one of the parameters that is influenced by the Iron content and supply to the erythrons and is not affected by inflammatory status and therefore the use of the sTfR/log ferritin (sTfR-F) index can be a reliable indicator of functional iron deficiency.

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Publication Date
Tue Feb 27 2024
Journal Name
Pharmacia
Association of the rs1801133 and rs1801131 polymorphisms in the MTHFR gene and the adverse drug reaction of methotrexate treatment in a sample of Iraqi rheumatoid arthritis patients
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Background: Methotrexate is one of the mainstays for treating rheumatoid arthritis (RA) with a wide range of adverse drug reactions, however, it’s the relationship between adverse drug reactions and genetic polymorphism remains to be highlighted, and there is a lack of studies concerning Arabic Iraqi population regarding this aspect.

Objective: Evaluate the association between genetic mutations in the MTHFR gene in SNPs (rs1801133G&gt;A and rs1801131T&gt;G) on the adverse drug reaction for RA Iraqi patients.

Methods: An observational study, that involved 95 Iraqi RA patients with established RA. Patien

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Publication Date
Mon Jan 01 2024
Journal Name
Farmacia
ASSOCIATION OF NFE2L2 GENE POLYMORPHISM (rs35652124) WITH DEVELOPMENT OF RETINOPATHY IN IRAQI TYPE 2 DIABETIC PATIENTS, IN RELATION TO VASCULAR ENDOTHELIAL GROWTH FACTOR AND ENDOCAN SERUM LEVELS
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Publication Date
Sun Dec 10 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Detection of Multiple Sclerosis Lesions in Supra- and Infra-Tentorial Anatomical Regions by Double Inversion Recovery, Flair, and T2 MRI Sequences: A Comparative Study in Iraqi Patients
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Background: In young adults, multiple sclerosis is a prevalent chronic inflammatory demyelinating condition. It is characterized by white matter affection, but many individuals also have significant gray matter involvement. A double-inversion recovery pulse (DIR) pattern was recently proposed to improve the visibility of multiple sclerosis lesions. Objective: To find out how well a DIR sequence, FLAIR, and T2-weighted pulse sequences can find MS lesions in the supratentorial and infratentorial regions. Methods: A total of 37 patients with established diagnoses of multiple sclerosis were included in this cross-sectional study. Brain MRI was done using double inversion recovery, T2, and FLAIR sequences. The number of lesions was count

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
A Study of Apelin-36 and GST Levels with Their Relationship to Lipid and Other Biochemical Parameters in the Prediction of Heart Diseases in PCOS Women Patients
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This work studies the role of serum apelin-36 and Glutathione S-transferases (GST) activity in association with the hormonal, metabolic profiles and their link to the risk of cardiovascular disease (CVD) in healthy and patients' ladies with polycystic ovary syndrome (PCOS). A total of fifty-four (PCOS) patients and thirty-one healthy woman as a control have been studied. The PCOS patients were subdivided on the basis of body-mass-index (BMI), into 2-subgroups (the first group was obese-PCOS with BMI ≥ 30 and the second group was non-obese PCOS MBI<30). Fasting-insulin-levels and Lipid-profile, Homeostatic-model assessment-of-insulin-resistance (HOMA-IR), follicle-stimulating-hormone (FSH), luteinizing-hormone (LH), testosterone and

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Publication Date
Tue Dec 02 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Oral signs and symptoms and hyperglycemic status of type II diabetic patients in relation to cytomorphometric findings of gingival and buccal cytobrush smears
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Background: Brush cytology is an accepted technique that gets renewed interest. It is now used as an aid for the diagnosis and observation of possible epithelial changes that could be associated with oral mucosal diseases. This study aimed to evaluate the cytomorphometric changes in gingiva and buccal mucosa of type II diabetics and to assess their relation to oral symptoms and glycemic status. Materials and methods: Cytological Papanicolaou stained smear were prepared from cheek and gingiva of 20 non treated cases, 20 treated diabetics and 20 healthy persons of both sex after measuring their HbA1c and recording their oral symptoms. Hundred unfolded epithelial cells were evaluated qualitatively using MCID software to measure nuclear and cy

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Publication Date
Tue Dec 02 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of salivary levels of Proteinaceous biomarkers Matrix Metalloproteinase (MMP-8) and C-Reactive Protein (CRP) in type 2 diabetic patients with periodontitis
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Background: Diabetes mellitus is a chronic metabolic disorder of the carbohydrate, protein and fat metabolism, resulting in increased blood glucose levels. Various complications of diabetes have been described with periodontitis being added as the sixth complication of diabetes mellitus. Matrix metalloproteinase-8 (MMP-8) has been identified as major tissue-destructive enzyme in periodontal disease. MMP-8 is released from neutrophils in a latent, inactive pro form and becomes activated during periodontal inflammation by independent and/or combined actions of host-derived inflammatory mediators .C-reactive protein is a systemic marker released during the acute phase of an inflammatory response. Subjects, materials and methods: Total samples

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Publication Date
Thu Mar 14 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Impact of MDR-1 Gene Polymorphism (rs1128503) on Response to Imatinib or Nilotinib in Iraqi Patients with Chronic Myeloid Leukemia: An Observational Study
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Background: There is a significant molecular response to imatinib given at standard doses in individuals with chronic myeloid leukemia (CML) whose ABCB1 polymorphisms are present. Objective: To investigate the impact of the polymorphism in the ABCB1 gene rs1128503 on the effectiveness of nilotinib or imatinib therapy. Methods: From May 2022 until the end of January 2023, the current study was carried out in a single research institution, the National Center of Hematology, Baghdad Teaching Hospital at Medical City, Iraq. 76 people with chronic phase myeloid leukemia (CML-CP), who had previously received a diagnosis using the European Leukemia Net (ELN) criteria, enrolled in the trial. The PCR product was delivered to Macrogen Corpora

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