A hypothesis test is a method of statistical inference on sets of random variables, such as Hand Eczema Severity Index (HECSI) scores obtained from patients with hand eczema following treatment with hand creams “handy help” or “silky smooth”. If the values of the HECSI are normally distributed, a researcher can use Student’s t-test to compare the mean HECSI scores in both groups. The null hypothesis is that the mean scores are equal in both groups and the alternative hypothesis that the mean scores are not equal.
A 65-year-old woman was presented with an unusual object sticking out of her chest. The patient has no pain, dyspnoe or fever. Her medical history included a mitral and tricuspid valve repair 15 years ago. Six months ago, a central venous catheter was placed for dialysis.
- Age: 29
- Gender: Male
- Medical history: None
- Initial presentation: Dyspnoea, pain in right side of chest, saturation 80%, bulging neck veins, no breath sounds at the right side of chest, right side of the chest more convex.
“Nurse, can you help me sit up?”, “Nurse, I would like to pee.”, “Thank you, nurse”. These are sentences I, as a female doctor in training, heard frequently from patients during my internship at internal medicine. I visited the patients that were addressed to me daily, never correcting patients because the mix up did not really bother me. At the end of one day a nurse came to me and said that a patient had complained that although there was a very friendly nurse, the doctor never visited him. He was almost at the point to make an official complaint about this. I was sure I visited this patient that day, but because I had not corrected the patient in his “thank you, nurse” he never knew I was the doctor (or in this case: the medical student).
As a young female intern it is always possible that a (often elderly) patient addresses you as nurse. In their beliefs, by experience, cultural background or because it has always been that way, a female is a nurse and a male a doctor (of course this is somewhat exaggerated). I never felt annoyed nor offended when a patient called me nurse, but I also did not correct them. Moreover, I never requested a nurse to help explaining that I was not the nurse but a medical student.
Following the experience with the unsatisfied patient about the medical attention he presumably had not gotten, I now always make clear I am a doctor-in-training. This is not just to avoid complaints, but it can be reassuring for patients to know that the doctor is giving them the attention they need.