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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 Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
BIOCHEMICAL FEATURES of IRAQI PATIENTS INFECTED WITH HEPATITIS E VIRUS COMPARED WITH THOSE INFECTED WITH HEPATITIS A VIRUS
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This study was designed to compare the effect of two types of viral hepatitis A and E (HAV
and HEV) on liver functions in Iraqi individuals by the measurement of biochemical changes
associated with hepatitis.
The study performed on 58 HEV and 66 HAV infected patients compared with 28 healthy
subjects. The measured biochemical tests include total serum bilirubin, serum transminases (ALT
and AST) alkaline phosphatase (ALP) and gamma glutamyl transferase (GGT).
The study showed that adolescent and young adults (17-29) years, were mostly affected by
HEV while children (5-12) years were frequently affected by HAV. The severity of liver damage in
HEV patients was higher than HAV patients as a result of high serum transa

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Publication Date
Mon Jan 01 2024
Journal Name
Open Life Sciences
Evaluation of the role of some non-enzymatic antioxidants among Iraqi patients with non-alcoholic fatty liver disease
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Abstract<p>Non-alcoholic fatty liver disease (NAFLD), characterized by hepatic fat accumulation in individuals consuming little or no alcohol, has become highly prevalent globally. Oxidative stress plays a central role in instigating inflammation and cell death pathways driving NAFLD progression. This case–control study aimed to elucidate the association between circulating levels of the pivotal non-enzymatic antioxidants – coenzyme Q10 and vitamins E and C – and liver injury parameters among 60 Iraqi NAFLD patients versus 30 healthy controls. NAFLD diagnosis entailed over 5% hepatic steatosis on ultrasound excluding other etiologies. Patients spanned three age groups: 20–29, 30–39, an</p> ... Show More
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Publication Date
Sun Jan 01 2023
Journal Name
Gastroenterology Review
The impact of sofosbuvir/ledipasvir on chronic hepatitis C-infected paediatric patients: a Middle East single-centre experience
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Publication Date
Tue Nov 17 2020
Journal Name
Annals Of Tropical Medicine And Public Health
Correlation Study of Aromatase, Some Sex Hormones, and Body Mass Index Among Iraqi Patients with Polycystic Ovary Syndrome
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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effects of Aloe vera Gel, Sesame Oil and Camphor Oil on Pseudomonas aeruginosa Isolated from Burnt Patients
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Three isolates of  P. aeruginosa were isolated from burnt patients. The ability of these isolates for adhesion and formation of slime layer were tested, the result showed that all isolates were able to adherence on the smooth surface. The sensitivity of  P. aeruginosa isolates for antibiotics were tested , all isolates were sensitive  to Gentamycin, Piperacillin and Amikacin Ciprofloxacin, and  resist to Tetracyclin, Amoxicillin, Cephalexine , Ceftriaxone. Ciprofloxacin and Amikacin were found effective against P. aeruginosa isolates with MIC values of 3.8 μg/ ml for  Ciprofloxacin  and 0.244 μg/ ml for Amikacin The antibacterial effect of Different concentrations of Aloe

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Publication Date
Tue Aug 30 2022
Journal Name
Research Journal Of Pharmacy And Technology
The Distribution of ABO blood groups among type 2 Diabetes mellitus patients with or without Chronic Microvascular Complications
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The ABO blood group system is highly polymorphic, with more than 20 distinct sub-groups; study findings are usually related to ABO phenotype, but rarely to the ABO genotype and animal models are unsatisfactory because their antigen glycosylation structure is different from humans. Both the ABO and Rh blood group systems have been associated with a number of diseases, but this is more likely related to the presence or absence of these tissue antigens throughout the body and not directly or primarily related to their presence on RBCs. A total of fifty-two 52 patients without complication of DMII, two hundred sixteen 216 patients with complication of DMII and seventy-one 71 person as healthy control were included in the study. The resu

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Publication Date
Sat Feb 01 2020
Journal Name
Meta Gene
Interleukin-2 serum level, genetic polymorphism (rs2069763), anti-rubella antibody and risk of multiple sclerosis among Iraqi patients
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Background: Multiple sclerosis (MS) is a chronic neurodegenerative autoimmune disease mediated by autoreactive T cells against myelin-basic proteins. Cytokines are suggested to play a role in the etiopathogenesis of the disease. Among these cytokines is interleukin-2 (IL-2). Aim of the study: To investigate the association between IL2+166 G/T single nucleotide polymorphism (SNP: rs2069763) and MS in Iraqi patients. Serum level of IL-2 was also detected. Anti-rubella IgG antibody was further determined in the sera of patients. Patients and methods: Eighty MS patients (28 males and 52 females; age mean ± SD: 39.2 ± 16.1 years) and 80 healthy control matched patients for age (32.15 ± 16.13 years) and gender (28 males and 52 females) were en

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Detection similarity and differences between Uropathogenic Escherichia coli isolated from recurrent urinary tract infections and bladder cancer patients
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Background: Urinary tract infections (UTIs) and their complications such as Bladder cancer (Bl. C.) are a health growing problem worldwide. Objective: To shed light on this subject, present study was done to investigate relationship between recurrent urinary tract infection (RUTI) due to Escherichia coli (E. coli) and Bl. C.Type of study: Cross-sectional study. Methods: This study included 130 patients with RUTI, 50 patients with Bl. C. and 50 control of both sexes (aged 7-85 years) attending Al-Zahra Teaching Hospital in Al-Kut/Wassit governorate and Al-Harery Teaching Hospital of specialized surgeries/Baghdad. The patients were divided into two groups: the first group (n=130) included those who were suffering from recurrent UTI without

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Publication Date
Sat Oct 20 2018
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of the Quality of Health Services from Patients’ Perspective: A Comparative Study between Public and Private Hospitals
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ASTRACT

The current study aimed to identify the quality of health services provided by the Omani health sector through the comparison between public and private hospitals in Dhofar Governorate, Oman. A questionnaire has been developed to collect data from 360 patients who received health services in one public Hospital (Sultan Qaboos) and three private Hospitals (Badr Al-Sama, Lifeline, and Al-Hakeeim). The data were analyzed using independent samples T-Test and One Way ANOVA. The results of the study showed that the quality levels of health services offered in private hospitals were better than public hospitals. The study results also reveled that there are significant differences between public hospitals and private hos

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Publication Date
Mon Feb 15 2021
Journal Name
Nursing Open
Recitation of quran and music to reduce chemotherapy‐induced anxiety among adult patients with cancer: A clinical trial
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Abstract<sec><title>Aim

The aim of this study was to assess the effectiveness of listening to music or Quran in reducing cancer patients’ anxiety before chemotherapy administration. Reducing anxiety in people with cancer, prior to chemotherapy administration, is a crucial goal in nursing care.

Design

An experimental comparative study was conducted.

Methods

A simple randomization sampling method was applied. Two hundred thirty‐eight people with cancer who underwent chemotherapy were participated. They are assigned as Quran, music and control groups.

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