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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 Dec 23 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Students Experience of Hybrid- Education Model at The University of Baghdad College of Pharmacy
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The impact of COVID-19 pandemic on education models was mainly through the expansion of technology use in the different educational programs. Earlier impact of COVID-19 was manifested in the complete and sudden transition to distance education regardless of institution preparedness status. Gradually, many institutions are moving back to on-campus face-to-face education. However, others including all higher education institutions in Iraq are adopting the hybrid education model. This report presents part of the end of semester evaluation survey conducted at the University of Baghdad College of Pharmacy for the Spring 2021 semester. The survey aims to address points of strength and weakness associated with the hybrid education model and spe

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Publication Date
Fri Mar 15 2024
Journal Name
Alustath Journal For Human And Social Sciences
Assessing Iraqi ESL Fourth Year College of Physical Education and Sport Sciences Students' Writing Anxiety
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يعد القلق من الكتابة مؤشرا هاما قد يعيق القدرات الكتابية ويؤدي إلى عدم كفاءة الأداء. تهدف هذه الدراسة إلى تقييم القلق الكتابي لدى طلاب السنة الرابعة في كلية التربية البدنية وعلوم الرياضة العراقيين دارسي  اللغة الإنجليزية كلغة ثانية (ESL) , حيث واجهوا صعوبات وعقبات في هذا المجال. ان تصميم الدراسة الحالية هو  تصميم وصفي واداة القياس لهذه الدراسة تتالف من مقياس مكون من (20) فقرة. ان عينة الدراسة الحالية  مختارة

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Publication Date
Sat Sep 23 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Clinical Pharmacist in Reducing Drug Related Problems in Decompensated Liver cirrhosis patients
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Patients with decompensated cirrhosis have typically prescribed a combination of therapeutic and prophylactic medications. Polypharmacy increases the probability of medication errors and drug related problems. Clinical pharmacists are highly effective at identifying, resolving, and preventing clinically important drug-related problems in their patients' care. The objectives of the study were the identification and classification of drug-related problems, as well as the discussion of these problems with health care providers (physicians, pharmacists, and nurses) and patients. Reduce their incidence as effectively as possible and educate all research participants on the significance of following their prescribed drug regimen

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
The role of TNF-? in the pathogenesis of multiple myeloma “a study in Iraqi patients”
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During recent years, there has been an increasing interest in the investigation of the cytokines roles in pathogenesis of cancer, thus the study aimed at evaluating the level of tumor necrosis factor-alpha(TNF-?) in sera of Iraqi multiple myeloma (MM) patients. Beta 2-microglobulion (?2-m) was assessed to determine if there was any association between this cytokine and the level of ?2- m, as the latter is related to the stage of the disease. In addition, the age and gender were also taken into consideration. Furthermore, we investigated the relationship between IgG and TNF-? in sera of patients. 49 Iraqi patients (27 males and 22 females).The patients were also divided into two groups: the first group included (17) patients who were

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Taste Detection Thresholds in Relation to Salivary and Serum Zinc in Patients on Simvastatin Treatment
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Background: Hyperlipidemia is an elevated fat (lipids), mostly cholesterol and triglycerides, in the blood. These lipids usually bind to proteins to remain circulated so-called lipoprotein. Aims of the study: To determine taste detection threshold and estimate the trace elements (zinc) in serum and saliva of those patients and compare all of these with healthy control subjects. Methods: Eighty subjects were incorporated in this study, thy were divided into two groups: forty patients on simvastatin treatment age between (35-60) years, and forty healthy control of age range between (35-60) years. Saliva was collected by non-stimulated technique within 10 minutes. Serum was obtained from each subject. Zinc was estimated in serum and saliva

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
The frequency of IgM-anti HAV in the sera of patients with hepatitis in Iraq
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Three hundred and fifty five patients with hepatitis were investigated in this study all cases gave negative result with HBs Ag , IgM-anti HCV , IgM-anti HEV, IgM-anti HDV and anti-HIV tests . The frequency of IgM-anti HAV was 113 and the percentage was 32 % in all ages but when these patients divided into five groups dependent on ages. The highest percentage of IgM-anti HAV was (45%) in age <10 and the percentage declined with age increase till to 9% in age >41 year.

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Publication Date
Sun Apr 30 2023
Journal Name
Al-kindy College Medical Journal
Estimation of Salivary IL-6 Level in relation of Periodontal Status in Patients with Hyperthyroidism
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Background: The overproduction of thyroid hormones is known as hyperthyroidism. Increased susceptibility to caries and periodontal disease are two potential oral symptoms. The interleukin-6 (IL-6) was observed to significantly increased in the hyperthyroid group. According to multiple research, IL-6 dysregulation has been linked to a number of oral disorders, including periodontal diseases. The study aimed to evaluate periodontal health status in relation to IL6 among hyperthyroidism patients.

Subjects and Methods: The sample was composed of 90 female patients aged 25-45 years attending endocrine disorder

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Publication Date
Sun Apr 02 2017
Journal Name
Research Journal Of Pharmaceutical, Biological And Chemical Sciences
GLP-1, GPCR Levels and their Relationshipwith Some Parameters in Nondiabetic Dyslipidaemia in Iraqi Patients
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Abnormalities in the Lipid and lipoprotein levels are common in the general population and are considered as very important risk- factors for cardiovascular disease .In this context the effect of cholesterol, which is one of the most clinically relevant lipids is very important. Aim of the present study was to determine the levels of GLP-1 and GPCR in non- diabetic dyslipidaemic patients and compare the results with the control group, which may be used as a novel biomarker to predict heart disease in these patients. The study was also aimed to find the relationship between GLP-1 and GPCR with lipid profile and glucagon in the patient group. The study involved 90 non-diabetic dyslipidaemia patients, with 90 healthy controls. The subjects wer

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Publication Date
Mon Jul 18 2022
Journal Name
Journal Of Genetic And Environmental Resources Conservation
Estimation of immunological markers (IL1Alpha, IL-6 and CRP) in colorectal cancer in Iraqi patients
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Cytokines are A type of protein that is made by certain immune and non-immune cells and has an effect on the immune system. Some cytokines stimulate the immune system and others slow it down. Interleukins (ILs) can be divided into several families with more than 40 subfamily members. They can interact with a variety of cells that alter the immune system and act on a wide range of cancers. In the past several years, ILs have attracted substantial attention because of their distinct roles in CRC that provide a new and promising strategy for CRC. In general, ILs facilitate CRC by promoting tumorigenesis, tumour growth, angiogenesis, and cancer cell invasion and metastasis and inhibit CRC via complex pathways. The Bioassay Technology Human Inte

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Publication Date
Mon Jan 01 2024
Journal Name
Scripta Medica
Effect of proteolytic enzymes and insulin sensitiser in treatment of joint osteoarthritis in diabetic patients
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Background/Aim: Knee osteoarthritis is a frequently crippling chronic condition. Numerous pharmacological medications have been successfully utilised to treat knee osteoarthritis. This research aimed to compare the efficiency of metformin and serratiopeptidase in treating and preventing osteoarthritis development via distinct mechanisms. Methods: Between 1 January and 30 May 2019, a randomised-clinical-trial was done at Al-Kindy Hospital on 80 osteoarthritis patients, divided in two groups. Group I was given metformin 850 mg orally, whereas Group II was given serratiopeptidase 20 mg and metformin 850 mg orally. Parameters in these groups were compared with forty healthy normal controls. Results: Following treatment, patients in Grou

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