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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
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
The Degree of Using Computers in Administrative Jobs and the Obstacles of Usage in Public Education Schools in Sharoorah Governorate: Saudi Arabia
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This study aimed to identify the degree of use computers in administrative functions (planning, organization, controlling, and evaluation) among school leaders and assistants in public education schools in Sharoorah governorate ، as well as to identify obstacles of  use computers in administrative functions from the perspective of school leaders and assistants male and female in public schools during the academic year 1439-1440, the study sample  (66) school leaders and assistants, males (58), a and females (44), , and to answer the questions of the study, the researchers developed a questionnaire consisting of  (60) items, has been verified sincerity and persistence, and data analysis was used frequencies, percentages an

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Associations Between Phonological Processing and Working Memory in Students with and without Reading disabilities in Basic Education Cycle One Schools in Muscat
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The study aimed to examine the phonological processing profile for students with and without reading disabilities in cycle 1 schools of basic education in the Governorate of Muscat, Sultanate of Oman. The study participants included 306 students, 165 students with reading disabilities and 141 students without reading disabilities. The Comprehensive Test of Phonological Processing (CTOPP) and Working Memory Test (WMT) were administered to the participants. The results of the study showed that the mean score of students without reading disabilities was higher than that of students of reading disabilities in all measures of phonological processing, and that there are statistically significant differences on the  case of students in all

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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of an Educational Program upon Academic Nurses’ Practice Concerning Documentation of Nursing Sheets in the Medical and Surgical Teaching Hospitals of Sulaimani Governorate
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Objectives: The study objectives are to determine the impact of education program upon the academic nurses'
practice concerning documentation of nursing sheets, and to find out the relationship between nurses knowledge
and their demographic characteristics, which include age, sex, and years of experience in medical and surgical
wards.
Methodology: A quasi- experimental study was carried out at the medical and surgical wards in teaching
hospitals in Sulaimani governorate from the beginning of March up to June 2007٠
To reach the objectives of the study anon-probability (purposive) sample of (25) academic nurses who work in
the medical and surgical wards in teaching hospitals.
The data were collected through the use

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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)
Acquired Error in using Antibiotic for Surgery Patients in Iraqi Hospitals
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The use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 from Al-

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Publication Date
Fri May 10 2024
Journal Name
South Asian Research Journal Of Pharmaceutical Sciences
Influence of Human Leukocyte Antigen in Susceptibility to Migraine in Patients
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Migraine affects more than one billion individuals each year across the world, and is one of the most common neurologic disorders, with a high prevalence and morbidity, especially among young adults and females. Migraine is associated with a wide range of comorbidities, which range from stress and sleep disturbances to suicide. The complex and largely unclear mechanisms of migraine development have resulted in the proposal of various social and biological risk factors, such as hormonal imbalances, genetic and epigenetic influences, as well as cardiovascular, neurological, and autoimmune diseases. Experimental findings suggest an involvement of neuroinflammatory mechanisms in the pathophysiology of migraine. Specifically, preclinical

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Publication Date
Tue Jan 01 2019
Journal Name
Research Journal Of Pharmacy And Technology
Reading of Immune picture in Chronic Myeloid Leukemia in Iraqi Patients
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Chronic myeloid leukemia (CML) is a myeloproliferative disorders characterized by formation of Philadelphia chromosome. After disease development, several events may associate with the reduction of anti-tumor immunity. The present study was designed to investigate the immunological profile of innate and adaptive immune response in Iraqi patients with CML. Patients were grouped into untreated (UT), treated (T) with chemotherapy, while another apparently healthy individuals were recruited to represent the control (C) group. Methods: ELISA technique was used to estimate serum levels of GM-CSF, IL-1a, IL-8, IL2, INF-?, IL-4, and IL-10 while SRID was used to estimate serum levels of C4, IgM, IgA, and IgG. Results: Regarding to innate immune resp

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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)
Acquired Error in using Antibiotic for Surgery Patients in Iraqi Hospitals
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The use of antibiotics (AB) in surgery focused in either treating established infection or to prevent suspected post-operative infection. Inappropriate use of antibiotic for treatment of patients with common infections is a major problem worldwide, with great implications with regards to cost of treatment and development of resistance to the antimicrobial agent. Moreover, antibiotics may often be dispensed without a clear clinical indication. This study was conducted to estimate the medication errors in using antibiotic for surgery patients which may effect their wound healing. A 260 patients with clean-contaminated and contaminated surgery were included from two teaching hospitals, 160 patient from Medical city hospital and 100 fro

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Publication Date
Sat Jun 30 2018
Journal Name
Journal Of Advanced Laboratory Research In Biology
Evaluation some Biochemical Levels in Patients undergoing Hemodialysis in Baghdad Governorate
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The objective of investigating some biochemical parameters like urea, creatinine, Hb and other parameters as CRP and leptin in the serum of ESRD patients on hemodialysis pre-dialysis. Method: Sample of 250 cases which consists of the patient with ESRD, their mean ages were 52.66 ± 12.55 years with ranged from 18-83. Moreover, under hemodialysis treatment not less than three months. Apparently, 20 healthy subjects were selected as (control) for comparison. Results: The results showed that there was a significant increase (p<0.01) in the serum urea, creatinine, CRP, and leptin. While, revealed significant (p< 0.05) decrease in the levels of uric acid, serum glucose, albumin, inorganic phosphorus, potassium, Hb and platelet in patien

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Publication Date
Wed Oct 18 2017
Journal Name
Al-kindy College Medical Journal
Non Motor Symptoms In Patients With parkinson's Disease In Baghdad Hospitals
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Background:Parkinson’disease(PD) is a neurodegenerative disorder of the central nervous system characterized by resting tremor, bradykinesia, cogwheel rigidity, and impairment of postural reflexes; the frequency of PD increases with aging.Clinically Parkinson's disease characterized by two groups of symptoms: motor and non-motor symptoms.Non-motor symptoms can be categorized as autonomic, cognitive/psychiatric (may include depression, dementia, anxiety, hallucinations), sensory and rapid eye movements (REM) sleep behavior disorder (RBD).

Objectives:The objectives of this study are to find out the frequency of the non-motor symptoms of idiopathic Parkinson disease in a group of patients in Baghd

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Global Pharma Technology
Some Biochemical Parameters in Congestive Heart Failure Patients in Baghdad City
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