Speaking Notes - Oet

Speaking Sub-Test Overview
The speaking sub-test consists of two roleplay scenarios. The interviewer will take the part of the
patient and the candidate takes his/her professional role as a doctor. The interview is usually
about 20 minutes long and structured as follows:
1. Identification check (not assessed)
2. Brief chat regarding the candidate’s medical career (not assessed)
3. The first roleplay including 2/3 minute preparation time and 5-6 minute roleplay
(assessed)
4. The second roleplay including 2/3 minute preparation time and 5-6 minute roleplay
(assessed)
During the preparation time you must read the roleplay card handed to you and you can make
notes on the card or underline key words. You may ask questions to interviewer if there is
anything you are unsure about, especially vocabulary. This is important because if you
misunderstand the situation it could effect how you approach the task.
Generally, if the interviewer is a male then the patient will be a male and if the interviewer is a
female then the patient will be a female. You can use the interviewer's name to address them
with if you like, or simply refer to them as Sir/Madam. Whatever you feel more comfortable with.
The interviewer may also take the role of a parent or carer of the patient i.e if the patient is a
child, or has a serious illness.
Role-play Structure
The roleplay scenarios are based on real situations you are likely to encounter in you work as a
nurse in Australia. There are a variety of possible settings for the roleplay including:
• Suburban Health Clinic
• Community Health Centre
• Nursing Home
• Hospital Ward
• Hospital Emergency Department
• School
A typical roleplay structure is as follows:

• Brief introduction dependent on the task.
• Ask questions to help you assess the situation.
• Respond carefully to what concerns the patient has.
• Provide an explanation of the condition & respond to further questions and concerns of
the patient.
• Provide advice and reassurance as required.
• Short simple concluding sentence.
You only have 5-6 minutes to complete the roleplay so it is important to follow the task closely
and not spend too long on any one section. If the roleplay lasts more than 6 minutes the
interviewer may signal you to end the roleplay. This could be a problem if you have not finished
key aspects of the task
Stage 1: Introductions and Opening Questions
Introductions are a very important part of the roleplay as they allow you to start the conversation
in a positive way and in line with requirements of the roleplay card. Therefore the first thing to do
is read the card very carefully looking for information which will help you, as a health professional,
determine how to approach the patient or carer.
OET SPEAKING COLLECTION BY RAMJI 1

Important factors to consider
• Identify the setting such as Hospital Ward, Community Clinic, School or Large Company.
This will signify the relationship you have with the patient or carer.
• Identify the patient, male, female, parent of child etc. Note, in the exam, most cards are
not gender specific, so that if the interviewer is a male the patient will be a male, and if the
interviewer is a female, then the patient will be a female.
• Is it the first time to meet the patient, or are they a regular patient of yours? For example,
if you know the patient is a good idea to begin with a familiar tone such as
o Hi Jane, how can I help you today? Rather than.
o Hello I am Kate Naomi your Nurse. How may I address you?
• It is very important to start the roleplay in a confident manner. Here are some standard
ways to begin the conversation.
Starting the Interview
If it is the first time to meet the patient you can begin with
• Hello I am Kate your Nurse. Could you tell me your full name please?
If you know the patient it is a good idea to begin with a familiar tone such as
• Hi Jane, how can I help you today?
At a clinic or health centre

• Good afternoon Sir/Madam, I’m Kate your Nurse today. What seems to be the problem?
• Good afternoon Patricia, you’ve brought your daughter along I see. What seems to be the
problem?
• Good afternoon John, please sit down. I’m Kate your nurse. What brings you here today?
• Hello Steven, you’re here to have your stiches removed, aren’t you?
At a nursing home or hospital ward

• Hello Maria, how are you feeling today?
• Hello John, you're looking better today. How do you feel?
• Good afternoon, Madam. I’m Kate, the nurse who'll take care of your daughter during her
hospitalization.
Taking the patient history contentment
Once you have made the initial introduction, you will need to ask some questions to determine
the exact nature of the patient’s problem or concern. Some of this information will be given to you
on your card, but it is a good idea to ask the basic questions anyway as forms the basis of your
consultation. Just remember, however, to keep your line of questions quite narrow and specific to
the patient’s condition as you have only 5~6 minutes to complete your task so there is no time for
a general history.
Asking questions about the patient’s medical problem

• Have you ever had a serious illness in the past?
• Are you allergic to anything?
• How long have you been feeling this way?
• Have you ever been in hospital before?
Asking questions about the patient’s social history

• Will anybody be at home to look after you when you are discharged?
• Do your family live near by?
• Do you have any friends or neighbours who can help you?
• Is there anything you need help with at home, such as cooking meals, or cleaning the
house?

Stage 2: The Main Body
Once you have taken the history to a satisfactory level it is time to move to the second stage of
the roleplay which is often an explanation about a certain condition or method of treatment. This
may take up to a third of the roleplay (1-2 minutes) so it essential that you do it in a clear and well
organised manner as outlined below:
Informing the patient

• Based on my examination you are suffering from…….
• The blood test results indicate that your child has………
• The tests show that it is probably a condition known as……
Describing the condition

Make sure your explanation is clear and well organised. Patient with burns example:
Let me explain the three kinds of burns:

- Third degree, which is very serious…..
- Second degree, which is less serious but can be painful and result in scarring
- And first degree, which your son has, is only superficial and does not leave scarring………..
Is that clear?....Good. Now, the dressing only needs to be on for a few days and the cut will heal.
Do you know anything about this condition? No? Okay I will explain it to you.
- It is a condition caused by….
- The symptoms include…….
- The best treatment is to…….
- It is highly contagious so you need to…
Try not to talk continuously. Stop from time to time to check if the patient understands your
explanation.
• Is that clear?
• Do you understand so far?
• Do you have any questions?
Reassuring the patient

• It’s nothing to get alarmed about. It’s just a routine check.
• There really is nothing to worry about. The burns are only minor and your son will
completely recover.
• Let me reassure you, the home care services are excellent and will help you manage your
condition; provide meals if needed and even make you a cup of tea.
Persuading the patient

• If you return to work you run the risk of doing further damage to you health.
• As I said, if you follow my advice and keep the wound clean, it will completely heal, free of
infection. However if you do not follow my advice, and allow the wound to get dirty again,
then infection may occur.
• The doctor has said that it is very important to take all your medications.
• According to the doctor you are ready to leave hospital today.
Stage 3: Concluding the Roleplay
This step can be a difficult part for some people. The important thing to remember is to make the
closing sentence short and concise. Here are some examples of how to do this:
At a clinic or health centre

• Is there anything else you would like to ask me?.......Okay take care now Mr Jones.
• Thanks for coming to see me today. Goodbye.

• Please come and see me again in a week.
• Here are some brochures to help you to understand the treatment procedure. Please
come again if you have any problems with the medication.
• I would like to see your child again in two months time. Take care now.
• If you are concerned, or if you have any further questions, please make an appointment
and come and see us.
At a nursing home or hospital ward

• I’ll come back in an hour to check on you.
• I’ll come back and check on your condition later today.
• If your condition/situation gets worse, please let me know.
• If you need me again, just press the buzzer.
• If you are concerned, or if you have any further questions, just ring this buzzer and we will
come and help you.
Techniques for Asking Questions
Correct questioning is a key aspect of the medical interview. It has many functions and is used in
all stages of the role-play. We ask questions in order to
• Identify the patient's main problem or concern
• Gather information
• To confirm what we have heard
• To encourage the patient to express themselves
• To check that the patient understands
Therefore, a good questioning technique can help the role-play run smoothly and allow for
effective communication between the health professional and the patient.
Open Questions
Open questions are often used at the start of the interview as they allow the patient to tell their
story. Open questions often begin with wh & how question words. Always listen attentively to
what the patient says in response to these questions as this will guide you on what to ask next.
What Where/When/Why How long How often How many/How

much
What kind of Where does it hurt? How long have How often do How many
exercise do you you had the pain? you brush your cigarettes do you
do? teeth? smoke per day?
What does your When did the pain How long has How often do the How many hours
daughter usually start? your daughter fits occur? sleep do you get
have for had this rash? each night?
breakfast?
What time does When was the last How long have How often do How many children
she go to bed? time you visited a you been on this you take this do you have?
dentist? medication? medicine?
What time did the Why are you come How long have How often do How much do you
accident happen? here today? you had this you get drink?
cough? headaches?
Closed Questions
Closed questions are useful to get specific details that you may not have got from the open
questions. They are also effective in the OET exam as they encourage natural interaction
between the health professional and the patient.

Do/Does Is/Are Have/Has Can/Could
Do you drink alcohol Is your daughter Have you had any nausea Can you cook for
every day? toilet trained? and vomiting? yourself?
Does the pain wake Are you in any pain Has there been any Could you open your
you up at night? at the moment? change in your symptoms? bowels this morning?
Do you know what Is there asthma in Have you been taking your Can you put pressure
eczema is? the family? medication? on your foot?
Does anyone in your Are you eating Has your condition Could you tell when
family have high blood normally? improved since you started you first noticed the
pressure? taking drug x? rash?
Introducing the Question Topic
One common questioning technique which is very effective is to introduce the subject first with
the phrase what about or how about then follow with a yes/no question as in the sample
dialogue below.
Nurse: What brings you here today?

Patient: Well nurse, I haven’t been feeling well recently.
Nurse: I‘m sorry to hear that, please tell me more.

Patient: I have been getting tired a lot.
Nurse: I see, what about your appetite. Are you eating well?
Patient: Not really, I haven’t felt hungry.
Nurse: What about your sleeping habits. Are you getting enough sleep?
Patient: Well about 4 or 5 hours a night
Nurse: Oh, it’s really not enough, is it?

Patient: I guess not.
Nurse: How about your work. Are you under any stress at the moment?
Patient: Yes, a little as it’s the end of the financial year so I am busy.
Embedded Questions
You can soften your questioning technique and sound more polite by using embedded questions.
Practice this form as it easy to get the word order wrong. Note, however, that embedded
questions follow the word order of statements not questions.
Direct Question Embedded Question

Why have you come here today? Could you tell me why you have come here today?
How did you injure your leg? Could you tell me how you injured your leg?
What time did the accident happen? Do you remember what time the accident happened?
When did the pain start? Can you tell me when the pain started?
How long have you had the pain? Could you tell me how long you’ve had the pain?
Is it a sharp or dull pain? Could you tell me if it is a sharp or dull pain?
Does the pain bother you at night? Can you tell me if the pain bothers you at night?
Why do you want a prescription for Can you explain why you want a prescription for
sleeping tablets? sleeping tablets?

Encouraging Reluctant (unwilling/loath/unenthusiastic) Patients
Sometimes the patient may need encouragement to provide the information that you need to
make a proper assessment of the patient's condition or situation. In these cases, try not to move
onto the next stage too quickly. It is better to persist until you get the information that you need. A
good technique in this situation is
• Tell me more about that please, John.
• Could you tell me more about that, Mary?
• Please tell me more.
• Is there anything you would like to tell me?
Probing Questions
Probing questions are sometimes necessary to get more detailed or precise information from the
patient.
• What do you mean by that?
• Where exactly is the pain?
• You look a bit anxious. Is there anything else that is troubling you?
• Can you explain exactly why you are worried?
Checking Understanding
It is very important to periodically check that the patient can follow your explanations and advice.
• Is that clear?
• How does that sound?
• Do you think you can do that?
Tag Questions
Tag questions are used to confirm that your information is correct, and are a good indicator of
confidence and and fluency with English. However, they can be tricky to use, as it easy to make
errors.
• It's your first visit to this clinic, isn't it?
• You are here to get your blood test results, aren't you?
• You haven't been taking your medication regularly, have you?
• You didn't sleep well last night, did you?
• Your daughter is only 8 years old, isn't she?
• It is causing you quite a bit of discomfort, isn't it?
Responding to a Patient
Listening is a key component of the medical interview and it is important to listen attentively to
what the patient says, as this is of more importance than what is written in your role-play card.
Careful listening will help you to improve your communication skills by allowing you to respond
appropriately, and show empathy and concern for the patient's condition or situation. Here are
some example responses.
• Now, I understand how you feel…...you are worried about returning home and whether you
can manage, but let me reassure, we can provide good quality home care and there are a
range of professional services available. Would you like me to tell you more about that?
• Well, you mentioned that you have had this condition for a few years, could you tell me about
the mediation you have been taking?
• Now, as you said, the wound is causing you pain. That is why I recommend you visit our
outpatient clinic as soon as possible.
• I can see that you are worried, but try not be too concerned as this condition can be
managed with medication and rest.

• I am very sorry to hear that. Would you mind if I ask you a few further questions regarding
this situation?
o Do you have any other difficulties?
o Is there anything else that is bothering you?
o Apart from chest pain, what other symptoms have you experienced?
• I see that must be a very difficult situation for you. But the good news is, that there are
several options available which will help you. Would you like to hear more about that?
• I totally understand how you might feel, but let me reassure you, this condition is not as
serious as you might think.
Providing Information
It is very important that, as a health professional, you are able to express information in a clear
and organised manner. This worksheet provides a framework for doing this as outlined below.
1. Begin with a topic sentence outlining what you are going to explain.
2. Use signposting language to facilitate patient understanding.
3. Check that the patient has understood your explanation before moving on.
Topic sentence Signposting Checking Understanding

Let me explain why I have arranged Firstly.....Secondly.....Thirdly...... Is that clear?
this appointment. Finally, First of all....... Is that Okay?
What I am going to do now is It is also important to...... It is How does that sound?
discuss the importance of proper also necessary to.....
diet including a nutritious breakfast
and having meals on time.
I’ll explain to you the importance of This means..... That's the Do you think you can do
healthy lifestyle. reason why....... that? Are you prepared to
do that?
How much do you know about Therefore.... So..... However,..... Do you have any
Jaundice? Okay, let me explain. Now, ....... In addition...... questions so far?
Explaining Condition
• Well from what you have told me, I think you are suffering from a condition known as...
• Well, based on my examination it appears that you have a condition known as______. It's
quite a common condition and we see a lot of it at this time of year. The good news is it is
quite a treatable condition, and if you follow my advice, you will recover quickly.
• This is a contagious (communicable) condition and therefore it can be transmitted to others.
For example, if you have close contact with your family members or friends, they may catch
this condition as well. So for the next week, it would be a good idea to avoid any physical
contact with others and make sure you don't share towels or eating utensils. If you follow this
advice you can certainly reduce the risk of infecting others.
• Based on your clinical history and my experience, I suspect that you may be suffering from
hepatitis A. Now I would like to tell you more about this condition. Firstly hepatitis A is an
infectious disease caused by a virus which is spread through contaminated food or water,
through eating utensils as well as poor hygiene practices. It is not very common in Australia,
but it is prevalent in some developing countries. Now I would do a couple of tests, such as a
liver function test to confirm the diagnosis. Is that clear
Treatment and Advice
• There are many things you can do to relieve arthritic pain, for example doing light exercise 30
minutes a day will be helpful, and I also recommend reducing alcohol consumption.

