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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 Mar 10 2021
Journal Name
Baghdad Science Journal
The impact of volatile oils of three medicinal plants on the bacteria isolated from patients with tonsillitis
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Were collected three types of medicinal plants from their natural habitat after Astkhalasalziot volatile manner steam distillation and determine the quality and quantity of vehicles chemical for each of the oils obtained using a technique JC discouraged when you merge oily thyme and lemon grass against bacteria either when using oils in three did not have a different effect

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Publication Date
Wed Oct 17 2018
Journal Name
Iraqi Journal Of Laser
Thermal Effects of 940 nm Diode Laser on Dental Socket Blood after Teeth Extraction for Diabetic Patients
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Abstract: Background: High percentage of diabetes patients complain from post extraction hemorrhage. Many types of hemostatic materials are used to stop bleeding after teeth extraction: diode lasers are good hemostatic agents owing to their highly absorption by hemoglobin therefore they are used in soft tissue procedures with relatively no effects on dental hard tissues due to their poorly absorption by water and hydroxyapatite. Objectives: The aim of this study is to evaluate the efficiency of diode laser to assist the clot formation after tooth extraction for type II diabetes patients with minimum temperature elevation to prevent periodontal destruction. Materials and methods: From 12 type II diabetes patients (7 males and 5 females wi

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Publication Date
Thu Nov 21 2019
Journal Name
Al-kindy College Medical Journal
Effect Of Pomegrante Peels And Bay Leaves On Multidrug Resistant Bacteria Isolated From Urinary Tract Infection Patients
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Background: Alternative natural therapy by plants extracts had opened  wide  door   for   the    use  of  natural products as an alternative therapy instead of many antibiotics and drugs , which had many harmful side effects.Also, an increased interest has been centered on the industrial wastes, especially plant raw materials which contain phenols (e.g. Pomegranate peel and Bay leaves) which is a sources of natural antioxidants ,which are on the contrary  of  synthetic  antioxidants that  had restrict use  due to  their  health  risks , carcinogenesis and toxicity .

Objectives :This study was done to fi

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Publication Date
Fri Jun 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Occurrence and pattern of antibiotic resistance among dental plaque bacteria from gingivitis patients and their clinical correlation
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Background: A diverse group of bacteria live in biofilms in the oral cavity. On dental surfaces biofilms form plaque that is potentially involved in caries and periodontal diseases. Periodic studying of plaque microflora and their antimicrobial sensitivity patterns strongly affects the clinical practice in plaque-induced oral diseases. Materials and methods: Dental plaque samples were collected from 22 patients having ages ranged between 33 and 49 years with gingivitis that met the study criteria. Plaque, gingival and gingival bleeding indices (PI, GI, GBI) were measured for each patient. Laboratory procedures included microbiological examination of plaque samples followed by antibiotic sensitivity testing using disc diffusion method were

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Levels of Glucose-6-phosphate Dehydrogenase in Type 1 Diabetes Mellitus patients with Nephropathy and Cardiovascular disease complication: Perry H. Saifullah|Saad M. Nida|Israa B. Raoof
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The aim of this study is to evaluate oxidative stress in diabetes mellitus (DM) Type1 by the measurement of Glucose-6-phosphate Dehydrogenase (G-6-PD), an enzyme expressed in human RBCs, is important in the generation of reduced glutathione which is the key product in oxidative stress controls. The Study was carried on 80 samples of blood and serum of National Diabetes Center (NDC). The study groups under fasting conditions and they divided as:20 samples of diabetes mellitus patients without complications and 20 samples of diabetes mellitus with cardiovascular (CV) complications and 20 samples of diabetes mellitus with Nephropathy (Neph) complications compared with 20 control group with average age (13-67) years.. The results sh

