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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 Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Using the Abbreviated Version of Modification of Diet in Renal Disease Formula as A Primary Estimate for the Prevalence of Undiagnosed Chronic Kidney Disease in Patients with Acute Stroke
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Introduction: The association between acute stroke and
renal function is well known. The aim of this study is to
know which group of patients with acute stroke is more
likely to have undiagnosed Chronic Kidney Disease and
which risk factors are more likely to be associated with.
Methods:We studied 77 patients who were diagnosed to
have an acute stroke.Patients were selected between
April2011andJune 2011 using the " 4-variable
Modification of
Diet in Renal Disease Formula " which estimates
Glomerular Filtration Rate using four variables :serum
creatinine ,age ,race and gender.
Results :The study included 38 male and 39 females
patients ,aged (35-95) years. Glomerular Filtration Rate in
patients wi

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Innovation, Creativity And Change (ijicc)
The relationship between conceptual knowledge and procedural knowledge among students of the mathematics department at the faculty of education for pure sciences/IBn Al-Haitham, university of Baghdad
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Scopus
Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Implement some basic health accreditation standards Issued by the Health Care Accreditation Council (HCAC) for auditing the Performance of Hospitals: Applied research at the Education Children Protection Hospital
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The health care provided by health institutions and all kinds suffers from many problems, and since the health services provided are related to human life, it is necessary to shed light on this activity and identify the causes of these problems. This research aims to Definition of health institutions (hospitals) Performance audit of these institutions according to the latest indicators, which are the standards of health accreditation for hospitals, specifically the basic standards issued by the Health Care Accreditation Council (HCAC) to reach the level of performance and Knowledge of Constraints that lead to in an acceptable manner consistent with the approved standards. In theoretical and practical study, a number of conclusions were r

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Crossref
Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Efficiency of Human Resources Information System and Its Impact on The Level Effectiveness of Employees Performance Appraisal System / Practical Research on Ministry of Higher Education and Scientific Research
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Abstract

The research aims to determine the role of the efficiency of Human Resources Information System in the effectiveness of Employees Performance Appraisal System in the Ministry of Higher Education and Scientific Research / Center for the ministry, it was touching the researchers need the ministry to devise methods that employ outputs Human Resources Information System in the organization surveyed for the development of methods and levels of process evaluate the performance of its employees, in order to identify the extent of the role played by human resources information system in the process of assessing the performance of employees, we raised the question of the President as follows:

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Postoperative Nurses' Interventions for the Patients with Laparoscopic Cholecystectomy at Baghdad Teaching Hospitals
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Objective: The study aimed to assess the postoperative nurses' intervention for the patients with laparoscopic
cholecystectomy and to determine the relationship between Nurses' interventions and their demographic
characteristics.
Methodology: Quantitative design (a descriptive study) was started from 20th November 2012 up to 1st
September 2013. Non-probability (purposive sample) of (50) nurses, who were working in surgical wards, were
selected from Baghdad teaching hospitals (Baghdad Teaching Hospital, Digestives System and Liver Teaching
Hospital, AL-Kindy Teaching Hospital, and AL-Kadhimiyia Teaching Hospita). The data were collected through
the use of a constructed questionnaire, which consisted of two parts; the

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Publication Date
Sun Jul 01 2018
Journal Name
The Iraqi Postgraduate Medical Journal
Molecular and Serologic Detection of HLA-B27 among Ankylosing Spondylitis Patients with Some Clinical Correlations
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BACKGROUND: HLA-B27 can effect clinical presentation and course of ankylosing spondylitis. Different detection techniques of HLA-B27 are available with variable sensitivities and specificities. OBJECTIVE: To compare serologic and molecular diagnostic techniques of detecting HLA-B27 status and to correlate it with some clinical variables among ankylosing spondylitis patients. PATIENTS AND METHODS: A cross-sectional study was conducted on 83 Iraqi patients with ankylosing spondylitis. Clinical and laboratory evaluations were reported. HLA-B27 status was determined in all patients by real-time PCR using HLA-B27 RealFast™ kit; ELISA method was used as well to detect soluble serum HLA-B27 antigens using Human Leukocyte Antigen® kit. RESULTS:

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Publication Date
Thu Apr 01 2021
Journal Name
Biochem. Cell. Arch
Biological Therapy for Patients With Rheumatoid Arthritis and Its Effect on Periodontal and Immunological Parameters
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Rheumatoid arthritis and periodontitis use analogous effector destructive procedures, in that the inflammatory cells and pro-inflammatory cytokines that drive chronic bone erosion in RA and chronic periodontal destruction in Periodontitis are alike. Periodontitis (PD) has appeared as a hazard factor in a number of health situations as rheumatoid arthritis (RA). To determine the effect of anti-tumor necrosis factor alpha biological treatment (methotrexate and Enbrel or infliximab) on periodontal status of patients having rheumatoid arthritis with periodontitis in comparison to those having periodontitis without rheumatoid arthritis and control healthy subjects and to determine the serum levels of anti-cyclic citrullinated peptide (ACCP) in t

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Publication Date
Thu Jan 30 2020
Journal Name
Al-kindy College Medical Journal
The Actual Practice of Breast Self-Examination among Sample of Iraqi Patients with Breast Cancer
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Background : To assess the actual practice of breast self-examination (BSE), as an early detection tool for breast cancer, among a sample of patients affected with breast cancer in Iraq.Methods: A random sample of 200 female patients with breast cancer was analyzed to evaluate the extent of their actual practice of breast self-examination before the diagnosis of the disease.  The examined variables included the age of the patients, marital status, education, occupation, smoking habit, family history of cancer, frequency of gravidity, parity and abortions. Results: The age of patients ranged from (24-70) years with a mean age of 48 years. The highest frequency of the examined sample

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Publication Date
Mon Apr 01 2019
Journal Name
Indian Journal Of Public Health Research And Development
Analysis of Serum Il-6 and CRP Levels among Autoimmune and Non- Autoimmune Hypothyroid Patients
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Hashimoto Thyroiditis (HT) is the most common autoimmune thyroid disease and the commonest cause ofhypothyroidism. C-reactive protein (CRP) is synthesized in hepatocyte in response to autoimmune disorders;strongly induced by IL-6. This study aimed to estimate serum IL-6 and CRP levels in autoimmune and non-autoimmune hypothyroidism. The present study included 60 Iraqi female hypothyroid patients divided to 30autoimmune and 30 non-autoimmune, with age ranged between 24-50 years and 30 healthy controls withage ranged between 27-52 years. Serum samples were collected from study groups. The levels of thyroidhormones (TSH, T4 and T3) were determined by using automated Chemiluminescence Immunoassay (CLIA)analysis system. Detection the levels of t

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Publication Date
Wed Aug 01 2018
Journal Name
Global Journal Of Health Science
The Effect of Nebulized Salbutamol on Serum Potassium and Blood Sugar Level of Asthmatic Patients
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BACKGROUND: Nebulized Salbutamol have great advantages for patients with respiratory problems by depositing drugs directly to the lungs, inspite of reported adverse metabolic effects on different electrolytes and glucose heamostasis of patients.AIM OF STUDY: To evaluate the effect of nebulized salbutamol used in the management of patients with asthma who have normal serum potassium and blood glucose levels. in the emergency department after 30 and 60 minutes of administration and to find out if these results are of clinical importance that should be taken in consideration when treating patients especially those with abnormal glucose hemostasis or electrolyte disturbance. PATIENTS &amp; METHODS: The study is a prospective follow

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