• It's a good idea to check your daughter's temperature because this condition can cause fever,
and if you find any other symptoms, such as nausea, vomiting or diarrhoea, then please
contact your local doctor.
• With appropriate treatment, you can expect to make a full recovery.
• There are some basic precautions that you can take to protect your family. Firstly, you must
not share utensils. Secondly, do not share your plates and glasses, and finally you should
wash your hands regularly. Can you do that?
• We need to manage your condition so that is doesn't get any worse. Therefore, there are a
few things you need to consider. First of all, you need to lose weight.
Secondly, you need to cut down your drinking. Thirdly, you need to cut out saturated fats from
your diet and finally you need to quit smoking. Are you prepared to do that?
Here are some role-play scenarios which demonstrate successful communication

between a nurse and a patient.
Conditions: Jaundice
Nurse: Good morning Jane! How are you today?

Patient: I am fine, but I really want to go home. I couldn't sleep here in the hospital. Actually, I
don’t like staying in the hospital. Is it possible to go home today, Nurse?
Nurse: I understand how you feel Jane. I know you really want to go home, but let me discuss
your situation and your baby’s condition. I recommend that you and your baby stay here
in the hospital for observation.
Patient: But why Nurse? I would really prefer to be at home instead of hospital.
Nurse: Because we noticed that your baby is very sleepy, not feeding well and becoming
jaundiced. That’s the reason why your baby needs to stay here for treatment.
Patient: What do you mean by jaundice Nurse, what causes it? Can you please explain it to me?
Nurse: Yes, I’ll explain it to you now. Jaundice is a yellowish discolouration of the skin. One of
the most common reasons why newborn babies have jaundice is because of an
infection in the blood. Usually, the doctor will order a blood test to diagnose your baby’s
condition. If the blood test results are higher than normal, the doctor will order some
antibiotics for your baby. Also, your baby will undergo phototherapy. This means your
baby will stay under lights, which will help to lower the bilirubin level in your baby’s
blood.
Patient: But I'm worried Nurse about the side effects of the treatment for jaundice.
Nurse: You don’t have to worry Jane. But let reassure you, about 99.9% of the babies who
have jaundice and receive early treatment, recover from the condition.
Patient: Okay Nurse. I’ll stay here, but please do the best for my baby.
Nurse: Of course, we’ll do our best. Thanks a lot Jane.
Condition: Poor Nutrition
Nurse: Good morning Mrs. Wilson. I am Mary, the Charge Nurse in this school. How are you
today?
Patient: Good morning Mary. I had to take some time off from work this morning to come here,
is everything okay?
Nurse: I'm glad you came. Let me explain why I arranged this appointment. I am worried
about your son’s condition. After school commences, he frequently complains of
tiredness and he is also getting headaches.
Patient: Yes Nurse, I am worried too. I am a sole parent and I have three kids. It is hard to look
after them.
Nurse: Ah I see. I understand your situation Mrs. Wilson. Do you mind if I ask you a few
questions regarding your son’s general health?
Patient: No, go ahead.
Nurse: Do your children have a regular breakfast? Are they eating well?

Patient: Honestly Nurse, I don’t know. Because in the morning I have to leave early, my eldest
daughter Marie is the one who’s looking after her brothers and sisters.
Nurse: What about in the evening, Mrs. Wilson? What is your family routine in relation to meals
and bed times?
Patient: At night time I have to go to bed early as I'm very tired. I am working in a factory and I
have to go there at 5:30 in the morning. My kids usually watch a bit of TV at night, I
can’t monitor them because, as I have said, I go to bed early. With Ronnie, he seems to
be okay after having a bowl of coco pops and some soft drinks when he gets home in
the afternoon.
Nurse: Okay Mrs. Wilson, What I am going to do now is discuss the importance of proper
diet including a nourishing breakfast and having meals on time. Your child needs
to have a nourishing breakfast so that he will have energy for the whole day. Also it will
help for your child's brain function and concentration in class. How does that sound?
Patient: Uhhmmm, I see.
Nurse: Good, Now, another thing I'd like to mention is having soft drink with meals is not
good for your son, especially if your son is not having regular meals. This is because
soft drinks are acidic and high in sugar. Secondly, I suggest that you organise a weekly
plan for your family’s meal. For example, you can cook some food on the weekend
then store it in the fridge so your eldest daughter Marie can heat it up at meal time. After
cooking the food, put it in the container and make a label, please include the time and
date so that you cook the food and have a routine check at night before you go to bed if
your kids eat their food. Also, you can stock some groceries. For example, you can
buy some cereals, Weetbix, milk, bread and jam. So it will be easy for your children to
prepare their breakfast. Lastly, please explain to your kids, especially to Ronnie, that
having enough rest and sleep will help him keep going in the morning and he won’t feel
tired in the afternoon. So is that clear for you Mrs. Wilson?
Patient: Yes Nurse. Thanks very much. That is a really good advice.
Nurse: Your welcome Mrs. Wilson. I will set another appointment for a follow-up visit. Is that
okay with you?
Patient: Yes Nurse.
Nurse: That’s good. Thank you very much Mrs. Wilson. See you soon.
Myocardial Infarction
Nurse: Good morning David, how are you today?

Patient: Nurse, I am worried about my condition. I think it will affect my future health.
Nurse: I understand your concern David. Let me explain your condition and how you can cope
with this. Firstly, it is important for you to know that returning to normal life is a gradual
process, but I can assure you that if you follow your doctor’s advice you’ll make a full
recovery. Secondly, you really need to take your medications regularly.
Patient: Is it necessary to take all the medication, Nurse? Because, you know, my doctor gave
me too many tablets.
Nurse: Yes David, it is very important to take all your medications because it will help you to
recover quickly and will prevent heart attacks.
Patient: Okay Nurse I’ll take all the medications. Can you give me advice about a suitable diet
and exercise routine.
Nurse: Sure David, I’ll explain to you the importance of healthy lifestyle. In your case David,
the most important thing is to give up smoking. Have you heard that there is a helpline
that you can call if you want assistance in quitting smoking?
Patient: No I haven't. But I think it must be hard to quit smoking.
Nurse: Many people think that it is hard at first, but once you start, you will find out that it’s not
that hard. Also, I’ll give you a pamphlet that you can read and it contains some websites
that have all the information and testimonials from previous smokers that have already
quit smoking. Aside from that, it is also important to watch your diet and do regular
exercise. You must avoid fatty foods, decrease your caloric intake and have a balanced
diet. You can eat fish instead from pork. Fish contains Omega-3 that is good for your

heart. While exercising regularly will improve your circulation. Before we proceed do
you have any questions, David?
Patient: What about my work Nurse? Am I able to go back to work soon?
Nurse: Yes David, as long as you follow all of our advice. Just make sure that you’re getting
regular rest in-between activities. Also, if you feel pressure at work, you can do deep
breathing exercises. It will help you to relax and relieve the pressure at work. Do you
have any other questions, David?
Patient: None, I think I’ll be fine. Thank you very much Nurse.
Nurse: Your welcome. Take care now.
Study Strategy
While it is impossible to control what a patient will say in the interview. You can at least be half
prepared by having a clear approach as described above. To develop confidence and skill in this
area, practise writing out dialogues based on common situations which require explanations
including:
• the cause of a condition or illness
• a particular medical condition
• a treatment procedure
• the pros and cons of a particular medication
• lifestyle advice
• a prognosis
Handy Hint
Study the transcripts from the Dr. Norman Swan series: Health Minutes to build up your
vocabulary and range of expression in a medical context. This really works and I know of many
students who have improved their spoken expression considerably and passed OET due to
dedicated study of Dr. Norman Swan!
Giving Practical and Personal Advice
When talking to the patient, you can make the communication more meaningful and relevant by
giving your advice within the context of the patient's situation or condition. The example below
does that by using both the parent and child's name and framing the advice within their context. If
you don't do this, your speech can sound impersonal and as if it's from a text book.
Nurse: All right, Mrs. Smith. Let me have a look at John first. Fine, based on the examination, it
appears your son is suffering from a condition known as “Eczema”. Have you ever heard
of this?
Parent: No, I haven't. What is it?
Nurse: Okay, I'll explain it to you. Eczema is also called “atopic dermatitis”, and it is an
inflammatory skin condition in early childhood. Some experts say it might be related to
allergy. But the exact causes of this condition are still not known.
Patient: Is it serious? I am really worried about John. You see the rash has become cracked and
weepy.
Nurse: I totally understand your concern, Mrs. Smith. Let me reassure you that eczema is a self-
limiting skin condition. Most children will get better after a short period of time even
without any treatment. But of course, with appropriate management, the rash will diminish
more quickly.
Patient: So, could you give me more advice on the treatment options? You know, not only rash,
but also itchiness, have made John feel so uncomfortable.
Nurse: All right, Mrs. Smith. Don’t worry. If you can follow my suggestions, John will get much
better soon. We have some very effective strategies to cope with eczema. I'd like to
explain them to you one by one. Is that ok?
Patient: Yes

Nurse: Good, well first, as I said, the rash might be related to allergy and irritation, so please
avoid things that may irritate the skin, like soaps, woollen clothes, and so on. And also
keep John away from dust and pets, because they are the main sources of allergen.
Secondly, please keep an eye on the food John eats, to find the possible food that may
trigger the condition or make it flare up. Especially pay more attention to eggs, milk and
wheat. Thirdly, stop John scratching the rash. It can make it worse especially when the
skin has become cracked and infection follows. Finally, I'll prescribe some skin emollient
for you. You can apply it on the rash, 4 times a day, to keep the skin moist. That's a good
method to control the flare-up.
Patient: Thank you. What about the future. I mean, will he grow out of it?
Nurse: As I said, eczema is a self-limiting skin condition. When the skin function becomes more
mature, this condition will heal and it won't be a problem anymore.
Patient: What about John’s brothers and sisters? Are they likely to suffer from the same
condition?
Nurse: Well, unfortunately yes. It is possible, because eczema is familial. If one child has eczema
in the family, his siblings may be more likely to have it than other children. But it is nothing
to get alarmed about, the risk is very low.
Referring to other Health Professionals
As a nurse, it is not necessary to be an expert in all areas. So often the best advice is to refer to
another health professional. Here are some ways to do that.
Diet: Now regarding your diet, I can refer you to a dietitian and they can provide really good
guidelines and healthy food options, based on your condition.
Quit smoking: Now in order to quit smoking, I recommend that you attend our hospital's quit
smoking program. They run regular classes and I can tell you that it has helped many
patients succeed in giving up smoking. Would you like to do that?
Self injecting insulin: I understand that self injecting insulin can be challenging at first, but at our
clinic we run weekly training programs which are run by our nurses. They can take you
through the process step by step and help you gain confidence. Would you like me to
make an appointment for you?
Alcohol: Alcohol addiction is quite a serious condition, and you really need some outside support
to help you overcome this. Therefore I recommend that you contact Alcoholics
Anonymous, or I can contact them on your behalf, and arrange an appointment. How does
that sound?
Community service: There are many home services that can help you in your transition to home
life. For example, Meals on Wheels can provide nutritious meals everyday, so you will not
need to cook all your meals. The Blue Nurses will come and provide all your nursing care
needs including help with medications, dressing your wound and with showering. We can
also arrange a social worker to help with any other difficulties you may encounter.
Rehabilitation: One way to speed up the recovery process and to increase mobility is to visit a
physiotherapist. They will be able to design a rehabilitation program based on your needs
and it can make a big difference. Would you like to try that?
Sport activities: You need to start an exercise program, and I recommend joining a local gym or
sports centre. They will be able to create a fitness program that can help you lose weight
and feel healthier. Do you think you can do that?
Positive Language
Using positive language will help you gain the patient's trust and build a good nurse-patient
relationship. It will also help you reassure or persuade a patient to follow your advice.
• That's a good question John, and I will explain it to you now.
• I'm glad you asked and let me explain the treatment procedure.
• The staffs here are very experienced and will take good care of your daughter.

• The nurses here are very experienced with looking after children and they will make sure
your daughter is comfortable.
• I have many patients who have taken this medication with good results.
• The surgeons at this hospital are very experienced with this procedure so you do not need to
worry too much. They will take good care of you.
• I know it sounds difficult at first, but with practice I am sure you will be able to administer the
medication by yourself.
• Many of my patients have attended the quit smoking program and as a result have been able
to quit smoking successfully. I am sure it can help you as well.
• After your shower, you will feel much better.
Explaining Risks
One way to reassure a patient is to explain the degree of risk associated with a condition or
treatment.
• It is a common condition and it is treatable and with the right treatment we can reduce the
risk of any serious complications and your son will make a complete recovery.
• It is not as serious as you might think and I can tell you, the risk of developing any further
complications is quite low.
• Firstly, if you stay in hospital for further observations and treatment, then risk of further
complications will be minimised and you will be able to make a full recovery.
• I have to say, the chances of having a severe allergic reaction to these vaccinations are
extremely rare. While mild side effects such as redness around the injection site or mild fever
are not unusual, more severe reactions occur at a rate of less than 1 in 10,000 so there really
is no need to be concerned. And of course the benefits far outweigh these risks. For
example, your child will be protected against the common diseases of childhood, including
measles, mumps and rubella, as well as the potentially life threatening consequences which
can occur.
Consequences
One effective way to persuade a patient to follow your advice is to explain the consequences of
what will happen if they don't. Conditional sentences with "if" allow you to do this.
• It is better that you stay in hospital so that if there is a change in your condition, we can give
you immediate care and help you avoid any future complications.
• If you take sleeping tablets for a long period, you may become addicted to the medication
and on top of that, using sleeping tablets is only a short term solution, and for a long term
solution, you may need to make some lifestyle changes. Do you think you can do that?
• It is a common and potentially serious disorder, and if left untreated can lead to further
complications such as…………
• If you don't follow my advice, you may need to stay in hospital longer. You don't want that to
happen, do you?
• If you don't follow my advice, the infection could get worse and then you may need to be
hospitalised. You wouldn't like that, would you?
• If the wound is left untreated, the infection will get worse and spread to other parts of the
body.
• It is really important that you stay in hospital so that we can complete our investigations. If
you go home now, there is a risk that you could have a stroke or heart attack. That is why I
am asking you to stay in hospital, so that we can monitor your condition and bring your blood
pressure back to normal levels.
• If you stop taking your medication, then you run the risk of having another heart attack.
• The best advice is to get plenty of rest. If you go back to work too soon, then you may not
make a full recovery and your condition could get worse. You don't want that to happen, do
you?

