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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
Sun Jul 02 2023
Journal Name
Journal Of Pakistan Association Of Dermatologists
The frequency of acute radiodermatitis and associated risk factors among patients with breast cancer treated by radiotherapy
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Background: Acute radiodermatitis is a common side effect during and after radiotherapy course in breast cancer patients treated by radiotherapy. This study assess the frequency of acute radiodermatitis and record the predictive factors for acute radiodermatitis. Patients and Methods: A descriptive case series study conducted at Baghdad, Iraq from August 2020 to September 2021. 70 female scheduled for radiotherapy sessions enrolled in this study. sociodemographic data were recorded and Skin examination before radiotherapy and weekly till the end of the radiotherapy sessions was done to report the frequency, risk factors, clinical picture and grades of acute radiodermatitis based on The National Cancer Institute’s Common Terminology Crite

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Publication Date
Wed Mar 05 2025
Journal Name
Iraqi Journal Of Biotechnology
Effect of Genetic Polymorphism (rs2619363) on SNCA Gene among Iraqi Patients with Parkinson’s and some Gastrointestinal Disorders
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Parkinson’s disease (PD) consider as a progressive ageing neurodegenerative disease, Parkinson’s consider as a heterogenous disease, with mainly initiate through correlation between genetic and epigenetic by inducing of different factors on some related genes, these factors like (environmental, toxicants, nutrition, heavy metals, pesticides, some drugs) and also(trauma on head ,strokes) in addition to unknown reasons which cause an idiopathic PD .Current study aims to focusing on specific related PD gene called SNCA by single nucleotides polymorphism (rs2619363) as a risk factor for PD initiation disease in PD patients in addition to study the effect of polymorphisms on random Iraqi patients with different gastrointestinal

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Publication Date
Sun May 05 2024
Journal Name
Review Of Clinical Pharmacology And Pharmacokinetics - International Edition
Emergency department presentation and management of patients with acute decompensated heart failure at the Baghdad Teaching Hospital
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Acute decompensated heart failure (ADHF) is a leading cause of hospital admission and many factors are known to precipitate decompensation. We aimed to assess the decompensating factors of heart failure and the management of patients admitted to the emergency department (ED). A total of 107 patients were examined, all diagnosed with ADHF in the ED of the Baghdad Teaching Hospital, from June 2017 to December 2017, and presenting with decom¬pensation (pulmonary oedema, peripheral oedema, and fatigue). The mean patient age was 62.5 ± 9.8 years (range: 43–85 years); the majority of them were in their 7th decade (37.4%), and men were slightly more than women. Hy¬pertension was the most commonly associated comorbidity (68.2%), follow

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Publication Date
Wed Dec 01 2021
Journal Name
International Journal Bioautomation
Model for Prediction of the Weight and Height Measurements of Patients with Disabilities for Diagnosis and Therapy
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Background: Accurate measurement of a patient’s height and weight is an essential part of diagnosis and therapy, but there is some controversy as to how to calculate the height and weight of patients with disabilities. Objective: This study aims to use anthropometric measurements (arm span, length of leg, chest circumference, and waist circumference) to find a model (alternatives) that can allow the calculation of the height and the body weight of patients with disabilities. Additionally, a model for the prediction of weight and height measurements of patients with disabilities was established. Method: Four hander patients aged 20-80 years were enrolled in this study and divided into two groups, 210 (52.5%) male and 190 (47.5%) fe

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Evaluating the Clinical Outcomes of Three Medication Regimens for Treating a Sample of Iraqi Persistent Asthmatic patients
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Abstract     Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma.      This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthmatic patients in Baghdad City. The study com

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluating the Clinical Outcomes of Three Medication Regimens for Treating a Sample of Iraqi Persistent Asthmatic patients
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Abstract

    Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma. 

    This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthm

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Publication Date
Mon Oct 14 2019
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Comparison of Clinico-Pathological Presentations of Triple-Negative versus Triple-Positive and HER2 Iraqi Breast Cancer Patients
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BACKGROUND: Breast cancer remains the most common malignancy among the Iraqi population. Affected patients exhibit different clinical behaviours according to the molecular subtypes of the tumour. AIM: To identify the clinical and pathological presentations of the Iraqi breast cancer subtypes identified by Estrogen receptors (ER), Progesterone receptors (PR) and HER2 expressions. PATIENTS AND METHODS: The present study comprised 486 Iraqi female patients diagnosed with breast cancer. ER, PR and HER2 contents of the primary tumours were assessed through immunohistochemical staining; classifying the patients into five different groups: Triple Negative (ER/PR negative/HER2 negative), Triple Positive (ER/PR positive/HER2 positive), Luminal A (ER

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Publication Date
Tue Sep 01 2015
Journal Name
Iraqi Journal Of Science
Determination of Optimal Temperature and pH for Radial Growth of Some Dermatophyte Species Isolated from Leukemia Patients
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The study is concern on determine the effect of different temperatures (25, 28, 30 and 370C), and different pH values (4.5, 5.5, 6 and 8) on the radial growth (mm) of 15 dermatophyte isolates (Microsporum canis 7, Trichophyton rubrum 5, Trichophyton mentagropyhtes 3). The specimens for the current study were collected from nail infections in patients with different type of leukemia whom admitted at Baghdad Educational Hospital, 7th floor. The result revels that the optimum temperature for radial growth was 300C then 280C for all isolates, while the optimum pH for all isolates was 6.

Publication Date
Fri Mar 21 2025
Journal Name
The Indonesian Journal Of Community And Occupational Medicine
Observance of the Adherence to Antibiotic Prescriptions by Iraqi Dental Patients: A Different Perspective on Antimicrobial Resistance
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Background: The excessive use and abuse of antibiotics contribute to bacterial resistance, raising the risk of complications and treatment failures. This study investigates adherence to antibiotic prescriptions among Iraqi dental patients, highlighting implications for antimicrobial resistance.Objective: To assess adherence levels and identify factors influencing antibiotic therapy compliance among dental patients.Methods: A cross-sectional survey was conducted in which adult dental patients aged 18 and older, who had been prescribed antibiotics within the past year, participated. The modified Morisky Medication Adherence Scale-8 items was used to evaluate adherence, and data were analyzed with IBM SPSS Statistics software V26.Results: Amon

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Publication Date
Mon Nov 01 2021
Journal Name
Journal Of Multidisciplinary Healthcare
Development and Initial Validation of Stigma Towards Healthcare Providers Working with COVID-19 Patients Scale (S19-HCPs)
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