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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
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
The Role of Metformin in patients with Primary Hypothyroidism
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Background: Insulin resistance is present in 50% or more of patients with primary hypothyroidism. Metformin can decrease TSH levels in these patients by a complex matter, this can be of great help in clinical practice.

Objective: This study was designed to evaluate the effect of metformin in reducing TSH levels in patients with primary hypothyroidism.

Methods: Hundred patients with primary hypothyroidism, 82 females, 18 males were included in this study, everyone was followed up for two months after adding metformin 850 mg twice daily in addition to thyroxin.

Results: 36 patients (36%) have a normal baseline TSH and no change after 2 months, 64 pa

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Publication Date
Tue Jan 01 2013
Journal Name
International Journal Of Advance Biological Research
SOME BIOCHEMICAL CHANGES AFTER TREATMENT IN IRAQIS ACROMEGALIC PATIENTS
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Acromegaly is a rare disease produce generalize and serious alteration in the patient with active disease. Many of these patients are also diabetic. Many analytes, hormones, markers are change in these disease. The objective of study is to assess the modification in a number of parameters that changed during the acromegaly as a result of excess in GH and IGF1 levels. The study included 36 patients and 38 healthy controls, paired by sex and age and BMI. Serum concentration of GH and the other parameters including (insulin, glucose, lipid profile, uric acid ) were determined by biochemical method .Compared to controls, acromegalic patients had increased levels of GH, insulin, glucose, triglyceride, very low density lipoprotein(VLDL) (p<0.05)

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Publication Date
Wed Dec 01 2010
Journal Name
Al Mustansiriyah Journal Of Pharmaceutical Sciences
Evaluation ofAaspirin, Clopidogrel or Their Combination In Hypertensive Patients
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The objective of this study is to evaluate the effect of aspirin, clopidogrel or their combination on different parameters in hypertensive patients.Platelets adhesion, activation, and aggregation are central to thrombus formation, which follows atherosclerotic plaque disruption and causes acute coronary syndromes. Aspirin and clopidogrel exert their antiplatelet effects by inhibiting thromboxane A2 production and adenosine diphosphate–induced platelet aggregation pathways, respectively. This study was designed to evaluate the possible effects of aspirin and clopidogrel given either alone or in combination in patients with essential hypertension on blood pressure and other parameters in addition to lipid profile using a randomized

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Publication Date
Tue Feb 04 2014
Journal Name
American Journal Of Pharmacological Sciences
Self Medication Practice among Iraqi Patients in Baghdad City
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The practice of self medication is continuously increasing worldwide due to its important roles in curing minor conditions or symptoms. This study was conducted to evaluate the factors associated with self medication practice of Iraqi respondents residing in Baghdad City. This study was designed as cross sectional study in which data was collected via direct interviews with respondents using a previously prepared questionnaire. This study investigated 348 respondents from different age groups. The majority of respondents were male aged between 30-60 years, married with secondary or academic level of education and employed with accepted monthly income. The main reason for practicing self medication was previous experience with the same condi

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Oxidative stress status in hypertensive patients on amlodipine treatment
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Background: Oxidative stress may contribute to the etiology of hypertension in humans. Oxidative stress is an imbalance between reactive oxygen species (ROS) and antioxidant defense mechanisms, causing damage to biological macromolecules and dysregulation of normal metabolism and physiology. Amlodipine as an antihypertensive agent is a long-acting calcium channel blocker that dilates blood vessels and improves blood flow. The aim of this study was to assess the oxidative stress in hypertensive patients on Amlodipine treatment through the assessment of salivary Malondialdehyde (MDA) and superoxide dismutase (SOD) as a marker of oxidative stress.

Mat

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Publication Date
Fri Jun 30 2006
Journal Name
Al-kindy College Medical Journal
Oral Carriage Rate of Candida Species in Diabetic Patients
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Background: It is well known that oral carriage
of Candida species increase in many situations, like
obesity, debility, leukemia, viral infection, use of
certain drugs in addition to diabetes mellitus.
Objective: find the relation between diabetes and
its control on oral carriage of Candida.
Methods: Thirty four hundred oral swabs from
diabetic patients 67% are females and 33% are
males, 41.7% are type 1 diabetes and 58.3% are type
2.different culture media are used.
Results: we found that 37.9% of diabetics had oral
carriage, older age group had more but the
difference is not significant statistically P>0.05, in
addition females carry more Candida than males
P<0.05, while type of diabetes

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Publication Date
Fri Dec 20 2019
Journal Name
College Of Islamic Sciences
The role of a teacher of Islamic education In explaining the concepts of political freedom Educational guidance study
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The political struggle being waged by Muslims today is one of the most important issues that have preoccupied the Arab and international media, and the failures that have afflicted Muslims in our contemporary world have negatively affected the younger generations and led them, and with the influence of anti-Islam media, to rely on accusing Islam as a religion with all the negative in Islamic and Arab society . So secularism took its role in spreading these concepts by deviating from its course from the concept of science to the concept of (the religion).
    From here the calls for reform rose to return the Muslims to the incubator of Islam, so people turned around them, but they turned into competing Islamic polit

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Publication Date
Sun Oct 02 2011
Journal Name
Journal Of Educational And Psychological Researches
Levels of Geometrical Thinking of The Students of Mathematic Department in Basic Education College at AL- Mustansiriyah University
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This  research aimes to expose the levels of geometrical thinking among the students of mathematic department in Basic Education College at AL-Mustansiriyah University throughout their respondes on the test of  geometrical thinking which consists (50) multi- choice items  distributed on the first four levels of Van Hiele ( recognition – analysis – ordering – deduction ).

The validity and the reliability of the test have been investigated. Besides, the difficulty and its discrimination have been measured. The activity of the wrong variables has been measured.

The test has been applied on (180) male and female students of the first, second and third grades.

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Publication Date
Wed Jun 20 2018
Journal Name
Al-academy
The effect of CORT educational program on creative thinking for the secondary school students in art education subject
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The current research aims to identify (the effect of CORT program on creative thinking for middle school students in the art education history of ancient art subject).

     The research society continue of the5th of scientific students in ALsadreen secondary school of excellence which related of the Directorate of Education al-sader city, for the academic year (2015/2016), The sample was (35) students for each of the two groups (experimental and control). The equivalence between the research groups was carried out in the IQ variable, the age and the level of the father and mother.

     The researcher used the experimental method of partial control and the post-test. If the course of

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
The impact of the flipped classroom strategy on developing the communication skills in classes among art education students
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The technology and modern social communication medias have contributed to changing many of our concepts about education to a large extent; these technological advancements have created new challenges for the Instructor of course, but on the other hand it did provided him with expressive media, models and strategies that the old methods cannot fulfill, including the flipped classroom strategy, which is one of the modern technical solutions and in it's optimal use it can correct the weakness of the traditional education and can develop the communication skills as a whole among the students, in order to create a positive, active and interactive student.
The current research contained - four chapters: the first one included the methodolog

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