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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
Mon Jul 01 2024
Journal Name
Medical Journal Of Babylon
Epidemiology of Colorectal Polyps in Iraqi Patients
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Abstract<sec> <title>Background:

A colorectal polyp (CRP) is a growth on the lining of the colon or rectum. The incidence of CRPs is rapidly increasing with age. They are most often benign. The rectum is the most commonly affected site.

Objectives:

To determine the incidence, clinical presentation, and histopathologic types of CRP in Iraqi patients.

Materials and Methods:

It is a cross-sectional screening study conducted in the medical c

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
The major psychocutaneous disorders in Iraqi patients
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KE Sharquie, AA Noaimi, MS Younis, BS Al-Sultani, Journal of Cosmetics, Dermatological Sciences and Applications, 2015 - Cited by 8

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Publication Date
Wed Sep 03 2014
Journal Name
Iraqi Journal Of Science
Antineutrophil cytoplasmic antibodies in patients with tuberculosis
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Tuberculosis is caused by Mycobacterium tuberculosis; it is considered as one of the most common, infectious diseases and major causes of morbidity and mortality worldwide. A prospective study was conducted to obtain more clarification about the impact of causative agent and its treatment to enhance autoantibodies production such as ANCA and BPI which used as diagnostic markers for several diseases, and to provide further insight into the classical risk factors (age and sex).Seventy patients with tuberculosis involved in this study, 35 of them were untreated and 35 with treatment administration these patients were attending to directorate of general health national reference laboratory in Baghdad during the period between November/ 2012 and

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Serum Zinc in Iraqi Acute Leukemic Patients
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Background: Leukemia is a group of malignant disorders
associated with increased numbers of blood white blood
cells. Acute leukemia occurs at all ages. Because zinc
influences many body systems and functions, zinc is an
essential nutrient for tissue growth, cellular division,
protein synthesis DNA and RNA replication it also ought to
play a critical role in the growth of tumor. In this study,
serum zinc was estimated in leukemic patients and
compared with healthy subjects.
Methods: The subjects in the present study were; fourtyfour depressed patients aged (14-48 year), thirty-one
apparently healthy subjects were selected as control group.
Their sex and age were comparable to that of patients.
Determin

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Publication Date
Sun Sep 01 2019
Journal Name
Journal Of Physics: Conference Series
Autoantibody Profile in Systemic Lupus Erythematosus Patients
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Abstract<p>Systemic lupus erythematosus (SLE) is an autoimmune disease, in which the etiology is not well-understood; however, interactions between environmental and genetic factors in predisposed individuals have been recognized. As a consequence, immunological alternations occur and immune cells are involved, especially T and B lymphocytes that are activated to produce different immune components. Among these components are autoantibodies that react with self-antigens aside from non-self-antigens due to the proposed theory of molecular mimicry. Accordingly, the current study was designed to examine the profile of different autoantibodies in SLE patients by using the indirect membrane based enzyme immunoassay </p> ... Show More
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Publication Date
Fri Mar 01 2019
Journal Name
Research Journal Of Biotechnology
Etiopathogenesis of CMV in rheumatoid arthritis patients
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Rheumatoid arthritis (RA) is one of the autoimmune diseases characterized by the synovial inflammation which causes organs and tissues damage especially synovial tissues and joints. The study included 50 serum samples from patients with rheumatoid arthritis (RA) when compared with 50 serum samples from healthy individuals as control with age range 35 – 60 years (41.3 ± 2.4 years vs. 41.0 ± 2.0 years, respectively). ELISA technique was used to assess the Anti-cyclic citrullinated peptide IgG antibody (anti-CCP IgG Ab) level, anti-rheumatoid factor IgG antibody (anti-RF IgG) and anti-Cytomegalovirus (anti-CMV IgG) antibodies frequencies in the studied groups. The present findings demonstrated that all RA patients have 100% seropositive fr

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Publication Date
Tue Dec 01 2020
Journal Name
Baghdad Science Journal
Prevalence of Diabetes Mellitus in Hepatitis C Patients in Wazirabad Tehsil of Gujranwala District of Pakistan: hepatitis C in Diabetic patients
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Hepatitis, a condition of liver’s inflammation that can be self-limiting or, in certain chances, it may lead to liver cancer, fibrosis or cirrhosis. Hepatitis viruses mainly cause hepatitis in the world. People with hepatitis C have predominant chances to develop diabetes as HCV virus participates in causing type 2 diabetes. HCV virus causes pathogenesis in two ways: it either directly destroys the β cells of pancreas or contributes to the specific autoimmunity of β cells. The present cross sectional study was done in Wazirabad Tahsil of Gujranwala District to analyze the percentage of patients suffering from hepatitis C who had the risk of diabetes mellitus. For this research work, demographic information and data about any other me

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Physical Evidence Of The Product And Its Impact In Attracting The Customer AField research for a sample of private medical clinics in Maysan
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Abstract

     The current research problem includes a variety of research motivations to serve the private health sector, which is witnessing a great competition from internal and external environments. In this regard, private medical clinics are increasingly seeking to attract and retain customers through the quality of their service offerings represented by health services. Innovative and effective marketing methods to improve performance and stay in competition, by relying on the physical evidence of the product as a component of the marketing mix of services and its role in particular in packaging and supporting the health service with concrete evidence that affects the customer an

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
School Principals’ practices of servant leadership from teachers’ perspectives in basic education schools in the Sultanate of Oman
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The study aimed to explore the school principals’ servant leadership practices for primary teachers’ perspectives in the Sultanate of Oman, furthermore to investigate the differences in those practices attributable to variables (gender, qualification, educational stage, years of experience, governorate). The study relied on the descriptive approach, by employing the survey research design using the questionnaire as a main tool for data collection, which included five dimensions of servant leadership (altruism, humility, enhancing teacher development, emotional healing, commitment to community development), Data collected from (1094) teachers in basic education schools, and they were chosen randomly. The results of the study indicated

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Autonomic Dysfunction in Interictal Period in Patients with Migraine
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Background: migraine is a chronic neurovascular disorder characterized by intermittent attacks of sever headache with or without aura that can include various combinations of neurological, gastrointestinal tract (G.I.T), and autonomic changes, without evidence of primary structural abnormalities. The Autonomic nervous system involvement suggested by many symptoms and signs including nausea, diarrhea, constipation, coldness in the extremities, paroxysmal tachycardia and chest pain.
Objectives: To evaluate autonomic functions in patients with migraine and to clarify the autonomic dysfunction weather its sympathetic, parasympathetic, or combined. Also to assess the severity of this dysfunction and its relation to age, gender and type of

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