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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 Apr 30 2025
Journal Name
Journal Of International Studies
RESHAPING THE WORLD, RETHINKING ACTORS: THE ROLE OF SUB-STATE ACTORS IN FOREIGN RELATIONS
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International relations scholars have increasingly debated the evolving landscape of actors that challenge the traditional state-centric world order. A key element of this transformation is the rise of sub-state actors, which engages in alternative diplomacy parallel to the state, transcending traditional state-centric frameworks. This paper explores the significant shifts in international actorness over the late 20th century, focusing on the emergence and implications of sub-state diplomacy, or "paradiplomacy." First, the study introduces sub-state actors and their role in challenging the dominant state-centric discourse. It then examines the dynamic evolution of paradiplomacy, highlighting how sub-states have expanded their global

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Publication Date
Tue Dec 21 2021
Journal Name
Open Access Macedonian Journal Of Medical Sciences
The Impact of Social Support on Students’ Behavior in the Context of Iraqi Medical Education
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BACKGROUND: Mental health problems are reflected and linked to human behavior in many aspects. Medical students are susceptible to a wide variety of events that compromise their mental well-being, social life as well as their academic achievements. AIM: This study aimed to find the impact of social support on medical students’ behavior in Iraq via assessing their depression, anxiety, and stress status. METHODS: A cross-sectional online survey-based study targeted all medical students in Iraq. The employed questionnaires covered mental health status of participants by evaluating their perceptions of depression, anxiety, and stress using. Data were analyzed using the Statistical Analysis System. RESULTS: The study revealed a signifi

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Educational And Psychological Researches
The impact of education differentiated strategy to modify the alternative conceptions Geographical concepts when students First grade average
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The aim of this study was to know ( the impact of education differentiated strategy to modify the alternative developments of geographical concepts when students first grade average) .
      To achieve the goal of this study , researcher relied on the experimental design of a partial set , the design is ( the experimental group with a control group of post-test )
.

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Publication Date
Sat Nov 10 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Satisfaction of Patients, Coronary Arteries in Related to Nursing and Medical Care
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Objectives of the study: The study aims to assess satisfy of the coronary artery patients for the care product from
the nurse and physician and to find out the relationship between patient satisfaction with the social and the
clinical characteristics of the patients.
Methodology: A descriptive design study conducted using the evaluation approach for the duration of June 3
rd
2012 to January 31, 2013. Non-probability sample of (60) patients who were visiting or admitted (inpatient or
outpatient) to the teaching hospital in Baquba with the diagnosis of coronary artery disease. A questionnaire have
been built and develop by the researcher based on review of literature and previous research, the form included of
(3) p

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Publication Date
Mon Mar 09 2026
Journal Name
Journal Of The College Of Law /al-nahrain University
The financial regulations approved in private universities and colleges in accordance with the Law of Private Higher Education No. (25) of 2016
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Publication Date
Sun Jul 01 2001
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
INHERITANCE OF DARK HEAD AND SIPHON IN THE LARVAE OF CULEXQUINQEFASCIATUS SAY
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A new spontaneous mutation (dh) is described for Culex quinquefasciatus Say. This
phenotype was observed in the second generation to cause complete coloration of the head
capsule and the siphon of the larvae. This character is mainly detectable in the larval stage
and slightly in the adult stage.
The reciprocal mass matting between mutants from F2 generation and normal wild type
sibs, revealed that the mode of inheritance can be controlled by an autosomal recessive
gene(s). This happened for both sexes with slightly variability in their expression. No
significant larval mortalities were found in all crosses.

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Publication Date
Wed Dec 20 2023
Journal Name
Discourse And Interaction
Refusal and politeness strategies favoured among Iraqi and Malaysian learners in marriage proposals
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The study targets exploring the similarities and differences between Iraqi and Malaysian learners of English in refusing marriage proposals. Also, it examines the favored politeness strategies that learners use to protect their interlocutors’ face, heeding both their social distance and status. Data were gathered by a Discourse Completion Task (DCT) which contained six marriage situations. Responses were analyzed based on Beebe et al.’s (1990) refusal taxonomy and Scollon et al.’s (2012) politeness system. The findings indicated that both the Iraqi and Malaysian learners preferred the indirect refusal strategies in marriage proposals, as well as the hierarchical politeness in the form of independence strategies regardless of t

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Publication Date
Wed Dec 20 2023
Journal Name
Discourse And Interaction
Refusal and politeness strategies favoured among Iraqi and Malaysian learners in marriage proposals
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The study targets exploring the similarities and differences between Iraqi and Malaysian learners of English in refusing marriage proposals. Also, it examines the favored politeness strategies that learners use to protect their interlocutors’ face, heeding both their social distance and status. Data were gathered by a Discourse Completion Task (DCT) which contained six marriage situations. Responses were analyzed based on Beebe et al.’s (1990) refusal taxonomy and Scollon et al.’s (2012) politeness system. The findings indicated that both the Iraqi and Malaysian learners preferred the indirect refusal strategies in marriage proposals, as well as the hierarchical politeness in the form of independence strategies regardless of t

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Publication Date
Fri Sep 30 2022
Journal Name
College Of Islamic Sciences
Style ''Affirmative say'' in the holy Quran Ibn Ashour's interpretation is a model
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Abstract

This study talks about a wonderful Qur'anic style. relates to one of the methods used in it. And it's the rhetorical style:  ''Affirmative say''. It is useful in arguing with the opponent, nullifying his reasoning, and proving the opposite meaning of the opponent. The study will be conducted from a Qur'anic perspective based on the study of examples of it, and partly in interpretive treatment through the book of editing and enlightenment of Taher Ibn Ashour, known for his art in matters of rhetoric and methods of controversy. This is with the rooting of this issue, and the relationship of industrial sciences to it as a Qur'anic style.

Keywords: ''Affirmative say, style, Qur'anic rhetoric, Arabic rhetoric, Co

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Publication Date
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Modernity when Zaki Almelad
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The Islamic thought still suffers from the problems posed by Western thought in the modern era, especially after the establishment of the modern Arab state, and replacing the intellectual reference that prevailed at that time, which is represented by Islamic thought with another intellectual reference represented by Western thought. Since then, thinkers and innovators and reformers and intellectuals of the Islamists, Are trying to get out of these many problems and multiple, after imposing the nature of that thought and those references with all their consequences, and one of these problems that is still Islamic thought suffers, the bilateral problem that some academics have raisedThe title of the symposium failed The Islamic thought and

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