Breaking Bad News
You may face a role-play task where you need to break bad news to a patient. This is a difficult
circumstance, and you need to be careful with the language you use.
Example 1
Nurse: John, what I would like to tell you is that the cause of your symptoms could be more
serious than you think, and that there is a risk that it is some kind of brain disorder.
Therefore, I believe that it is very important that we do a few further investigations
including a CT scan and an EEG.
Patient: What kind of brain disorder?
Nurse: Well we don't know at this stage, but we need to rule out the possibility of epilepsy or a
brain tumour
Patient: Oh no, this is really serious
Nurse: Well, it may be serious, but you are in very good hands, and the first step is to complete
our investigations.
Example 2
Nurse: We have the test results back and unfortunately the news is not good.
Patient: What do you mean? Have I got cancer?
Nurse: Yes I am afraid so. I realise that this comes as a shock to you. (pause)
Patient: Oh my gosh, what will happen now?
Nurse: Well, there are some treatment options such as chemotherapy.
Patient: Chemotherapy. But that can make your hair fall out
Nurse: Yes there are unpleasant side effects, but it is the most effective treatment option for your
condition.
Patient: Will it cure me?
Nurse: Well, we hope you will improve after a course of treatment, but we can not say definitely
that you'll be cured. But we will keep a close eye on you and repeat the treatment if
needed.
Patient: I see
Nurse: Now, It may be a good idea to talk to someone about this. Do you have any relatives or
close friends who can help you and provide support?
How to Improve your Speaking Skills
For many, getting a B grade in speaking is a big challenge. The basic skills that you will require to
achieve a B grade include:
• The ability to speak with a reasonable degree of fluency with minimal hesitations
• The ability to use a wide range of grammatical structures so that you can make smooth
and effective communication with the patient including the ability to ask questions, explain
dental conditions, reassure, give advice, persuade and so on
• A good range of vocabulary within the dental and medical context
• A confident manner so that you can lead the role-play from start to finish
• The ability to explain common dental conditions in non-technical language understandable
by the general public
So, to achieve this level of communication ability in English, you can develop the required skills
by working through the following stages
Stage 1
• Write out dialogues of a medical interview between a nurse and patient using the role play
scenarios in your course. While doing this, study the worksheets listed under "Interview
Techniques" and learn how to use the various structures and expressions.

Research medical conditions and learn how to explain them simply and clearly in layman's
•
language, and within the Australian context.
• Practice doing the role-plays at home by yourself or even better with a friend and record
your voice (Audacity software is a good, free computer based software for this)
• Analyse your own speaking and keep practicing until your fluency, range of expression,
grammar and confidence improves. Ask yourself the following questions
§ Could I ask appropriate questions?
§ Was able to clearly explain the dental condition?
§ Was my fluency good?
§ Did I hesitate a lot?
§ Was my pronunciation clear?
§ Was my grammar and sentence structure accurate?
§ Could I lead the role-play?
• Do this every day with different conditions and keep doing it until you feel confident in your
ability to complete a medical interview.
Stage 2
• Once you have developed confidence and have a good understanding of how to structure
a medical interview you can begin doing role-plays by simply researching the topic, but
not reading the role-play cards. Then, either with your teacher or with a friend you can act
out the role-plays unrehearsed, without any dialogue support. This will give you a good
idea of your level, and your ability to respond appropriately to the patient without
preparation. Make sure you continue to record your own speech, so that can identify your
strengths and weaknesses and do the necessary study.
Stage 3
• The final stage is when you can confidently respond to any role-play scenario, regardless
of the topic, and complete a medical interview without any preparation, apart from the 3
minutes allowed by OET on exam day. Once you have reached this stage, you will know
you have a chance of achieving a B grade or higher.
How long does it take to reach this level?
Well that depends on your starting point, including the level of your English and knowledge of
common medical conditions and situations. Of course, work experience as a dentist, either in
Australia or in your own country will be helpful. If you have an IELTS score of 6 or 7, then with
serious study you may be able to reach B level within 3~6 months. For some it will take longer,
even up to a year, but if you keep working hard you can make it.
For those who already have the basic English Language skills required as well as a dentistry
background, then progress can be much quicker and a successful result can be achieved within 1
or 2 months.
Handy Tip
This technique has helped many health professionals improve their speaking sufficiently to
achieve a B grade in speaking, but it requires dedication and hard work.
Overall Communicative Competence
One of the categories the assessors use to judge the English level of candidates is “Overall
Communicative Competence”. For this criterion, you need to demonstrate your ability to handle a
typical conversation between you as a health professional and the interviewer as a patient. This
means you must lead the conversation based on the roleplay scenario on your card. You must
ask questions clearly to find out the patient’s condition and /or main concern. You must also
respond appropriately to questions from the patient (interviewer).

Do I need to follow the card completely?
No you do not, although it obviously very useful as a guide regarding the direction the
consultation will take. What you need to do is spend 2 or 3 minutes reading the card, as allowed
in the exam format. Use this time carefully to plan your roleplay, and underlining the important
parts of the roleplay. This includes
• Identifying the setting
• Making notes of any important points regarding the patient’s medical history
• Identifying the main concerns of the patient
• Identifying what the task requires you to do
Be patient rather than card focussed
Once you are ready, begin the roleplay in the appropriate manner. The key points is, try to not be
too focussed at this stage on the content of your card. Focus your attention on the patient and
respond to their condition and concerns. There is a danger that if you pay too much attention on
what your card says then you may not respond to what the patient says. If you focus on your card
and not the patient you will find it difficult to have a meaningful conversation with the patient.
Remember, the card is used as a guide only, and once in the roleplay respond as naturally as
possible to the patient and let your instincts take over. If you do this, the task will take its natural
course. Also remember, the interviewer has a role to play as a patient so you need to respond to
their questions.
Another important point is not to talk over the patient. If they interrupt you, you have to allow this
and respond to their question. Although it is expected that you do 75% of the talking, (as it is your
English that is being assessed not the interviewers!) it is not good for you to talk continuously. So
when explaining important points, ask questions to the patient and seek clarification to ensure
they are following what you say.
Talk to the patient rather than at the patient
You need to demonstrate your ability to talk to a real person and show compassion for their
situation.. Remember, although you may have the medical knowledge to advise the patient,
always do this in the context of their unique situation, which is far better than just talking in
general or “from the textbook” The way to do this is to ask questions then respond to the patients
comments based on your medical knowledge. For example if you are dealing with a child who
has eczema, and you may know that there are various factors which can cause this condition
such as animal hair, woollen clothes etc, do not say: Ensure that your child does not come in
contact with pets and avoid using woolen clothes and soaps. This may be correct advice, but is
far better to asks questions to determine the environment of the patient. So you could have a
dialogue as follows:
First, as I said, the rash might be related to allergy and irritation, so please avoid things that may
irritate the skin, like soaps.
Have you noticed any itchiness after bathing your son?
Animals hair is another irritant. Do you have a pet? / Does your son come in regular contact with
animals?
In this way, rather than delivering your speech in a monologue, you will be having a meaningful
conversation with the patient, and offering advice based on the specific context of their situation,
rather than just speaking in general terms, which may not be relevant to their situation.
Whose job is it to keep the conversation moving?
It is also important that as a medical professional, you lead in the role play. That means you need

to begin and end the roleplay and if the patient is silent, then you need to fill gaps and not wait for
patient as they may not say anything. It is also important to note that silence in the roleplay is not
a favourable thing from the candidates point of view as it can indicate that you are not in control
of the interview. So always be prepared to keep the conversation moving.
Intelligibility
This refers to how clearly you speak and can be broken down into the following categories:
• Pronunciation
• Intonation
• Syllable and word stress
• Rhythm
While you are not expected to speak like a native speaker, it is expected that what you say can
be clearly understood. Therefore you need to ensure that you pronounce words clearly,
particularly words specific to a medical consultation.
For all people from non English speaking backgrounds there are some sounds, stress patterns or
rhythm which are difficult. It is important that you identify which aspects of English are difficult for
you and work hard to improve in those areas. Recording your own speech is a useful starting
point.
There are a range of strategies to improve clarity of speech, but it requires dedication and
determination to improve in this area, especially if your speech patterns have become “ingrained”
after many years of English speaking. It is also hard if you are not living in Australia or another
English speaking country. Listed below are some strategies which can help you improve in this
area.
Listen and Repeat
Find podcasts which have transcripts and read aloud in time with the audio. This will help you
develop rhythm, syllable and word stress as well as fluency. You should do this regularly and it
will also help you improve your listening skills at the same time. Suitable websites include
• Health Minutes: http://www.abc.net.au/health/minutes/
• The Better Health Channel: http://www.betterhealth.vic.gov.au
Record your own Speech
This is a very useful technique as you once you listen to your own speech you will be able to
analyse your own strengths and weaknesses and develop your skills accordingly. So practice the
roleplay tasks for your profession with a friend or colleague and record your roleplay. Then
analyse your performance. Remember, practice makes perfect!
Software which allows you to record your voice digitally includes:
• Audacity: http://audacity.sourceforge.net/
• Pamela for Skype: http://www.pamela.biz/en/
Medical Terminology
Many medical words such as the names of various conditions are long and difficult to pronounce.
A good website which features English and US pronunciation of most common medical words is:
• http://www.thefreedictionary.com/
Fluency
This is a challenging category especially if you are not using English on a daily basis. If your
speech contains too many hesitations or pauses you will be marked down. To get a B grade or
above in the exam your aim is to speak at an even and controlled speed. If fluency is a weak area
for you, then practicing the scenarios often can help you become more familiar with the various
stages of the roleplay and what expressions are suitable for each stage. You need to practice

roleplay scenarios regularly so that you have the confidence to respond to the scenario and
patient with a reasonable degree of fluency.
How to Increase Fluency
All role plays will be similar in that you are required to do three things:
1. Find out about the patient by taking a brief, specific history (note, there is not usually
enough time to ask general questions so always focus on the situation at hand)
2. Provide information about the condition
3. Teach the patient how to manage the condition
Depending on the situation, it may be necessary to provide comfort and reassurance to the
patient or even persuade the patient to do something against their wishes in order to improve
their health.
Therefore you can improve fluency be becoming familiar with suitable expressions that allow you
to deal with these situations. In addition, the wider range of vocabulary you have, then the more
fluent you will be able to speak. See functions of language for examples of how to do this.
Another sources of good spoken language is the website:

Look carefully at the vocabulary and expressions used by Norman Swan and try to
incorporate this into your speech. You will be surprised at what it difference it can make in a
relatively short time if you work hard.
How to Decrease Fluency
For some students, lack of fluency is not the problem, but rather rushed speech. If your speech is
rushed or words are joined together in a non-standard manner, then the patient may not
understand you. This is especially important when you are explaining complex conditions or
giving important advice. In such situations, it is necessary to develop some self awareness so
that you can consciously control the speed at which you deliver information. Technical words,
including names of illnesses, medications and treatment methods, should not be rushed or “lost”
within a sentence. A good strategy is to always ensure that the patient can follow what you say by
regularly checking with them i.e Is that clear?
Appropriateness of Language
Technical Language
In this category, you are basically being tested on your ability to explain medical and technical
jargon commonly used in your profession, into simple, clear language. You can be guaranteed
that if you use technical language, the patient (interviewer) will ask you to explain what you mean.
That does not mean you cannot use some medical terminology, it just means that you need to be
ready to explain it in simple terms to the patient.
If you need improvement in this category, practice explaining a variety of conditions common to
your profession in simple terms. You may find it useful to record your own speech and do this on
a regular basis. Again, you will find the old adage: “Practice makes Perfect” is the key to success.
Don’t be too Formal
Although a consultation is a formal situation, it is very common to use casual and natural
expressions when talking to a patient. This will help the patient to feel comfortable and at ease.
This will also make it easier to provide reassurance or comfort if required or gentle persuasion.
Always aim to speak in a friendly, clear and positive voice.

Don’t be too Casual
The roleplay is a formal situation in that you are not friends with the patient. You may also be
dealing with an elderly patient so it may good to speak in a respectful manner.
Some inappropriate expressions if overused include:
• yeah Vs yes
• wanna Vs would like to
• gonna Vs going to
Gender
A common error is incorrect use of pronouns. Him /his when the patient is a female or her/hers
when the patient is a male. If you have difficulties with pronouns, write them down in large letters
on your role-play card as a reminder!
Resources of Grammar and Expression
This relates to how accurately you speak. To achieve a B score you will need to demonstrate
good grammatical control in your speech. You can improve your grammar and sentence structure
by writing out dialogues for for various scenarios common to your profession and have them
checked by your teacher or a native speaker friend. See functions of language for examples of
how to form suitable sentences.
Below are a list of common errors which you should study carefully so that you can avoid them in
your own speech.
Incorrect Correct
• I will now explain you what caused • I will now explain what caused your condition.
your condition. • I will now explain to you what caused your
Explanation: Explain cannot be followed by condition.
pronoun such as you or me. • I will tell you what caused your condition.
• I concern about your drinking habit. • I am concerned about your drinking habit.
Explanation: concern needs to be used as (Adjective)
either an adjective or noun • I have a concern about your drinking habit.
(Noun)
• I recommend she should start her • I recommend she start her vaccination program
vaccination program as soon as as soon as possible.
possible
Explanation: recommend and should have
similar meaning so these words should not
be used together.
• I recommend you need to lose weight • I recommend (that) you lose weight.
Explanation: as above recommend and
need have similar meaning
• I suggest you to take the medication • I suggest that you take the medication as
as prescribed by your pharmacist. prescribed by your pharmacist.
Explanation: The expression suggest is not • I suggest you take the medication as prescribed
followed infinitive forms with to by your pharmacist.
• I suggest taking the medication as prescribed
by your pharmacist.
• I strongly advice that you brush your • I strongly advise that you brush your teeth twice
teeth twice a day. a day. (adjective)
Explanation: advice is a noun, advise is the • My advice is to brush your teeth twice a day.
verb (noun)

• Let me give you some advices. • Let me give you some advice.
Explanation: advice is an uncountable noun
so cannot be used in the plural form
• Some of our staffs were on leave. • Some of our staff was absent.
Explanation: staff is an uncountable noun • Some members of our staff were absent.
so cannot be used in the plural form.
• I have many experience • I have many years of experience
Explanation: experience is this sense an • I have a lot of experience
uncountable noun so cannot be used in the
plural form
• there is a serious reaction in few • There is serious reaction in
children
Explanation: experience is this sense an
uncountable noun so cannot be used in the
plural form
• The condition will recover itself over • The condition should resolve itself over time.
time. • Your daughter will recover over time.
Explanation: incorrect word
• We don't know what cause of this • We don't know what the cause of this problem
problem. is. (noun)
Explanation: incorrect sentence structure • We don't know what caused this problem.
and word form (verb)
• Your condition have worsened. • Your condition has worsened.
Explanation: verb subject agreement is
incorrect.
• You should to increase your intake of • You should increase your intake of fruit and
fruit and vegetables vegetables
Explanation: should is a modal verb and
cannot be followed an infinitive form
• It will helps a lot. • It will help a lot
Explanation: do not conjugate the verb after
will
• You might be painful • You might have pain (noun)
Explanation: Incorrect sentence structure • The gum might be painful (adjective)
• He is very expert. • He is an expert in the field.
Explanation: expert is a noun so cannot be • He has a lot of expertise in the field.
modified.
• You are getting fits for 3 times? • You have had fits on 3 occasions?
Explanation: Incorrect sentence structure • You have had 3 episodes of fits?
• The side effects are very minimum. • The side effects are very minimal (adjective)
Explanation: minimum is a noun, adjective
form required.
• How should I call you? • How should I address you?
Explanation: Incorrect sentence structure • What should I call you?
Useful Website
English Med is a useful website which contains some sample conversations & transcripts
between a health professional (usually a doctor) and a patient.

