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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
Sat Nov 01 2014
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
Frictional melanosis of rubbing thighs in Iraqi patients
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KE Sharquie, AA Noaimi, AA Hajji, Journal of Cosmetics, Dermatological Sciences and Applications, 2014 - Cited by 5

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Publication Date
Sat Jun 30 2007
Journal Name
Al-kindy College Medical Journal
Urine Cytology in Patients with Long Standing Dialysis
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Background: Dialysis is in common use to treat patients
with end stage renal failure .However longstanding dialysis
harboring some cellular changes in various body fluids.
This study was conducted in order to detect these changes
in urine.
Objective: The study was conducted to detect cellular
changes in urine of patients with longstanding dialysis.
Method: Fifty-three urine samples were examined
cytologically obtained from patients with longstanding
dialysis during 6 months period. Freshly voided midstream
urine samples were taken . Samples were centrifuged and 2
to 3 drops of sediments were smeared on 2 glass slides and
fixed in 95% ethyl alcohol then stained with Hand E stain
to be evaluated.
R

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Laparoscopic versus open appendectomy in patients with acuteappendicitis
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Background: Laparoscopic surgery for
appendicitis is now a well established and
advanced method of performing general surgical
procedures.
Objectives: To compare the outcome of
laparoscopic and open appendectomies in terms
of operative time, analgesic requirement,
postoperative complications, hospital stay, return
to normal activity and condition of scar.
Methods: This prospective study was carried
out from 1stMay 2008-1st January 2010, involving
110 patients (45 male and 65 female) with
features suggestive of acute appendicitis were
divided into 45 patients laparoscopic
appendectomy (LA) group and 65 patients open
appendectomy (OA) group, after taking informed
consent. LA was done with the

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Public Health Research &amp; Development
Certain Hematological Denotations in Chronic Renal Failure Patients
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Publication Date
Sat Jun 30 2007
Journal Name
Al-kindy College Medical Journal
Lung Cancer in a Sample of Iraqi Patients
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Background: Lung cancer is responsible for the most
cancer deaths in both men and women throughout the
world. Deaths from lung cancer (160,440 in 2004,
according to the National Cancer Institute) exceed the
number of deaths from four other major cancers combined
(breast, colon, pancreatic and prostate).
Objective: To assess the behavior and the approaches of
lung cancer in a sample of Iraqi patients.
Methods: This descriptive retrospective study was
performed using the records of 390 patients proved to have
lung cancer that had attending the Thoracic Surgery
Department of Surgical Specialties Hospital-Medical City
\Baghdad for the period from January, 1st
, 2001 to
December, 31st
,2002.
Res

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Publication Date
Fri Jun 30 2006
Journal Name
Al-kindy College Medical Journal
Serum Zinc Level in Patients with Heart Failure
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Background: Zinc is involved in a variety of
metabolic processes and it has a well known
antioxidant activity, so the measurement of its serum
level can have a special value in several diseases.
Objectives: The study is designed to determine the
serum zinc level in heart failure patients and to
compare it with that of healthy individuals and to
study the significance of the results obtained.
Methods: Atomic absorption spectrometer
technique was used to determine serum zinc level in
fifty heart failure patients and fifty healthy individuals
who were age and sex matched.
Results: The mean serum zinc level in healthy
individuals was about 45.5% greater than that of heart
failure patients. This diffe

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Publication Date
Sun Mar 04 2018
Journal Name
Baghdad Science Journal
Detection of Chlamydia pneumoniae in Ankylosing Spondylitis Patients
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Ankylosing spondylitis is a complex debilitating disease because its pathogenesis is not clear. This study aims at detecting some pathogenesis factors that lead to induce the disease. Chlamydia pneumoniae is one of these pathogenesis factors which acts as a triggering factor for the disease. The study groups included forty Iraqi Ankylosing spondylitis patients and forty healthy persons as a control group. Immunological and molecular examinations were done to detect Chlamydia. pneumoniae in AS group. The immunological results were performed by Enzyme-Linked Immunosorbent Assay (ELISA) to detect anti-IgG and anti-IgM antibodies of C. pneumoniae revealed that five of forty AS patients' samples (12.5%) were positive for anti-IgG and IgM C. pneu

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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
Physiological and Immunological Disturbance in Rheumatoid Arthritis Patients
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            Rheumatoid arthritis (RA) is a systematic autoimmune disorder with chronic inflammation changes of unknown etiology. Various synovial inflammatory and proliferative alterations may contribute to the cartilaginous tissues and invasive bony tissues, leading to destructive joints and malformed bones. This disease is mostly due to infective microorganisms or genetic susceptibility causing immune system disturbances through triggering both T-cells and B-cells. Furthermore, different immune cells may secret cytokines, which are responsible for some RA pathogenesis activity. From ninety individuals, serum sample was collected; thirty of them were normal and sixty cases were patients with RA attended a privet medical clin

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Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Change in Taste in Diabetic Patients with Facial Nerve Palsy
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Background: Bell's palsy was defined as facial weakness of lower motor neuron type caused by idiopathic facial nerve involvement outside the central nervous system without evidence of aural or more widespread neurologic disease. The cause is unclear, but the disorder occurs more commonly in diabetics.Objectives: to differentiate cases of idiopathic Bell's palsy from diabetic mononeuropathy presented with Facial nerve palsy by assessing the taste, because they differ in etiology, management & prognosis.Patients &Methods: One hundred and fifteen consecutive patients were referred for the treatment of facial palsy, from May the 5th 2012 to April 12th 2013 in Al-Kindy Teaching Hospital and The Neurosciences Hospital, in Baghdad / Ira

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Measurement of some Biochemical Values in Hemodialysis Patients in Baghdad
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One hundred of dialysis patients' mean age ( 51.18±8.28) years and one hundred healthy control group , where carried out  from different hospitals of Baghdad city , during the period between November /2012 until March/2013. Blood samples were collected before dialyzing for estimation   the concentration of urea, creatinine, uric acid, random blood sugar , calcium and cholesterol by enzymatic method detected spectrophotometerically.

The  aim of this  study is   to determine concentration of urea, creatinine, uric acid, RBS , calcium and cholesterol in hemodialysis patients in Baghdad . The results showed that there were  highly significant increases (P<0.01) in the mean of creatinine ,

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