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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
Tue Jun 01 2021
Journal Name
Al- Anbar Medical Journal
Evaluation of Antimicrobial Activity of Plants Extract Against Bacterial Pathogens Isolated from Urinary Tract Infection among Males Patients
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Publication Date
Fri Feb 01 2013
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THE POSSIBLE RELATIONSHIP BETWEEN SERUM TUMOR NECROSIS FACTOR ALPHA LEVEL AND THE RECOVERY OF PATIENTS WITH PULMONARY TUBERCULOSIS
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Mycobacterium tuberculosis is the cause of the major world health issue, tuberculosis (TB). The cytokine, tumor necrosis factor alpha (TNF-α) has been implicated in protection against TB in the early stages of the disease. TNF-α is an effective cytokine in the killing of intracellular M. tuberculosis. This study inducted to investigate whether there is any relationship between levels of TNF-α in sera of TB patients and their recovery, and is there any difference in the level of this cytokine in sera of female and male TB patients. This study included 29 patients with pulmonary TB (18 female and 11 male), their ages ranging from 37 to 59 years. All of them received first line TB therapy. They were consulted at Pasture Center during Septem

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Publication Date
Sun Dec 01 2019
Journal Name
Gene Reports
Hepatitis B virus genotypes among chronic hepatitis B patients from Baghdad, Iraq and their impact on liver function
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Hepatitis B virus (HBV) infection is a significant global health problem. Populations of different ethnicities show great heterogeneity in HBV genotype frequency distributions. A cross-sectional study was conducted during June–October 2018 to determine frequency of HBV genotypes among chronic HBV patients from Baghdad, Iraq. The method of detection was nested polymerase chain reaction system. Further, the study assessed the impact of HBV genotypes on serum level of liver-function tests: total serum bilirubin, alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase. Eighty chronic HBV patients were enrolled in the study. Six HBV genotypes were identified (A, B, C, D, E and F). The most frequently encountered genotypes

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Publication Date
Tue Jun 01 2021
Journal Name
Al-anbar Medical Journal
Evaluation of Antimicrobial Activity of Plants Extract Against Bacterial Pathogens Isolated from Urinary Tract Infection among Males Patients
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Urinary tract infection (UTI) is a considerable problem aecting the health of people each year. It is caused by various Gram-positive (G+ve) and Gram-negative (G-ve) pathogens. It is an important illness in the world aecting all age groups across their life span. Objectives: To identify the most common aerobic bacteria that cause UTIs and their antibiotic susceptibility and antimicrobial activity of plant extracts of the males' patients. Materials and methods: The study involved 35 midstream urine samples from the male students (University of Baghdad, Baghdad, Iraq) with suspicious symptoms of UTI, during the period from January-March 2018. Each urine sample was cultured rst on Mannitol Salt Agar and MacConkey agar plates to dierentiate

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Publication Date
Tue Sep 05 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Protective Health Behaviors among Critical Care Nurses Concerning Pressure Ulcer Prevention for Hospitalized Patients at Baghdad Teaching Hospitals
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Background: Pressure ulcers remain a serious complication for immobile patients and a burden for healthcare professionals. Objectives: To assess health behavior prevention among critical care nurses regarding pressure ulcer prevention for hospitalized patients and to find out the relationship between critical care nurses health behavior prevention and sociodemographic variables. Methods: A cross-sectional design study was carried out in critical care units at three teaching hospitals. The study period extended from November 1, 2022, to January 28, 2023. Non-probability purposive sampling, whose target population was 100 nurses who work in critical care units in Baghdad, Iraq. The data were collected using a self-administered questio

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Publication Date
Sun Dec 30 2012
Journal Name
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Does the tertiary health care for Type 2 diabetic patients can help to Meet the recommended glycemic targets
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Objectives: To study the effect of providing tertiary (specialized) health care for type 2 diabetic patients to meet the WHO and ADA standards and glycemic targets.
Method: Six months, Jan. – Jun. 2010, cohort study was conducted on 600 adult diabetics who registered in the National Diabetes Center (NDC) / Al-Mustansiriya University, Baghdad – Iraq. They were followed for 3- 6 months; each time patients were examined physically and their blood pressure, height, weight and BMI were measured. Fasting blood samples were taken from all patients to test the FPG, HbA1c, T.Chol, TG, HDL and LDL.
Results: Patients’ age was 52.85±15.56 year and the male/female ratio was 1.01, the median duration of disease was 7 years and their BMI w

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Natural Sciences Research
Genetic Study for G-Protein Coupled Receptor from Saccharomyces Cerervisiae and From Sera of Patients with Heart Thrombosis
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Aim of the present study is Identification of specific gene for GPCR using specific primers .and identification of difference in PCR analysis in patients with heart thrombosis and compared with healthy, Sequencing of PCR product regarding GPCR compared for all three subject, Identification the similarity of human GPCR with local strain of yeast fifty healthy control and fifty patients with thrombosis which diagnosed medically with cardiac specific troponin t, troponin 1 levels and electro myocardiogram ECG. The aged for all subjects ranged (39-75) years patients were lying in cardiac care unit at Ibn- al- Nafees teaching hospital and Sheikh Zayed teaching hospital. Genomic DNA of whole blood was extracted from buffy coat and cell cu

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Intervention Program on Nurses' Practices concerning Diet Instructions for Orthopedic Patients treated by Internal Fixation Devices
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Abstract

Objective(s): To determine the interventional program effectiveness on nurses' practices concerning diet instructions for orthopedic patients treated by internal fixation devices.

Methodology: A quantitative approach using prexperimental design is conducted to determine the effectiveness of an interventional program on nurses’ practices regarding orthopedic patients diet instruction and teaching after internal fixation implemented. The study has started from 1st of April 2022 and ended on 15th of December, 2022. The conduction of the study in Misan governorate  / Al-Zaharawy surgical hospital. A non-probability, purpo

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Publication Date
Sun Sep 01 2019
Journal Name
Baghdad Science Journal
Detection of 16S rRNA Methylases and Co-Resistance with β-lactams among Klebsiella pneumoniae Isolates from Iraqi Patients
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Out of 150 clinical samples, 50 isolates of Klebsiella pneumoniae were identified according to morphological and biochemical properties. These isolates were collected from different clinical samples, including 15 (30%) urine, 12 (24%) blood, 9 (18%) sputum, 9 (18%) wound, and 5 (10%) burn. The minimum inhibitory concentrations (MICs) assay revealed that 25 (50%) of isolates were resistant to gentamicin (≥16µg/ml), 22 (44%) of isolates were resistant to amikacin (≥64 µg/ml), 21 (42%) of isolates were resistant to ertapenem (≥8 µg/ml), 18 (36%) of isolates were resistant to imipenem (4- ≥16µg/ml), 43 (86%) of isolates were resistant to ceftriaxone (4- ≥64 µg/ml), 42 (84%) of isolates were resistant to ceftazidime (1

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Publication Date
Wed Mar 30 2022
Journal Name
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The point of download of the faculty members for the reality of administrative motivation for the faculties of physical education and sports sciences deans of Baghdad and Al-Mustansiriya Universities Authors
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The aim of the research is to identify the reality of administrative motivation for the deans of the faculties of physical education and sports sciences at the universities of Baghdad and Al-Mustansiriya from the point of download of the faculty members. The number of the exploratory sample was (7) faculty members, they were taken in a random way, while the rest of the sample number was (150) faculty members who considered the application sample for the scale, and the two researchers also adopted a questionnaire for the scale and it is applied to the Iraqi environment. phrase, which are phrases that are interrelated with the administrative leadership motivation in the faculties of physical education and sports sciences. The researchers did

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