Language Functions
Effective communication is very important in the medical interview. As a health professional, it is

necessary to use language to achieve a particular purpose within a particular context. These
purposes can be categorised further into language functions and language learners can improve
their communicative ability by being familiar with and using the language patterns associated with
the various functions.
Note: The role-play scenarios used by OET have been designed to test the candidates ability
within the categories below so skill in these areas will help you achieve your required score.
Expressing Concern and Understanding
This is obviously a very important part of the medical interview. It requires you to listen carefully
to the patient then respond appropriately.
I know how.... • I know how you must be feeling.
I understand..... • I understand your concern
I understand how..... • I understand how you are feeling.
• I understand how you feel.
I'm sorry to hear that. • Oh, I 'm very sorry to hear that, but there is a solution to every
problem.
I understand why..... • I understand why you have this concern.
• I understand why you are worried about fluoride in the water
supply. However,.....
Yes, I can see that..... • Yes, I can see that it must be difficult for you to manage.
Reassuring
This is also a very important part of the medical interview. Therefore you need to be comfortable
using a variety of expressions to do this.
Let me assure you.... • Let me assure you, all the nurses here are experienced and
highly trained.
Let me reassure you • Let me reassure you that if we can strictly control his sugar levels
that..... within the normal range with proper medications, Tom will live a
normal life without any troubles.
As long as you..... • As long as you follow all the advice we have given you, you will
make a full recovery.
Try not to worry too • Alright, Mrs. Small. Try not to worry too much. If you can follow
much. my suggestions, John will get much better soon.
It is nothing to get • But it is nothing to get alarmed about, the risk of complication is
alarmed about. very low indeed.
Making Suggestions
Here are a few expressions you can use when giving suggestions.
It is important that...... • It is important that you take your medications regularly.
I suggest that..... • I suggest that you take a shower and go for a short walk. It will
make you feel much better.
If you like, I could.... • If you like, I could ask a nutritionist to give you some dietary
guidelines. How does that sound?

The most important • The most important thing (for epilepsy sufferers) is to avoid
thing is...... sports such as swimming, diving and rock climbing.
Offering Advice
There are many way to offer advice and you can demonstrate your language skill by using some
of the more complex structures
I advise that .... • I advise that you continue taking this medication.
My advice is that ..... • My advice is that you continue taking this medication.
What I would like you • What I would like you to do is reduce your alcohol consumption to
to do is..... no more than 2 standard drinks per day.
You should..... • You should follow a healthy diet and avoid foods that contain a lot
of fat and eat more vegetables and fruits
Why not....... • Why not try these healthier alternatives first?
Persuading
Many OET tasks require the health professional to convince the patient to do something they do
not want to do. A very useful technique in these situations is to explain the consequences if the
patient does not follow your advice.
I strongly • I strongly recommend that you return to the clinic immediately for
recommend that.... further treatment. Is that clear?
• I strongly recommend that you have a porcelain crown because it
can endure the chewing forces and it also looks quite real.
You really need • Patient: I don't want to see the specialist. It scares me and I can not
to..... afford it. Can I just get antibiotics or mouthwash
• Dentist: I'm sorry, but you really need to see the specialist and it's
the only way you can save your teeth. Without the treatment you will
lose your teeth.
if..... • If you do not modify your lifestyle, the disease may progress.
• If there are serious complications, you will need surgery to remove
the affected bowel.
Justifying
These expressions allow you to emphasise your opinion are can help in persuading a patient to
follow your advice.
That is the reason • We noticed that your baby is very sleepy, not feeding well and
why..... becoming jaundiced. That’s the reason why your baby needs to
stay here for treatment.
For this reason...... • Dentist: Based on my examination you have a fissure in that tooth. I
see the previous filling is loose. So I think you need to have your
tooth restored with a crown.
• Patient: Hum, I'd like to have another filling or it that doesn't work I
feel I can live without that tooth.
• Dentist: Well, if you don't do a crown then you have to get your tooth
extracted. Then there will be space and it's not easy to chew, and
also, it doesn’t look as good. For this reason I advise a crown.

Seeking Approval
Checking with a patient first before asking a question helps in developing a good rapport between
you and the patient.
Is it okay if..... • Is it okay if I ask you a few questions regarding your son's health?
Would you mind if I.... • Would you mind if I contacted Meals on Wheels on your behalf?
Is that okay? • First of all, I would like to ask you more questions to clarify what
the problem is and how severe it is. Is that okay?
Moving Forward /Changing the Subject
The now is quite useful as it signifies that you are moving to a new topic. In terms of the medical
interview, it is a way of controlling the direction of the interview. This is very important, as a health
professional you are in charge of the interview, not the patient.
Now,...... • Now, I'd like to talk about your discharge.
• Now, let's talk about your medications. Are taking them regularly?
• Now, lets talk about your current health. How are you feeling today?
Summarising
This is a useful technique, especially if you feel the interview has not gone the full 5 minutes, or if
the patient is not very communicative.
Let me go over • Let me go over again what we have talked about today. Your
again what we colonoscopy found that you have diverticular disease. You need to
have talked improve your diet which includes taking high fibre foods, vegetables and
about today. fruit. Also make sure your bowel movements are regular and do regular
exercise. I will see you in two weeks’ time. Take care.
To • To summarize, you came to see me because you have fever and
summarise..... persistent cough. I have ordered a chest x-ray and a phlegm test. The
results will be back in next week. I will see you in one week’s time.
Good bye.
Handy Tip
The list above is just a starting point. To improve your range of vocabulary and expression
as well as grammatical accuracy, practice writing out dialogues for each of the functions
described above based on the role-play tasks in your course.
Dos and Don'ts
There are many ways to successfully approach the speaking task. Below are a list of simple
points to remember to help you succeed on the day.
Dos Don'ts
Do read the roleplay card carefully and ask the Don't plan what you are going to say in
interviewer if you are unsure of any of the words advance. React to the scenario on your
or expressions in the task. roleplay card and plan your role accordingly.
Do react to what the interviewer (as patient) asks Don't plan what you are going to say in
or says and respond accordingly. This is much advance. React to the scenario on your
more important than simply following the tasks on roleplay card and plan your role accordingly.
the card.
Do focus on the patient and respond to their Don't be card focussed at the expense of the
questions and concerns. patient. It is much more important to respond
to the patient in a natural and caring manner
(where required).

Do take charge of the roleplay. You are a medical Don't wait for the interviewer to lead the
professional and should act accordingly by leading roleplay. They may not!!
the roleplay. This means you must start and This is your job.
conclude the roleplay, and if the patient is quite or
silent, then it is your responsibility to keep the
conversation moving.
Do utilise the allowed 2~3 minutes to identify the Don't rush through your card in 30 seconds
key points on your card including: and say you are ready to start! You may miss
• the setting some important details.
• whether you know the patient, or if it's the
first time to meet
• the main topic of conversation & relevant
background information
• task requirements
Do refer to your card occasionally during the Don't try to memorise the whole card. You
exam, especially if you are unsure of what to say. can refer to it as required during the roleplay.
Do be prepared to discuss matters which are not Don't feel you must complete every aspect of
on your card. The patient's card usually contains your task. Remember it is a guide only and
information which is not on your card. you will not be penalised if you do not
complete every detail of your card.
Do look at the patient during the roleplay. Don't look at you card only and read it while
Although only your speech is recorded, your the patient is talking as you must listen
communication will be more effective if you have carefully to what they the patient says so that
eye contact with the interviewer. you can respond appropriately.
Do stay focussed on the task at hand. You only Don't spend too much time on unrelated
have 5-6 minutes to complete the task! matters such as a detailed medical history as
you do not have time for this.
Do practise as many tasks as possible with a Don't ignore the task requirements and say
partner to ensure you are familiar with the what you think based on your medical
speaking test. Remember it is very different to knowledge. Remember it is a test of English
IELTS and requires different language skills, such language ability and not a place to
as the ability to persuade, convince and reassure. demonstrate your medical knowledge.
Do act confidently and speak with a positive voice. Don't show how nervous you are as this can
If you are unsure of the details of the condition, it negatively affect your result. Lots of practice
is okay to make it up! Remember it is a test of is the best way to overcome nerves.
English not your medical knowledge.
Do slow down your speech when using unfamiliar Don't use a lot of medical jargon and
words such as names of medications or treatment technical words. You need to use layman’s
procedures. Always be prepared to explain the language to describe the condition.
meaning of any medical terminology you use.
Do regularly check that the patient understands Don't speak in a continuously in a
your explanations. Ask questions such as: monologue.You are taking part in a 2 way
• Is that clear? / Can you do that? conversation.
Do stop speaking if the patient wants to interrupt Definitely do not talk over the patient. You will
you. You must respond to the patient. be penalised for this!
Correct a grammatical or vocabulary mistake Don't rush your sentences as you are more
immediately if you are aware that you have made likely to make an error. Try to remain clam
one. (Native speakers certainly do this!) and in control.
Do be aware of the gender of your patient and if Don't be too stressed if you make a gender
you say he instead of she, try to correct it. error, 1 or 2 slips is acceptable but more than
this may be penalised.

Possible Roleplay Topics
There is a wide range of possible roleplay tasks. You can prepare by being familiar with common
scenarios. It is common for there to be some conflict between what the patient wants to hear and
what the doctor has to say. Therefore your role, as a medical professional will be to clearly
explain the condition, reassure the patient where required and at times persuade the patient to
follow a certain course of action which they may not want to do. You will be assessed on how well
you are able to meet these requirements. Below is a list of topics which commonly appear in the
exam.
• Alzheimer's disease
• Asthma
• Broken Bone
• Burns
• Chicken Pox
• Cholesterol
• Complaint against hospital staff/procedure
• Diabetes
• Discharge of an aged patient
• Eczema
• Epilepsy
• Fear of surgery
• Head Lice
• Infection
• Immunisation
• Jaundice
• Medication change
• Myocardial Infarction
• Palliative care
• Poor nutrition
• Post surgery activity
• Pneumonia
• Urinary track infection
Ask yourself the question, do you feel confident dealing with these situations? If not you can
prepare for the speaking test by researching common medical conditions such as those above
and writing out possible dialogues between you and the patient. A useful website which explains
common conditions in layman's language is The Better Health Channel.

THE SPEAKING SUB-TEST
OET SPEAKING - A consultation “plan” for the OET test
The “stage” of Doctors / Dentists on this Nursing conversations on this side

the consultation side of the grid of the grid
Introduction Good morning / afternoon Good morning/afternoon, my name is
My name is Dr Mr Ramji, I am the Community Nurse /
…………………. Charge Nurse.
More What is your name? / Mr May I know your name, please?
Introductions Jones, right? Hello. I’m Jeff Jones.
Hello, I’m Jeff Jones
What seems to be the problem Right, How can I help you, today?
? What brings you here? Right, How are you today Mr Jones?
A small PATIENT GIVES A BRIEF OUTLINE OF HIS/HER PROBLEM
starting point Doctors/Dentists
… where From this point on - it is up to YOU, the OET candidate, to find out
the patient is something about this patient’s medical history, what medication
“at” with they are currently taking, maybe some other factors which would
regard to his affect the patient’s wellbeing – “social” things like husband/wife
or her has left them; they have just had the sack at work; they have been
medical / unemployed for a long time; they have just learned that their loved
emotional / one is very sick and may die --- something which would affect them
problem. mentally / emotionally - and would be impacting on their physical
health.
The patient’s problem may be simply one of lifestyle: too much to
drink, to smoke, to eat, too much work – and so on.
Questions to Doctors / Nurses
get information -‐ How long have you had this problem (pain)?
from the -‐ When did you notice the rash?
“patient” … -‐ Is it very painful right now? How painful? (On a scale of 1 to 10)
the same kinds -‐ Are you taking any medication?
of questions -‐ When do you take your pills?
you would have -‐ Do you do any exercise? Walking? Play tennis? Go swimming?
asked your own -‐ Have you been out of work for very long?
patients in your -‐ Are you coping with that situation?
own country -‐ What kind of things are you doing to get back on track?
HOW MANY MORE QUESTIONS

CAN YOU THINK OF?
The Nurses
Examination I need to check your pulse / I need to take a small sample of your blood
to check it / I need to have a look – can you lift up your shirt- take off your
shirt – I need to check your weight – please stand on the scales over
there.

Doctors/Dentists Nurses
The Patient You have no need to fear … this
becomes Hospital / this Clinic has done this Do you have any form of phobia or
difficult – “non operation / procedure many times paranoia?
compliant” – before and we have had many
does not want to successful results. What makes you think that? You
follow your have no need to fear.
suggested plan What makes you think that? I am a
of action / Doctor / I am a Dentist – with many This Clinic / this Hospital has an
treatment years of experience – and in all that excellent reputation
time nothing like that has ever
Lots of happened … so why should it happen We have done this kind of thing
objections: to you? many times before – you will be fine
No money Statistically speaking, the likely What makes you think that?
outcome for you is excellent.
Very fearful I am a qualified Nurse with many
Now Mr Jones / years of nursing experience. In all
Worried about Now Jeff - you say you don’t want that time I have never seen
scars after the to follow this treatment/take this something like that happen.
operation medication/have the bridgework done
Doesn’t want to but – if you don’t – the end result may

take lots of time be far worse – [worst case scenario]
off work if you don’t take this medication
if you don’t get the operation
Patient has then [what MIGHT happen] to this
heard that patient …….
terrible things
might happen
You need to get Of course, the final decision is up to So, Mr Jones – does that clear up
your Patient’s you. Are you happy to go ahead with your worries? Does that make you
cooperation – this operation? / happy to go ahead feel a bit better?
their with this dental procedure?
“agreement” to So, Mr Jones - do you understand
YOUR plan of You can get a second opinion if you why it is important for you to stick to
action wish – of course – but the sooner you the diet? ….to take the pills? … to
get this done, the better not smoke? … to get plenty of rest?
Dentists Nurses
Do you have some time right now ? I will come back and see you later on
Time We could make a start. today - tomorrow - in a few days;
Management Doctors I will make sure someone calls on
I will give you something right now for you tomorrow/next week/later on
the pain. today … to see how you are getting
on.
Tell the patient Dentists I will need to see you 3 more Nurses I am going to get in touch
what is going to times: once to make an impression; with the local Council to arrange
happen – the do the repair work; fit the some home help; I will make sure
Plan of Action denture/bridge. the Doctor is informed – see if the
Doctors I would like to review your medication can be changed;
progress – can you come back and
see me in one week’s time/one
month’s time?

