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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 Jul 24 2020
Journal Name
Al-kindy College Medical Journal
Irritable Bowel Syndrome: The Most Common Presentation, Severity Ranking and Therapeutic Regimens among Patients Attending Outpatient
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Background: Irritable bowel syndrome (IBS) is one of the most common GI disorders in people under 50 years of age.
Objective: To Formulate an overview about demographics of IBS and patterns of presentation, to determine IBS patients severity ranking, and to recognize the main regimens with their patient satisfaction.
Methods: This is a cross sectional clinical study that is conducted in Outpatient Consultant Internal Medicine Clinic in Al-Kindy Teaching Hospital from 11/12/2017 to 24/12/2017. The patients suffering from IBS are diagnosed by a consultant according to the symptom-based Rome criteria for functional GI disorders, by implementing a questionnaire collecting thorough information. 77 cases of IBS patients were collected (2

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Publication Date
Sat Nov 03 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Short Wave Diathermy and Therapeutic Ultrasound on The Management of Patients With Knee Osteoarthritis
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Objective : The present study is aimed to evaluate the effectiveness of short wave diathermy and
ultrasound therapy for the management of patients with knee osteoarthritis
Methodology : all patients who referred to the Medical Rehabilitation Unit in Baghdad Teaching
Hospital and Sadr A!-Qanat Center. The period of the study was from October 2004 to April 2005, total
number of patients was 24 (9 male and 15 female). Age range of patients was 42-70 years. Complete
clinical and radiological examinations were achieved on all patients and referred to the Medical
Rehabilitation Unit for physiotherapy. Short wave diathermy and ultrasound therapy were applied on
all patients.
Results : Demographic distribution revealed th

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Publication Date
Wed Mar 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Complete Blood Count and saliva parameters as an indicator for infected patients with coronavirus covid-19
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Background: Coronavirus, which causes respiratory illness, has been a public health issue in recent decades. Because the clinical symptoms of infection are not always specific, it is difficult to expose all suspects to qualitative testing in order to confirm or rule out infection as a test. Methods: According to the scientific studies and investigations, seventy-three results of scientific articles and research  were obtained using PubMed, Medline, Research gate and Google Scholar. The research keywords used were COVID-19, coronavirus, blood parameters, and saliva. Results: This review provides a report on the changes in the blood and saliva tests of those who are infected with the COVID-19.COVID-19 is a systemic infection that has

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Publication Date
Sat Oct 01 2022
Journal Name
Journal Of Medicine And Life
The effect of COVID-19 on emergencies and pain among orthodontic patients attending a teaching hospital
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This study aimed to evaluate the effect of the COVID-19 outbreak on emergencies and pain among orthodontic patients attending a teaching hospital. The study was conducted among orthodontic patients receiving active orthodontic treatment or in a retention period at the College of Dentistry, University of Baghdad, Iraq. Their participation was voluntary, and they filled out an Arabic-translated questionnaire. The survey included general information, orthodontic problems, and a numerical rating scale for pain assessment. We used descriptive and inferential statistics (frequencies and intersecting frequencies), chi-square test and linear regression. Out of 75 orthodontic patients, only 54 (15 males and 39 females) were included in the s

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Publication Date
Sat Jul 08 2017
Journal Name
Research Journal Of Pharmaceutical , Biological And Chemical Sciences
Assessment activity and Partial purification of Alkaline phosphatase (AIP) from sera of patients with celiac disease
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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
The Effect of a Training Program on the Diabetic Patients Utilizing Skills of Insulin Injection Technique
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Objectives: The study aims to evaluate patients’ performance toward insulin injection after training program to
identify the variation in skill of patients in insulin injection technique with regard to some variable (i.e.
educational level and duration of insulin injection.
Methodology: A quasi experimental study has been conducted on diabetic patients.
An observational checklist had been prepared which consisted of 4 main areas with 37 sub-items, which are
syringe preparation for injection, insulin drawing; skin preparation for injection and insulin injection. Each of the
sub-items has 2 options yes or no. One score for positive answer and zero for no.
The sample of the study consisted of (n =30) males and females

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Publication Date
Thu May 05 2022
Journal Name
Al-kindy College Medical Journal
Comparative Study on the Corneal Endothelial Cell Count between Type 2 Diabetic and Non-Diabetic Patients
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Background: Diabetes mellitus is one of the commonest chronic disorders worldwide with a rapid rise in prevalence. In Iraq its prevalence is high especially in elderly age group. Patients with type 2 diabetes mellitus have higher vulnerability for complications, whether microvascular or macrovascular. Ocular complications are common in diabetes mellitus, and comprise diabetic retinopathy, diabetic papillopathy, cataract, glaucoma, dry eye disease and diabetic keratopathy. Diabetic keratopathy involves endothelial and epithelial tissues of the cornea, leading to persistent epithelial defect, corneal erosion, or corneal ulcers.

Aim of the Study: To compare the mean corneal endothelial cell count between patients wi

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Publication Date
Sun Jun 30 2024
Journal Name
Sports Culture
Designing and rationing of test to measure the motor compatibility for the eye and the leg for students of the Faculty of Physical Education and Sports Sciences, Samarra University
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The research aims to identify: 1-Designing a test to measure the movement compatibility of the eye and the leg for the students of the Faculty of Physical Education and Sports Sciences, Samarra University. 2-Codification (setting scores and standard levels) for the results of the motor compatibility test for the eye and the leg for students of the Faculty of Physical Education and Sports Sciences, Samarra University. The researchers reached the some following conclusions: 1-A test to measure the movement compatibility of the eye and the leg for the students of the Faculty of Physical Education and Sports Sciences. 2-There is a discrepancy in the standard levels of the research sample.

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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of Physical Education
Obstacles to achieving quality field application performance from the point of view of fourth-stage female students at the College of Physical Education and Sports Sciences, University of Baghdad
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The aim of the research was to prepare a scale of obstacles to achieving quality performance, field application from the point of view of fourth-stage female students, to identifyOn the difficulties and obstacles to achieving quality performance through field application from the students’ point of view for the topic (school administrative procedures, learners, cognitive achievement, school tools).The researchers used the descriptive approach in the research procedures as it is an appropriate approach to achieve the research objectives.,The following questions were asked:There are obstacles and difficulties faced by female students during the process of choosing schools, dealing with school administrations, and the difficulties fa

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Global Pharma Technology
Serum levels of cross-linked n-telopeptide of Type i collagen before and after non-surgical periodontal therapy in type 2 diabetic patients with chronic periodontitis
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Background: Diabetes mellitus is a major risk factor for chronic periodontitis (CP) and hyperglycemia has an important role in the enhancement of the severity of the periodontitis. It has been reported that the progression of CP causes shifting of the balance between bone formation and resorption toward osteoclastic resorption, and this will lead to the release of collagenous bone breakdown products into the local tissues and the systemic circulation. Cross-linked N-telopeptide of type I collagen (NTx) is the amino-terminal peptides of type I collagen which is released during the process of bone resorption. This study was conducted to determine the effects of nonsurgical periodontal therapy on serum level of NTx in type 2 diabetic patients

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