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Publication Date
Wed Nov 01 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Serum Soluble Angiotensin-Converting Enzyme-2 Level and Its Potential Association With The Renin-Angiotensin-Aldosterone System in Non-Hypertensive Iraqi COVID-19 Patients: An Observational Study
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Background: The novel coronavirus disease (COVID-19) is caused by Severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) which utilizes angiotensin converting enzyme2 (ACE2) to invade the host cells. This membrane-bound peptidase is widely distributed in the body; its activity antagonizes the renin-angiotensin-aldosterone system (RAAS). Once SARS-Cov2 enters the cell, it causes downregulation of ACE2, resulting in the unopposed activation of RAAS. The unregulated activity of the RAAS system can deteriorate the prognosis in COVID-19 patients. A soluble form of ACE2 (sACE2) was reported to have a role in the SARS-Cov2 invasion of the susceptible cells.

Aim of the study: This study aims to inve

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Immunohistochemical Targeting of p110β Isoform of phosphatidylinositol 3-kinase co-associated with Cyclin-Dependent Kinase 1 in a Group of Tissues from Iraqi Patients with Breast Cancer
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Background: While two-thirds of breast cancers express hormone receptors for either estrogen (ER) and/or progesterone (PR) , genetically altered PI3K pathway was found in more than 70% of ER-positive breast cancers.An aberrant activity of cyclin-dependent kinase 1 (CDK1) in a wide variety of human cancers has selectively constituted an attractive pharmacological targets in MYC-dependent human breast cancer cells.

Aim of the study:  Role of p110-beta as well as and CDK 1  in the pathogenesis of subset of breast cancers and contribution in their carcinogenesis.

Type of the study: is a retrospective study

Methods: This retr

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The accuracy of cone-beam computed tomography in the evaluation of boney support of teeth among patients with a unilateral cleft of lip and palate among IraqiPopulation
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Background: To evaluate the bony supports of the teeth adjacent to the area of cleft in patient with unilateral cleft lip and palate and to compare these measurements with the measurements of the same teeth in non-cleft side by using CBCT. Materials and methods: The CBCT scans of 30 patients having cleft lip( unilateral) and palate(unilateral), were analyzed and the measurements of the alveolar bony support for teeth that are adjacent to the cleft area were measured with those teeth located on opposite side (non- clef) side. For each tooth, the measurements will taken for the distance between the( cementoenamel junction) (CEJ) and the bony crest (AC) at the( buccal area) was measured and the thickness of the buccal plate At zero, one, tw

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Publication Date
Thu Mar 03 2022
Journal Name
Archives Of Rheumatology
Association of tumor necrosis factor-alpha promoter region gene polymorphism at positions -308G/A, -857C/T, and -863C/A with etanercept response in Iraqi rheumatoid arthritis patients
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Objectives: This study aims to evaluate the association between polymorphisms in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene at locations -308G/A, -857C/T, and -863C/A with the tendency of being non-responder to etanercept.

Patients and methods: Between October 2020 and August 2021, a total of 80 patients (10 males, 70 females; mean age: 50 years; range, 30 to 72 years) with rheumatoid arthritis (RA) receiving etanercept for at least six months were included. The patients were divided into two groups responders and non-responders, based on their response after six months of continuous treatment. Following polymerase chain reac

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Publication Date
Mon Jul 28 2025
Journal Name
Retos
The effect of the beehive strategy on deliberate thinking and learning the setting skill of volleyball among female students at the College of Physical Education and Sports Sciences for Woman
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Objective: Develop a deliberate thinking scale for the setting skill in volleyball for second-year female students in the College of Physical Education and Sports Sciences for Woman. Research methodology: The researchers used the experimental approach, employing a two-group approach (pre-test and post-test), to suit the nature of the research. The research community comprised (65) second-year female students from the College of Physical Education and Sports Sciences for Woman at the University of Baghdad for the academic year 2024-2025. The research sample was randomly selected, with (15) students in Section A, the experimental group, and (15) students in Section B, the control group. This group represented (46%) of the students. Th

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