Get the patient Is that OK? Is that OK?

to agree How does that sound? How does that sound?
Are you happy with that? Are you happy with that?
So … after OK, Mr Jones Do you have someone to help you?
some treatment OK, Jeff …. How are you getting home?
/ some
consultation … How are you getting home? Would you like me to arrange for a
Are you able to drive yourself? taxi to take you home?
Would you like me to call you a taxi?
What happens Would you like me to call a friend to Is there someone that could help
now? come and pick you up? with the baby / the child / the
children?
This is the time Do you understand what you must
when you have do? I would like to come and see you
to “wrap up the Change the mouth swab in ½ hr again tomorrow / next week
parcel” - add Rinse/floss after every meal I would like YOU to come and see
the pretty paper Here I have written it down me again tomorrow / next week….
and the bow OK?
and write out a Let me go over what we have been
greeting card through today: Don’t forget to change the dressing
(figuratively- - you came in to see me because … every second day
speaking … not - I have examined you and I think Don’t forget to KEEP THE
literally !!) … the your main concern is …. DRESSING DRY
“greeting card” - I have given you a prescription for Don’t forget to take ALL THE PILLS
is the reminder xyz / I have ordered a blood test / I – that is very important
– the summing have ordered an xray - the results Try not to eat so many sweet things
up of what you should be back tomorrow Try to eat more fresh fruit and
have talked vegetables
about – So .. is there anything else that is
reminding the troubling you? Well, I hope you are feeling a bit
patient of what better. If you need to see me
is going to OK --- I will see you again …. again, please do so. / I will see
happen If the pain does not go away – you again tomorrow TO HAVE
If you have any more trouble THE DRESSING CHANGED. / I will
… please come and see me see you again next week TO SEE
straight away IF THE STITCHES ARE ready to
Here is some literature come out
Here is/are a / some pamphlets
This pamphlet explains what we
Goodbye Mr Jones have been talking about.
Bye-bye Mr Jones
Bye-bye Mr Jones

Examples of Nurse- patient dialogue
Helping a Patient
Patient: Nurse, I think I might have a fever. It's so cold in here!

Nurse: Here, let me check your forehead.
Patient: What do you think?
Nurse: Your temperature seems raised. Let me get a thermometer to check.
Patient: How do I raise my bed? I can't find the controls.
Nurse: Here you are. Is that better?
Patient: Could I have another pillow?
Nurse: Certainly, Here you are. Is there anything else I can do for you?
Patient: No, thank you.
Nurse: OK, I'll be right back with the thermometer.
Patient: Oh, just a moment. Can you bring me another bottle of water, too?
Nurse: Certainly, I'll be back in a moment.
Pain that Comes and Goes
Doctor: How long have you been having this pain?

Patient: It started in June. So for more than five months now. My stomach hurts after some
meals, but not always.
Doctor: You should have come in earlier. Let's get to the bottom of this. Have you changed
your eating habits during this period?
Patient: No, not really. Well, that's not true. I'm eating the same foods, but less. You know,
the pain seems to come and go.
Doctor: How strong is the pain exactly? On a scale of one to ten, how would you describe
the intensity of the pain?
Patient: Well, I'd say the pain is about a two on a scale of one to ten. Like I say, it's not
really bad. It just keeps coming back...
Doctor: How long does the pain last when you get it?
Patient: It comes and goes. Sometimes, I hardly feel anything. Other times, it can last up to
half an hour or more.
Doctor: Is there a type of food that seems to cause stronger pain than other types?
Patient: Hmmm ... heavy foods like steak or lasagna usually brings it on. I've been trying to
avoid those.
Doctor: Does the pain travel to any other parts of your body - chest, shoulder or back? Or
does it remain around the stomach area.
Patient: No, it just hurts here.
Other Examples 1: Refusing meal
Nurse: Good morning, Ms Adams. How are you doing today?

Patient: Horrible! I can’t eat anything! I just feel sick to my stomach. Take the tray away.
Nurse: That’s too bad. I’ll just put this over her for now. Have you felt queasy for very long?
Patient: I woke up during the middle of the night. I couldn’t get back to sleep, and now I feel
terrible.
Nurse: Have you been to the bathroom? Any diarrhea or vomiting?
Patient: I’ve been twice, but no diarrhea or vomiting. Maybe I should drink something. Can I
have a cup of tea?
Nurse: No problem, I’ll get you a cup right away. Would you like black tea or peppermint
tea?

Patient: Peppermint, please.

Example 2
Example 3
Example-4

Example -5

Example -6
Example -7

Example-8

Example -9

Example-10

Example 11
Patient: "I can't be lying in this bed, I have to go home, I have to work and my children need
me!"
Nurse: you must be very worried about them. Who is taking care of them now?
Patient: "I’m just not myself since my blood pressure pill changes, I’m always tired!"
Nurse: What time of the day are you the most tired? Are you having any other symptoms?
Patient: "what's going on? First, they say they have to operate, and then when I’m beginning
to feel better, I get this infection. I don't think I’m ever going to get out of here!"
Nurse: It sounds very stressful. Is there any way to reduce your stress?
Patient: "I’m terrified of injection!"

Nurse: What can I do to make it less stressful for you?
Patient: "you think my doctor would have prevented me from getting phlebitis? But he's too
busy to care about what's happening to me."
Nurse: I agree about that! Phlebitis is a complication that occurs to some people and not
others. It’s frustrating that it happened to you.
Patient: (fidgeting) "nobody cares. My doctor wants me to go - just on home?

Nurse: you must be feeling pretty low. Who do you have to talk to? Your doctor must think
you've recovered well enough to go home.
Patient: "well, my husband had a car accident last year. He had to give up driving and he's
been do downever since. I’m afraid for him being by himself for so long."
Nurse: do you have anyone who can help with him? would you like to talk to the social
worker here? they are good at arranging help for those who need it.
Patient: "the doctor told me i needed a bunch of tests, because there is a lump in my neck."
and how does that make you feel?
Nurse: These tests helps to identified what is the best treatment?

Example -12
Client: “I can't possibly do all these things I am being told to do for my diabetes”
Nurse: “You sound overwhelmed”
Client: “It is just so much. I do not know where to start”

Nurse: “It is a lot. What is your biggest concern?”
Client: “I think it is the diet. I cook for my whole family and they don't like healthy food.”
Nurse: “Let's start with that. Let’s review what you have for a typical dinner.”
Client: “The harder I try to get along with my son, the more I feel he just wants to be left
alone”
Nurse: “It must be hard for you to reach out and have him reject you”
Patient: “That other nurse never even said good morning, just “turn over for your shot.”
Nurse: “It really upset you to be treated like that. I am here if you want to discuss it.”
Patient: “I am really worried about that CT scan. Is it painful?”

Nurse: “There is no pain. Some patients say they are uncomfortable when they have to lie
still for several minutes. What have you heard?”
Sample question/ presentation
Client’s adult daughter: “My mother is so scared. The nurses are no help since they don’t
speak Spanish.”
Nurse: Well, we have interpreter service so I will organise Spanish interpreter, is that ok for
her?
Client: “I know I should eat better, but it costs so much to buy the right food.”
Nurse:
Hospitalized Client: “What do you mean I have to take these pills. I thought I had all my pills
this morning?”
Parent: “I don’t know why the dentist gets upset with cavities in my three year-old’s teeth.
They’re just baby teeth.”
Mother of 2 year old: “I get so frustrated. My two year old just wouldn’t do anything I say.”
Mother of 13 year old: “I can’t get my daughter to stop sneaking out to see her boyfriend at
night.”
Client: “I know I should be exercising but I am just so tired when I get home from work.”
Client: “The nurse doesn’t seem to understand why I can’t check my blood sugar every day
like he says I should.”
Client: “I don’t want to stop drinking beer. Besides, it’s football season and I can’t watch
football without drinking beer.”
Client: “I know I should see my doctor about the wound on my foot. But I don’t like going to
the doctor.”
Client: “What do you mean I can’t eat ice cream every night? I love ice cream!”
Client: ”I know I should be exercising but I am just so tired when I get home from work.”
Client: “What do you mean I can’t eat ice cream every night? I love ice cream!”

Therapeutic communication techniques
Empathy “This must make you feel sad.”

Validation “So you are saying that….”
“Let me be sure I understand what you are saying.”
“Tell me what you understand about what I just said.”
Offering self I’ll sit with you awhile. “Go-on”, “Uh-huh”. Head nodding
Broad opening “What do you want to talk about?”
“Can you tell me more about that?”
"Tell me what's bothering you."
“Is there something you would like to talk about?
Open ended “Tell me about your pain?” instead of “Are you in pain?”
comments “Tell me about your family” rather than “How many children do you
have?”
Exploring “Would you describe that more fully.”
“What kind of work?”
“Tell me more about how you feel when you do not take your
medication.”
“Could you tell me about one of these time when you felt so upset?”

Focusing “You mentioned that you are having a problem with …”

“ You say you feel nauseous a lot.”
“This point seems worth looking at more closely.”
“You said something earlier that I want you to go back to.”
Reflection Patient: “Do you think I should tell the doctor I stopped taking my
medication?”
Nurse: “What do you think about that?”
Client: “ I probably should. But the medicine make me so tearful and
agitated.”
Nurse: “You sound a bit agitated now.”
Patient: “ I feel so tired, I don’t like it here.”
Nurse: “ tired?” / “You don’t like it here.”
Patient: Everyone here ignores me”
Nurse: “ignoring?”
Restating Client: “I told the doctor that I had problems with this medication, but
he just didn’t listen to me!”
Nurse: “Sounds like you are pretty angry at him.”
Client: “I don’t sleep well anymore.”
Nurse; “ You are having problems sleeping?”
Client: “I can’t sleep. I stay awake all night.”
Nurse: “You have difficulty sleeping”
Recognition “I notice that you become embrassed when …”
“I see that you have some pictures of the new baby.”
Directing
Verbalizing and Client: “How much is this x-ray going to cost?”

implied Nurse: “ You’re worried about your medical biils?”
Making observation “You seem sad today.”
“You’re limping as if your leg hurts.”
“You appear tense”
“I notice you are biting your lips.”
Sharing observation “You are trembling”
“You seem upset”
Acknowledging the Patient: “ I hate it here. I wish I could go home.”
patient’s feeling Nurse: “ It must be difficult to stay in a place you hate.”
Resuming verbal “ You wre saying that……”
activity after silence “What were you thingking?”
Verbalising, Implied Patient: “It’s a waste of time to do these exercise”
thought and feeling Nurse: You feel they aren’t beneficting you?”
Clarifying
“I am not sure I follow….”

“ Are you using theis word to mean…?”
“Before you go on, I want to understand wha yo menat by……”

Confronting
Limit setting
Placing the event in time or “Was this before or after…?”

sequence “What seemed to lead up to…?”
Encouraging Description of “What do you think is happening to you right now…?”
Perceptions
Giving Information “My name is…I am a ……… nurse..”
Seeking Clarification “What would you say is the main point of what you said?”
Presenting Reality “ I see no one else in the room”
“That sound was a car backfiring”
“Your mother is not here; I am a nurse.”
Patient: “Did you bring my car today?”
Nurse: “No, you do not have a car. I drove my car here
today.”
Voicing Doubt “That’s hard to believe.”
“Isn’t that unusal?”
“Really?”
Attempting to Translate Into “ From what you say, I suspect you are feeling relieved.”
Feelings
Encouraging Evaluation “How important is it for you to change this behavior?”
Suggested Collaboration “Let’s see if we can figure this out..”
“Perhaps we can discuss and discover what produces
your anxiety (pain, frustration, etc.)”
Summarizing “ Let’s see, so far you have said…”
Encouraging Formulation of a “What will it take to reach your goal of not hitting
Plan of Action anyone?”
Identifying themes ..asking “So what do you do each time you drink too much and
client to identify recurrent it’s time to go home?” What is the major feeling you
patterns in thoughts, feelings, have about all men?”
and behaviors
General leads (encourage the “Yes” “Uh hum” “I see.”
patient to continue) “ And then… ” “Go on”
“You were saying that…..”

Communication roadblock (Don’t use during communication)
Roadblock Examples
Reassuring -‐ Everything will be fine.
-‐ You will feel better soon.
Agreeing -‐ I agree.
-‐ I think you are right.
Approving -‐ That’s good.
-‐ I think you did the right thing.
Defending -‐ I did not say that.
-‐ Doctor Abc is a good doctor.
-‐ I am sure your father meant nothing by that command.
Using Y/N question -‐ Are you tired?
-‐ Would you like some water.
-‐ Could we talk now?
-‐ Did you sleep well?
Changing focus -‐ Client: I wish I were dead.
Nurse: Did your wife visit today?
Probing -‐ Why do you feel this way?
-‐ Why did you come to the hospital?
-‐ Why are you angry with your son?
Examples of nursing responses for patient question
Establish initial rapport:

-‐ Good afternoon, Mr. John
-‐ How can I help you?
Find out other concern

-‐ Is there something else you would like to talk about today?
-‐ Is there anything else worrying you today?
-‐ Would you like me to tell you a bit more about it?
Provide opportunity for you to response / Encourage and respond to questions

-‐ You look a little worried. You seem quiet distressed, is there something you want to
ask me right now?
-‐ I am wandering, how you feel about this?
-‐ How do you feel about all this?
-‐ You look worried. … is there something you want to ask me right now?
-‐ Is there something you would like to raise right now?
-‐ What troubles you about this?
-‐ What worrying you the most about this?
-‐ How do you think you are handling it?
-‐ How is it affecting your every day life?
Discuss management / offering option

-‐ Let’s now talk about what we need to / can do?
-‐ There are a number of thing we need to do for the best result. So let’s look at these
one by one.
-‐ I would like you to see an Occupational therapist who can give you some practical
way to look after your joint.

Meaning full explanation

-‐ Many women your age get this condition.
-‐ A lot of children have this condition at the moment.
-‐ We don’t quite know why people get this condition
Reassurance
-‐ This is not serious condition and it’s going to go way by itself in a few days.
-‐ This is something we can cure easily.
-‐ We can treat xxx successfully.
-‐ Although we haven’t cure for xxx , there is a lot we can do to manage it.
-‐ If we work together on there we can bring these sugar level down and keep you well.
-‐ There a lot we can do to bring down your blood pressure and get you out of danger.
-‐ So can we put out heads together to work out what we need to do?
-‐ Can we work together on this?
When a parent is against immunization

-‐ What is worrying you about the vaccination?
-‐ Can you tell me why you are worried?
-‐ Can you tell me why you are so concerned?
Responding after suggestion

-‐ Does that make you feel better?
Express professional concern

-‐ Bill, your cholesterol level is still very high and I am worried about you.
-‐ Anna, I have got your sugar test result here and I am pretty worried about your
health.
Referral
-‐ There are a number of other health professionals we need to work with to manage
your condition.
-‐ There are a number of people who can help us to manage your condition. I would like
to see a xxx and xxx.
-‐ I am going to refer you to a xxx specialist.
-‐ I would like to refer you to xxx. S/He is a expert in this field.
-‐ There is also a very good support group / association that you might like to contat.
Safety netting
-‐ If you experience / notice / feel xxx, please call me right way. I will give you my
mobile number.
-‐ If you experience xxx, go straight to the hospital without delay / call an ambulance
right away.
Follow up
-‐ Now after you have seen xxx, I would like you to come back to see me so we can
discuss the results.
-‐ Can you make an appointment to see me in about 10 days time?
-‐ In the meantime if anything is worrying you, please give me a call.
Leave taking / conclude

-‐ And here is useful pamphlet / website. Have a look at it and then we can discuss any
question it raised for you.

-‐ Okaey, I will see you in a few days / at the end of next week / the week after next.. /
after you have talked with the specialist.
-‐ Bye for now Ms Brown.
Dealing with resident or non-compliant patient

a. Make the patient understand that condition is serous by using an “if” sentence e.g.
- If you don’t stop smoking you won’t get better?
b. Empathise with the patient:
- I know it is not easy for you but ……..
c. Re-enforce the seriousness by restating what you said in a bet using different
possible:
- But unfortunately if you don’t …… you will get an infection / a serous disease /
much worse
d. Make a suggestion or inform the patient of his/her rights:
- Yes, you will need to ask your boss for some better safety goggles. You might
need to … talk to your husband/boss/superviser.
e. If the patient continues to be resistant right to end say:
- I would like you to think about what I have said because unfortunately it is the only
thing to do
Empathy
-‐ That must be very difficult for you to cope with.
-‐ Is there anything I can do to make you feel more comfortable?
-‐ You seem to be in a lot of pain. I can see you are in a lot of pain.
Pain assessment
-‐ Type of pain
o How would you describe the pain
-‐ Its intensity
o How bad does the pain get?
o On a scale of 1 to 10, 1 is less pain and 10 maximum pain, how do you rate
the pain?
-‐ The onset
o When did you start getting them?
o Do you have any idea what triggers them?
-‐ Its duration
o How long does it last?
o How often do you get this pains?
-‐ Changes in the site
o Can you describe any changes in your symptoms?
-‐ Its location
o Is that on the left side also?
-‐ Associated problems
o Apart from the headache, can you tell me about any other symptoms you
might have?

Asking about symptoms:
Nausea and vomiting assessment

Question for nausea and vomiting assessment

-‐ How long have you had the nausea?
-‐ What time of the day is nausea worse?
-‐ Is there anything that makes the nausea worse?
-‐ Is there anything you have found that makes the nausea better?
-‐ What effect do food, milk and antacids have?
-‐ Are you pregnant?
-‐ Past medical and surgical history (including medicine)?
-‐ Abdominal pain or discomfort, if so can you point to exactly where the discomfort is
and where it radiates?
-‐ Any pain on swallowing?
-‐ Any headache, diarrhoea, tinnitus, vertigo, angina
a. Muscle pain
1. When did it start? How long did it last?
2. Where is it exactly? Is it all over or only in a specific area?
3. Is it always in the same location?
4. What makes it better or worse?
5. Do other symptoms occur at the same time, like joint pain, fever, vomiting,
weakness, malaise, or difficulty using the affected muscle?
6. Is there a pattern to the muscle aches?
7. Have you taken any new medications lately?
b. Weight lost
c. Cough

d. Chest pain (http://www.rightdiagnosis.com/symptoms/chest_pain/questions.htm
• When did the chest pain start? To identify acute or chronic

• Is the chest pain constant or intermittent?
• Where exactly is the chest pain?
• Does the pain travel anywhere else?
• Can you describe the nature of the chest pain?
• What makes the pain better / worse?
• Is there a history of trauma to chest or back?
• Are you feeling shortness of breath?
e. Appetite
f. Phlegm
g. Passing water
h. Blood / stools
i. Shortness of breath
(http://www.rightdiagnosis.com/symptoms/shortness_of_breath/questions.htm )
- How long have you had the shortness of breath?
- Was the onset of shortness of breath sudden or gradual?
- What makes the shortness of breath worse?
- Any recent history of bleeding?
- Do you have any medical problem in past?
- Have you taking any medication?
- Do you smoke? How many buds per day?
-
j. Nose running
k. Throat sore
l. Wheezy
m. Mood
n. Sleeplessness
What questions will the doctor ask about your symptoms (and why)?
To get a better picture of your symptoms and condition the doctor will often ask questions
about your symptoms as this information can assist him/her in his diagnosis. He may even
request a brief family medical history as well as your medical history so he has an idea of
what inherited conditions may be causing your symptoms.
Firstly the doctor will want to know what symptoms you are experiencing. The doctor may
then ask more detailed questions about the symptoms.
1. Duration: How long have you had the symptoms? Have you had the symptoms
before? If so, what was done about it last time?
2. Severity: How bad is the symptom? Does it come and go or is it constant? Does it
affect your feelings, home life or work life? If so, to what degree are these
parameters affected?
3. Location: What part/s of the body does the symptom affect and does that change
over time?
4. Causes: Do you have any idea what may trigger your symptom? Do you have any
idea what may make your symptom better or worse?
5. Associated symptoms: Have you noticed any other symptoms?
6. Timing: If the symptom has been occurring for some time the doctor may want to
know what made you decide to seek a doctor's opinion. Did the symptom change in
some way or did someone say something to make you change their perception of the
importance of your symptom.
7. Past medical history: Do you have any current medical problems? Have you ever

received medical care and if so, what for? Have you ever been hospitalized? Have
you ever had a test such as an X-ray or CAT scan?
8. Past surgical history: Have you ever been operated on and if so, when? Were there
any complications?
9. Medications: Do you take any medication, supplements or herbal remedies? If so,
what dose, how often and what is it meant to be treating?
10. Allergies/adverse reactions: Have you ever had an allergic or adverse reaction to
any medication?
11. Smoking, drug and alcohol history: Have you ever, or do you currently smoke?
How often and how much alcohol do you drink? Do you or have you ever taken any
recreational drugs?
12. Obstetrics: Have you had any pregnancies? Were there any abnormalities or
complications during any of the pregnancies?
13. Sexual activity: Are you sexually active? Do you have more than one sexual
partner? Are any of your sexual partners of the same sex? Do you use any method of
protection? Have you ever had an STD?
14. Screening tests: Finally, your doctor may want to know if you have recently had any
screening tests such as a breast examination, pap smear etc.
Your answers to the doctor's questions help him/her to determine what other questions he
needs to ask to gain the necessary information. The doctor uses all of this information to
find out exactly what you are experiencing and thus making him/her better equipped to
arrive at an accurate diagnosis.
Summary of the questions your doctor may ask include:
1. How long have you had the symptom?

2. Have you had the symptom before – if so, what was done about it?
3. How bad is the symptom?
4. Are the symptoms constantly present or does it come and go?
5. How do you symptoms affect your work or home life?
6. How do the symptoms affect how your feel?
7. Where is the symptom located and does it change over time?
8. Does anything appear to trigger the onset of the symptoms?
9. What makes your symptoms better or worse?
10. What other symptoms do you have?
11. Do you take any medication, supplements or herbal remedies? If so, what dose and
how often and what is it treating?
12. Do you suffer from any allergies or adverse reactions to any drugs?
13. Do you have a history of or do you currently smoke or take recreational drugs?
14. Do you drink alcohol and if so, how much?
15. Have you had any previous surgeries? If so, where there any complications?
16. If you have had a pregnancy, were there any problems or complications?
17. Are you sexually active?
18. Do you have more than one sexual partner and if so are any of them of the same sex
as you?
19. Do you use any protection during intercourse?
20. Have you ever had an STD?
21. Have you recently had any screening tests such as a breast examination or a Pap
test?

History taking questions:
http://cai.md.chula.ac.th/lesson/english/content/content_a.htm
A.1 Chief complaint

1. What seems to be the trouble ?
2. What's been bothering you most ?
3. What brings you to the doctor today ?
4. What brings you into the clinic today ?
5. What is your number one complaint ?
6. What is the main problem you wanted to see me about ?
7. What kind of trouble have you been having ?
A.2 Present illness

1. What does it feel like ?
2. How long has that been going on ?
3. When did it begin ?
4. When did you first notice this problem ?
5. Have you ever had anything like this before ?
6. Is this an old problem, or is it something new ?
7. What seems to bring it on ?
8. When was the last time you felt perfectly well ?
9. Where do you feel pain ?
10. Where does it hurt ?
11. Where is the pain ?
12. Where does the pain go to ?
13. What do you do to help it go away ?
14. Have you taken any treatment for it ?
15. Has anyone at home or work had the same problem ?
A.3 Normal habits

1. How much do you smoke ?
2. How many cups of coffee do you drink each day ?
3. How much alcohol do you drink ?
4. How many cocktails do you drink in a day ?
5. Do you drink ? How much ?
6. How much beer do you drink on a weekend ?
7. What are all the pill and medicine that you take ?
8. Are you allergic to any drugs as far as you know ?
B. Common questions for information of past history and underlying diseases (semiclosed
questions)
1. AHave you ever had...(disease)...? (Peptic ulcer / Diabetes / Gall stones / Hepatitis)
2. Have you ever had a diagnosis of...(disease)...? (Appendicitis / Hemorrhoids)
3. Have you had any ...... before ? (Operations / Serious illnesses)
4. Has anyone in your family had....? (Polyps of the colon / Breast mass / Breast lump /
Coronary artery disease)
5. Did anyone ever find that you had...(symptom or disease or problem) (Peptic ulcer /
Jaundice / Urinary infection)
6. Do you take any...(medicine)...? (Tranquilizers / Laxatives / Analgesics)
C. Common questions for symptoms and/or complaints.

1. Have you been troubled with...(symptoms)...? (Abdominal colic / Stomach pain /

Coughing / Headaches)
2. Have you been suffering from....? ( Abdominal pain / Constipation / Vomiting)
3. Have you ever had any....? (Chest pain / Vomiting / Blood in the stool)
4. Have you recently noticed any...(symptoms)...? (Blood in your stools / Trouble
swallowing / Change in bowel habits / Lumps in your breasts / Loss of weight /
Fevers)
5. Are you having any...(symptoms)...lately ? (Trouble with your periods / Bleeding
between periods / Problems with sexual function / Crying spells / Difficulty urinating)
6. Tell me if you've ever experienced...(symptoms)...? (Breast pain / Difficult swallowing
7. Have you ever had...(symptoms)...in your chest ? (Pain ? Tightness / Pressure /
Heaviness / Squeezing)
D. Common questions about for some common symptoms

1. Do you get out of breath easily?
2. Have you had trouble climbing stairs?
3. Have you noticed swelling of your ankles?
4. Has there been any problem with your bowels lately?
5. How many times do you get up at night to urinate - (or pass urine)?
6. Have you been bringing up any sputum (or phlem)?
7. What brings you to the hospital / emergency room?
8. How long have you had these symptoms (pain, vomiting, headache)?
9. How was it (the symptom) last night / yesterday?
10. How has the appetite been?
11. Have you had any bowel movements today?
12. Have you had any bowel movements in the past three days?
13. Are your bowel movements regular?
14. Have you had any diarrhea?
15. How about all this nausea and vomiting?
16. Have you had any fever?
17. Point with your finger where it hurts the most.
18. Does it hurt when you move?
19. Does it help if you lie still?
20. Have you had a cold recently?
21. Have you been coughing lately?
22. Have you been short of breath at all?
23. Do you have any abdominal pain or burning about an hour after meals?
24. Have you had any pain or burning when you urinate?
25. Is there any change in the color of your urine?
26. Have you had any abdominal pain?
27. How long have you had the pain?
28. Where does it start?
29. Where does the pain go to?
30. Does it go anywhere?
31. How does the pain like? colicky?
32. How long does the pain last?
33. Have you had any pain like this before?
34. Does anything increase this pain?
35. Does anything help it? (relieve the pain?)
36. Do you have any other symptoms apart from this pain?
E. Common sentences or phrases or questions during physical examination

Good morning / afternoon Mr.....

I am a nurse for this afternoon....
Let me draw the curtain. Let's examine you on the couch.
Will you please take your shirt / blouse / skirt / pants off ? Lie down. Sit up, please.
I'm just going to take your blood pressure. It will be a little tight - but only very briefly
• Take a deep breath - in - out.
• Open you mouth wide, say aah !
• Just relax.
I'm going to feel your stomach now.

• Where does it hurt ? Is this painful ?Does it hurt more if I press or if I take my fingers
away ?
• Turn onto your left side and bring your knees toward your chin.
I'm going to do a rectal examination now.

• Does this hurt ?
• Turn around again now.
I am going to examine your neurological system.

• Look at this light.
• Follow the light / finger.
• Does this make you dizzy ?
• Screw your eyes up tight.
• Wrinkle your forehead.
• Blow your cheeks out.
• Open your mouth, put your tongue out.
• Turn your head to the left.
• Turn your head to the right.
• Shrug your shoulders.
• Squeeze my fingers hard.
• Lift your arms.
• Don't let me push them down?
• Push your arms down.
• Bend your elbows.
• Lift your leg straight up
• Bend your knees.
I'm going to test your reflexes now, just relax.

• Let me look in your ear; this side first, then the other side.
• Can you walk along this straight line ?
• Take a deep breath and blow hard.
• I'm going to tickle your feet now.
• Where is the rash ?
• This is going to hurt a little.
I'm going to look into your eyes now, please look straight ahead and try to keep
• your eyes on one spot.

=====
Test format and procedure
This subtest is specific to each profession.
The subtest is a face-to-face interview where candidates are required to participate in two
different role play situations typical of their health profession area. The details of each role
play are set out on two cue cards. Candidates take the role of the health professional while
the interviewer takes the role of the patient or client. This subtest is in three parts:
1. Warm-up conversation
- This is not assessed.
-‐ The purpose of the warm-up conversation is to explain the format of the test and to
help the candidate to relax. The interviewer will ask about areas of professional
interest, previous work, reasons for coming to Australia, future plans, etc.
2. First role play
- The interviewer hands the candidate a role play card which the candidate reads
carefully. Any questions are to be asked and answered before the role play begins.
The interviewer will fi nish the role play after about 5 minutes.
3. Second role play
- The above procedure is repeated with a different role play.
- The whole interview is recorded. It is important that the candidate and the interviewer
speak clearly so that the assessor can understand everything that is said. Two role
plays are provided to ensure the assessment is fair. The assessment is based on
both role plays.
TIPS on How to resolve concerns in Speaking- Part 1

http://sydneylanguagesolutions.com.au/blogs/tips-on-how-to-resolve-concerns-in-
speaking-part-1/
In the speaking component of the OET exam, you are given a clinical scenario where a
patient approaches you usually with a concern. The concerns can be classed generally into
two classes: Concerns about the ILLNESS and concerns about the TREATMENT aka non-
compliance. Since there is a lot to cover, I will give tips on only the first class of concerns in
this month’s blog.
1) THE ILLNESS.
Generally a lot of patient’s fears/reservations/anger stems from the unknown. Some of these
medical diagnosis can appear foreboding simply by the fact that it comes from the doctor or
the name itself. So most of the time this can be resolved by simply explaining all the aspects
of the illness in a clear and reasonable way.
Some aspects of the illness that you may have to explain are;
• -What the exact nature of the diagnosis is.
• -How seriously it will affect their health and daily function.
• -What the treatments/therapy will involve- it is important to explain why the treatment
is given.
• -What the prognosis will be.
Since this component of the exam will not be assessed on the content/medical knowledge of
the exam candidate, you do not need to know every illness under the sun to prepare for this.
However, you may need to know some common ones just so you do not get nervous for
stuck with what to say. Common ones could be hypertension, diabetes, stroke/heart attack,
quitting smoking/alcohol, immunizations etc.

e.g. I understand that you are worried about your hypertension. Hypertension is an elevation
of your blood pressure. This means that your heart has to worker a lot harder than normal to
pump blood around your body.
If it isn’t treated there is an increased chance that your heart may fail or that you may get a
heart attack or stroke. Therefore, it is vital that you keep your blood pressure under control.
Blood pressure is affected by many things.
Firstly, how much water and salt is in your body. If you have too much salt in your diet, this
can make your blood volume greater and therefore increase your blood pressure.
Secondly, the condition of your blood vessels. If your blood vessels becomes less elastic
due to age, damage from smoking or too much fat deposits from a fatty diet and not enough
exercise, then you will more likely not be able to regulate your blood pressure.
Thirdly, different levels of hormones can be released by various triggers such as stress,
drinking, obesity, diabetes etc that contribute to or worsen the hypertension.
It is a lot to take in, but I hope this helps you to see why it is so important for you to make
various changes in your lifestyle. Reducing your salt and fat intake in your diet, exercising,
avoiding smoking and alcohol are crucial for lowering your blood pressure.
If you can do this you will be able to significantly reduce the risk of the illnesses I mentioned
earlier which may lead to early death. Lifelong intake of blood pressure lowering medication
is preferrably a last resort so I would advise you to take these lifestyle intervention measures
first.
-Megan Lee, OET Trainer
How to Score Maximum Marks in OET Listening

Students think the OET listening task is difficult for multiple reasons, for example: “The
speakers talk too quickly!” or “I can’t write fast enough!” or “It’s so hard to think about
spelling and grammar whilst listening!”, etc.
Below are a few simple tips to help you score maximum marks:
1. SKIM through the questions and get a general idea of the topic at the time given at
the start
2. UNDERLINE and listen out for the key words of each question so you can listen out
for them during the dialogue
3. PREDICT some answers if you can – e.g. if the question says “What risk factors are
mentioned by the speaker for cardiovascular disease?”
4. 4. WRITE concise phrases instead of full sentences • For instance, “runny nose”
instead of “he had a runny nose”
5. 5. DO use common abbreviations such as: • “HR” for heart rate • “SOB” for
shortness of breath • Arrows to indicate INCREASE or DECREASE • Check the
OET website for what abbreviations are allowed!
6. USE your own abbreviations (for example, ‘yrs’ instead of ‘years’) then correct them
when you have time later
7. WRITE as you listen – and work on improving this!
8. DON’T try to rephrase what is being said as this will waste time
9. FIX up spelling, grammar and tense during the pauses between the questions, and
during the time given at the end of the task
10. MOVE on to the next question if you realise you have missed one, then go back and
GUESS an answer if you can
11. PRACTISE as much as you can!!!!!
-Carol L, OET Teacher


Occupational English Test Preparation: How to Speak Without Getting Stuck
5 minutes may seem like a short time, but if you encounter a topic or situation that is
unfamiliar, the 5 minutes can feel like an eternity. OET speaking session is a dialogue
between you (the health professional) and the interviewer (the patient). However, the
majority of time is devoted to you to show off your speaking skills. The interviewer will be
advised to speak minimally unless prompted by you with questions.
TIP 1
After the interviewer introduces the scenario, ask questions to clarify or establish the
situation/concern more fully. e.g. So how long have you had this pain for? What is exactly is
it about the drug that you are concerned about?
TIP 2
If you need more time to think about your response but you don’t want a big gap of silence,
mirror or reflect the concerns or questions the interviewer raises. This is not only good for
you to buy time but also a great way of expressing empathy and demonstrating that you
comprehend fully what they are saying. e.g. So from what I can understand Mr/s …., you are
worried about your son’s lack of concentration at school. I can see that it must have been so
serious that you considered the possibility of an underlying medical complication. I am sure
that coming up with a diagnosis would clear a lot of things up for you.
TIP 3
Don’t ever assume that the patient knows everything about the medical concern that they
are coming to you with. That is why they are consulting with you. Describe and define every
basic aspect of their health condition. e.g. Hypotension -> define it/ ask the patient if they
fully understand what it is. Particularly if they have concerns with compliance, going into a bit
more detail scientifically may be more persuasive for the patient.
TIP 4
If you need to explain to the patient about a certain procedure or therapy, ~remember!~
although the interviewer can see you, the examiner can’t as the role-play is voice recorded.
Therefore, make a concerted effort to describe every little detail in words, however obvious it
may sound. It is not the knowledge that they are grading you on but your speaking fluency.
e.g. using a walking frame: be descriptive right down to which hand/foot goes where and
when.
TIP 5
If you have no idea about the disease condition/treatment, hypothesise. e.g. That sounds
like a respiratory condition which the doctor will be able to clarify to you about. However,
from my understanding of respiratory conditions in general, it is important that you are
supplied with sufficient oxygen and make sure that your airways are cleared of mucus or any
foreign particles etc.
TIP 6
Remember to speak slowly ad clearly. This will not only stretch out the time and minimise
the amount of mistakes that you may say but also dilute out any thick accents.

SPEAKING SECTION – Cue cards
EAR ABSCESS
Setting Children’s Hospital ward

Patient
The patient is your three year daughter Elizabeth. She is being admitted to hospital for
treatment of an ear abscess. This is the first time your child has been in hospital and you are
anxious about how she will manage. You can’t be at the hospital all the time as you have
two other children aged Joan aged 5 and Sam aged 7. The nurse has requested information
about your daughter’s normal routine at home.
Task
• Explain your concerns to the nurse.
• Answer the nurse’s questions about your daughter’s routine. Give a brief answer.
Wait for the nurse to ask further questions.
• Ask about the flexibility of visiting hours.
Nurse
Elizabeth, a three year old girl has come with her mother to be admitted with an ear abscess.
Her mother is anxious about how she will settle in. You need information about the child’s
normal routine and habits to prepare a nursing care plan.
Task
• Reassure the mother about the care Elizabeth will receive.
• Ask whether she has any siblings she usually plays with at home.
• Ask about her normal routines at home
o Usual bedtime – morning or afternoon sleep?
o Food preferences – able to feed herself?
o Is she fully toilet trained?
o Has she brought any favourite toys or books with her?
• Outline visiting hours – 11am – 8pm but stress that overnight stays are possible in a
special visiting room.
Example answer
Reassure: You look a bit anxious. Is there anything else that is troubling you? Let me
reassure, I am experienced nurse in paediatric, I have been doing this care for more than 10
years. I look after your daughter during her hospitalisation and I can provide good quality
paediatric care and there are ranges of professional services available. Would you like me to
tell you more about that? By the way, would you mind to provide some useful information
about your child that will be helpful tips for preparing nursing care plan?
a. How many children do you have? Who is playing with her at home?
b. What is your daughter Elizabeth usual bed time?
c. What is her favourite food?
d. Is she able to feed herself?
e. Is she fully toilet trained?
f. Has she brought any favourite toys or books with her?
HEAD LICE

Setting Community Health Clinic

Patient
You are the mother of three children aged 3, 4, and 6. You have just discovered your 6-year-
old daughter has head lice. You are upset and embarrassed as you always wash the
children’s hair regularly. You have never encountered this problem before.
Task
• Respond to the nurses questions.
• Ask about any natural remedies you can use, as you don’t like chemicals.
• Ask about whether your other children will be infected also
Community Nurse
A young woman, the mother of three children aged 3, 4, and 6 has come to the clinic and
tells you she has just discovered her eldest daughter has head lice. She is upset and
embarrassed and assures you she always washes the children hair regularly. She has no
experience in dealing with the situation, as it has never happened before.
Task
• Reassure the mother and explain that head lice are contagious (spreadable) and
anyone no matter how regularly they wash their hair can get head lice.
• Suggest the mother contact any school or kindergarten her children attend as it quite
probable other children are also affected.
• Recommend and explain the use of a head lice comb.
• Suggest the mother visit the local pharmacy to obtain a herbal product with natural
(non chemical) pyrethrins.
• Say that because head lice spread when people play, cuddle or work together, it is
important to check the whole family.
• Offer to provide the client with a detailed leaflet on treating and controlling head lice.
Important information about lice:

http://www.public.health.wa.gov.au/cproot/473/2/Head%20lice%20fact%20sheet%20August
%202011.pdf
MYOCARDIAL INFARCTION
Setting Hospital Ward

Patient
You are a 42 year old male who arrived at the hospital via ambulance 10 days ago after
suffering from acute sub-sternal chest pain radiating to left arm. You have been diagnosed
with myocardial infarction. You are a businessman, married with 3 children. Your condition is
now stable, however, you are restless and worried that you will have to make big changes to
your lifestyle. Seek reassurance from the nurse.
Task
• Express nervousness about future health.
• Ask if all the medications are necessary.
• Will you be able to work soon?
• Express concern that it will be hard to make changes to your lifestyle.

• Request advice about suitable diet/ exercise routine.
Nurse
Patient is a 42 year old male who arrived at the hospital via ambulance 10 days ago after
suffering from acute sub-sternal chest pain radiating to left arm. Patient has been diagnosed
with myocardial infarction. Patient is a businessman, married with 3 children. His condition is
now stable, however, he appears restless and worried about his condition. He is overweight
and is a smoker. He has high blood pressure.
Task
• Provide comfort and stress the importance of a gradual transition back to normal life.
• Reassure the patient that he can expect a full recovery if he follows doctor’s advice.
• Discuss importance of taking medications regularly.
• Discuss the importance of giving up smoking.
• Provide advice on what assistance is available to assist in quitting smoking.
• Provide advice on suitable diet and exercise.
• Discuss importance of regular rest periods between activities.
• Respond to patient questions and provide reassurance
POST-SURGERY ACTIVITY
Setting Hospital Ward

Patient
You are Harry Jones aged 78. You are a bachelor who lives on his own. You were admitted
to hospital to have a large lesion removed from your back. You know you’ll be discharged in
the next few days but meantime you want to make the most of the rest and the hospital food.
You want the nursing staff to leave you in peace but a nurse says its time to get up and have
a shower. You are feeling quite cranky.
Task
• Point out that you will be home in a few days and there will be plenty of time to
shower then.
• Explain that at your age you need rest not exercise.
• Argue that a shower will only wet the dressing on your shoulder.
Nurse
Your patient, Harry Jones aged 78, is in hospital after surgery to remove a large lesion from
his back. He is recovering well and you want him to get up and walk about and to have a
shower. You have observed that he has neglected his personal hygiene and appearance.
Task
• Encourage the patient to have a shower, wash his hair and generally get cleaned up.
Be tactful as he can be quite cranky if he doesn’t want to do something.
• Say you will place a waterproof dressing over the lesion area.
• Stress the importance of exercise and good hygiene in ensuring a speedy recovery.
VACCINATION
Setting Children’s Hospital Ward

Patient
You are a the parent of a young boy aged 4 who was admitted through the Children's
Emergency Department for acute meningoencephalitis as a result of a complication following
mumps. He has fully recovered and is ready to be discharged home. You are unaware that a
vaccine is available in Australia which protects against mumps. You would like further
information and guidance regarding vaccinations. You also have a 2 year old son and have
only lived in Australia 6 months. You are concerned because some people say that
vaccinations are dangerous.
Task
Ask the following questions:

• Has your child has fully recovered?
• What vaccinations are available?
• What are the advantages & disadvantages of vaccinations?
• Are there any side effects from the vaccination?
• Are they expensive?
Nurse
A young boy aged 4, was admitted to hospital through the Children's Emergency
Department for acute meningoencephalitis as a result of a complication following mumps. He
has fully recovered and is ready to be discharged home. His parents are unaware that a
vaccine is available in Australia which protects against mumps. They would like further
information and guidance regarding vaccination for Mumps. They also have a 2 year old son
and have only lived in Australia 6 months.
Task
Explain to the parent:

• That the boy has fully recovered.
• The importance of a full vaccination program for both children.
• What vaccination is required for mumps and when to have it.
• The risks and benefits of the vaccination for mumps.
• Explain any side effects that might occur from the vaccination.
• That vaccination is a requirement of many schools.
• That vaccinations can be obtained from free health clinics.
Pain Relief
Setting: Accident and Emergency Centre

Patient
You are a male patient aged 23. You were in the city drinking with your friends and became
involved in a fight and were knocked unconscious. You hurt your head, hand and shoulder
and woke up on the pavement. Due to your injuries, you have decided to visit the A & E
centre to get some pain relief. You are having trouble getting your thoughts together but you
just want some pain medication so you can go home and “sleep it off”.
Task
• Tell the nurse what happened

• Insist you have a bad headache and want something to ease it

• You also believe your hand is broken
• Be difficult to convince to wait to see a doctor.
Nurse
You are an A & E nurse. A man has presented at A & E at 3am. He states his name is
Joseph Groom. He has suffered a head injury and may have mild concussion. He also has
cuts and bruises to his body, his right hand is swollen and his clothes are torn. He is
intoxicated. He insists he wants something for pain relief while waiting to see the doctor.
Task
• Ask for details about what happened
• Find out the extent of his injuries
• Explain that you cannot administer pain relief before examination by a doctor
• Explain that all medications have side effects and that in some cases these are
exacerbated by alcohol
• Try make him as comfortable as possible.
Recovery Room Patient
Setting: Operating Theatre – Recovery Room

Patient
You are Doris Mack aged 80. You have woken up following hip replacement surgery and are
having trouble getting your thoughts together. Keep asking for your daughter and say you
need a cup of tea as your mouth is dry.
Task
• Be confused about where you are
• Don’t pay any attention to what the nurse is saying - keep asking for your daughter
• Listen to the nurse’s explanation
• Say you need a cup of tea now as your mouth is dry
Nurse
You are a nurse in an operating theatre recovery room. 80-year-old Doris Mack is recovering
after hip replacement surgery. She is receiving IV fluids. She has been able to tell you her
name but seems confused about where she is. She keeps asking to see her daughter and to
have a cup of tea.
Task
• Explain her situation
• Check for understanding
• Re-explain if necessary
• Advise her that her daughter is waiting to see her in the post-operative ward
• Explain that hospital policy excludes visitors from the recovery room
• Explain why she cannot have fluids by mouth at this stage
• Assure her that she will be taken back to her ward shortly and then her needs will be
attended to based on the doctor’s orders.
Grief Counselling

Setting: Hospital Ward

Patient
You are Barbara Carter aged 19. You are in hospital with a broken pelvis after a car accident
in which your best friend, the driver of the car, was killed. Ann Phillip, your friend, was age
19 also and it was your idea to go to the beach for the day. You feel if you had not asked her
to go she would still be alive. Your parents say you are not responsible for the accident but
you feel awful. You can’t get it out of your mind, you can’t sleep and you have been crying.
Task
• Tell the nurse on night duty how you feel
• Explain that you were the one who wanted to go to the beach not Ann
• You don’t know what to say to her parents
• You can’t stop seeing the crash in your mind
• You wish you had died as well
Nurse
You are a nurse in a hospital ward on night duty. A young patient has been crying and is
unable to sleep. You know she has a broken pelvis as a result of a car accident. You don’t
have the full details but you believe a friend was killed in the accident.
Task
• Listen to what she wants to tell you
• Respond caringly and acknowledge her feelings
• Tell her that it is important to talk about her feelings with someone
• Reassure her that you will ask the Ward Manager to arrange for the chaplain or a
grief counsellor to visit her in the morning.
• Ask if she is in any physical pain
• Explain that the doctor has prescribed a sedative to help her sleep
• Suggest she take the sedative and a warm drink
Nappy Rash
Setting: Maternal and Child Health Centre

Patient
You are an 18 year old single parent and have brought your first child, a three month baby
boy, to the Maternal and Child Health Centre as he has developed nappy rash. You are
upset and ashamed. You change him regularly and always use a good strong disinfectant to
clean the changing table and always wash the baby thoroughly with a good soap.
Task
• Explain your concerns to the nurse
• Ask why this has happened
• How it can be treated
• What steps your should take to prevent it happening again
Nurse
A young single mother has brought her three month old son (her first child) to the clinic. She
is upset and ashamed because he has developed nappy rash. She changes his nappies

regularly, uses a strong disinfectant to clean the changing area and washes the baby
thoroughly with soap.
Task
• Identify reason for coming
• Reassure the mother that nappy rash can occur in well looked after babies
• Ask about the disinfectant used and explain that babies’ skin is quite sensitive
• Recommend that:
o she makes sure that her son’s skin does not come into contact with
disinfectant
o instead of soap that she uses a gentle skin cleaner such a Cetaphil
• Suggest the use of pawpaw ointment or zinc and castor oil cream, available from
local pharmacist, to prevent and heal nappy rash.
Hypertension
Setting: Emergency Department
Patient
You are a 71 year old woman who lives alone. You have come to the emergency hospital
because you have just taken your blood pressure on a recently purchased home automatic
blood pressure monitor. You are very alarmed because the systolic pressure was 210 and
the diastolic pressure was 110. You checked twice. You were diagnosed with hypertension
last year but ceased taking medication a few months ago after it returned to a normal range,
You don’t like going to the doctor so decided to get the blood pressure monitoring equipment
so you could check it yourself occasionally. You don’t like hospitals or any fuss but are
scared you’ll have a stroke.
Task
• Explain to the nurse that you are alarmed by the readings you got on your blood
pressure monitor and that you are afraid you’ll have a stroke
• Admit that you may have been premature in ceasing the blood pressure medication
and that you would like to start the medication again now
• Say that you live alone but are very independent and prefer to manage things
yourself
• Resist admission. You just want to be given the appropriate medication and then go
home
Nurse
A 71 year old woman has come into Emergency because she has taken her blood pressure
on her home monitor and registered a systolic pressure of 210 and a diastolic pressure of
110. You have confirmed that these reading are correct. The patient admits to being
diagnosed with hypertension a year ago but is not taking medication now. She lives alone.
The registrar who saw the patient says she will need to be admitted for further investigation.
Task
• Ask why she decided to cease taking her medication
• Explain why she must be admitted for treatment and further investigation
• Acknowledge her desire for independence but endeavour to convince her that in this
case hospitalization is the safest and best option.

Ten Expressions to Use In Speaking And Writing

1. Don't worry.
2. You'll be fine. / It'll be fine
3. What are you worrying for?
4. There's no need to worry.
5. There's nothing to worry about.
6. It'll turn out all right.
7. It isn't as bad as all that.
8. Whatever you may have heard...
9. Rest assured,...
10. I can assure you that...
How To Use These Phrases In Your English

1. The feeling of phrase 1 depends on intonation. If more stress and intonation are placed
on 'don't' it sounds kind and reassuring. With more stress on 'wor' it sounds a little
annoyed at the other person's anxiety.
2. Phrase 2 is showing your confidence in the situation having a good result.
3. Phrase 3 is mildly criticising the other person for worrying.
4. Phrases 4 and 5 are saying that the situation is completely fine and there is danger in
the future.
5. Phrases 6 and 7 are saying that the situation nowis bad but that it won't continue or isn't
as serious as it seems.
6. Phrase 8 is saying that the negative information is wrong. You follow this phrase with a
sentence giving the true, (more optimistic) information.
7. Phrases 9 and 10 are more formal and could be used in business letters.
Ten Expressions to Use In Speaking And Writing

1. I reckon you should stop now
2. Why don't you stop now?
3. How about stopping now?
4. If I were you, I'd stop now.
5. I suggest you stop now
6. You'd (really) better stop right now.
7. I would strongly advise you to stop
8. My advice would be to stop now
9. It might be a good idea to stop
10. You might try stopping
How To Use These Phrases In Your English
1. Phrases 1, 2, 3 and 4 are quite informal. Phrases 2 and 3 are more tentative (you are
trying not to be forceful with your ideas).
2. Phrase 4 is more forceful than the first three suggestion phrases.
3. Phrase 5 is neutral and can be used formally and informally. Using more stress on 'gest'
of 'suggest' makes it more tentative and more stress on the main verb makes it more
forceful.
4. Phrase 6 is quite forceful and gives the idea that not following the advice will have a
negative result.
5. Phrases 7 and 8 are quite formal in tone. Phrase 7 is really quite forceful and phrase 8
less forceful.
6. Phrases 9 and 10 are the most tentative phrases (least forceful). Phrase 10 sounds
more informal than phrase 9.

For details:
http://www.ihbristol.com/useful-english-expressions/example/giving-an-opinion2/8
John Murtagh's Patient Communication: This website provides excellent worksheets

summarising common conditions in simple language. The website is
http://www.nevdgp.org.au
General Information Travel Information Division Information NEVDGP Home
A-Z index Immunisation Weblinks Topics index Video index
John Murtagh John Murtagh Series

GP Series Common General
Introduction Problems:
General Alcohol: harmful use of Diabetes: foot care for
Problems Irritable Bowel
alcohol diabetics
Children's
Health Diabetes: insulin Marijuana ( See
Angina
Adolescent injections Cannabis)
Health Anxiety Diverticular disease Melanoma
Infections Asthma Ear: otitis externa Migraine
Mens Health Asthma: aerosol Nose: Stuffy, running
Musculoskeletal Ear: wax in your ear
inhaler nose
Disorders
Pregnancy Asthma: dangerous
Emphysema Peptic Ulcer
Prevention asthma
Women's Health Bells palsy Epilepsy Pityriasis rosea
The Elderly Eye: foreign body in the
Bites and stings Pruritus ani
eye
Cancer Fever Psoriasis
Cannabis (Marijuana) Glaucoma Schizophrenia
Circulation to legs:
Haemorrhoids Skin Cancer
poor circulation
Constipation Hay fever Sleep Problems
Stress: Coping with
Coping with a crisis Head Injury
Stress
Depression Heart failure Tension Headaches
Depression:
Heartburn Travel: Air Travel
medication for,
Diabetes: Hiatus Hernia Travel Sickness
Hypertension Varicose Veins

Test Information
The Listening sub-test takes around 50 minutes. The exact length depends on the length
of the audio recording. It has two parts and is the same for all OET candidates.
In Part A you listen to a recording of a consultation between a health professional and a

patient (dialogue). You take notes under the headings provided while you listen. This
part of the test usually lasts around 20 minutes.
In Part B you listen to a recording of a talk or lecture on a health-related issue

(monologue). There is a variety of tasks for you to complete while you listen. This part of
the test usually lasts around 30 minutes.
You hear the recordings for the two parts once only, just as you would in real life.
However, there are pauses during the recordings to allow you time to write your answers
and to read the next heading or question. At the start of each part, there is some time for
you to look through the headings and questions; at the end of the test, there is time for
you to check your answers.
You are given a printed answer booklet to write your responses in. You may write in pen
or pencil.
Listening Strategies
• When the recording starts, use the time allowed to look through the questions
carefully.
• Scan the headings and questions so you know what to listen out for .
• Use prediction skills – e.g., what vocabulary is likely to come up given this topic.
• Don’t write full sentences; make notes and be sure they are clear and unambiguous.
• To save time use common abbreviations and symbols such as BP for Blood Pressure
or an arrow for increase and decrease. This is acceptable in the exam.
• Write clearly, don’t make it difficult for the assessor to read your responses as you
may not get all the marks you could.
• Keep looking ahead at what is coming up (on the next page too).
• Use the pauses in the recordings to finish writing, review, and prepare for the next
section.
• Use the space provided for answers and the number of marks available for each
question to guide you about how much information to include.
• Don’t lose your place during the test; remain focused on each question.
• Check the format of each question: e.g., sentence completion; note-taking or listing;
table or diagram completion; true-false or multiple-choice questions.
• Look for any simple spelling errors that may accidentally change the meaning of your
answer (‘message’ for ‘massage’, ‘bills’ for ‘pills’, etc.).
• If a page is messy, use clear marks (e.g., arrows) to show which answer belongs to
which question or heading.
• Practice, Practice, Practice! This is the most important aspect of improving your
ability to take notes. The more you practice the better you will able to take notes and
listen at the same time.
• Build your vocabulary. When you encounter new words, find out the meaning and
write them down in a vocabulary booklet.
Useful Websites for Listening

One key aspect which will help you improve your listening and note-taking skills is lots of
practice. Below are some useful websites which have podcasts and audio files on health
related topics.

• The Better Health Channel: http://www.betterhealth.vic.gov.au

• The Health Report : http://www.abc.net.au/rn/healthreport/
• Health Check: http://www.bbc.co.uk/podcasts/series/healthc/
• The Naked Scientists: http://www.thenakedscientists.com/
• Catalyst: http://www.abc.net.au/catalyst/
• ESL Bits: http://esl-bits.net/advanced-listening/NEWindex.htm
• UEFAP: http://www.uefap.com/listen/exercise/exlis.htm
• Language and Learning Online:
http://www.monash.edu.au/lls/llonline/listening/lectures/2.xml
Improving Note-Taking Skills
The OET listening sub-test tests your ability to not only understand what you heard but also
to take notes. Therefore it is essential to develop good note-taking skills in order to pass this
exam. Recently many students have commented on how difficult the listening test has
become, especially Part B. Therefore to pass this section requires serious practice and it is
up to you, the language learner, to work hard to develop the required skill level in this area.
• The first step is to use the worksheets in this section of the website as a starting point
to develop listening and note-taking skills. After completing each task, you can gauge
your score and have an indication of your ability in this area.
• The second step is to practice listening and note-taking as much as possible on your
own. If you are weak in the skill area of note-taking, you should practice at least 30
minutes to 1 hour a day. If you do this for a period of 1 month, you will notice an
improvement.
• During the process you should also be learning new vocabulary and improving your
overall language skill.
• Some of the "linked to websites" have an extensive range of audio files on health
topics, often with transcripts. Most of these do not have questions or worksheets.
However, you can greatly improve your note-taking skill by listening to these audio
files while taking notes at the same time. Then check your notes by playing the
recording again or reading through the transcripts.
• The key to success is lots of practice. So don't delay and start now!
Procedure for listening tasks located on the Better Health Channel website
o You should print out the worksheets, or view on your computer and write
down the answers to the questions on a piece of paper, simulating test
conditions.
o Click on the link which will take you directly to the audio file
o After the web page opens for your chosen topic,do not read the fact sheet
as you are about to complete a listening task. You should click on the link
titled "Listen to Fact Sheet" The recording will now play.
o Play the talk once only and answer the questions in the spaces provided.
o You should pause the talk briefly (30~60seconds) after each question so that
you can complete the information and read the next question.Do not pause
during the question, as this will make the task easy and not simulate exam
conditions.
o The use of synonyms, acronyms ,abbreviations is acceptable. Minor spelling
errors are also acceptable.
Please note: As stated above, in order to best simulate exam conditions, do not
pause until all the information for a question has been given. If you pause the
recording too often you will not be developing the required note-taking skills.

Other Role-play cue cards
SETTING: Community Health Centre

PATIENT
You are a first time mother with a two-week-old baby. Your nipples are becoming sore and
cracked and your breasts are swollen.
Task
-‐Ask for treatment for the swelling.
-‐You are allergic to some antibiotics. Refuse to take them if they are offered and make sure
that any treatments offered do not contain antibiotics because you feel particularly
sensitive at this time.
-‐ Ask for general advice about breastfeeding. You were given some tips at the hospital but
are still struggling.
NURSE
A first time mother with a 2-week-old baby presents with nipple soreness and engorgement.
Task
-‐ Reassure her about the temporary nature of engorgement.
-‐ Offer treatment for the nipple soreness.
-‐ Explain effective breastfeeding technique.
SETTING: Hospital
PATIENT
You are an elderly patient staying in hospital while you recover from a hip operation. The nurse
visits you to deliver your lunch but you are unhappy with hospital food and have not eaten your
breakfast. You often skip meals.
Task
-‐ Greet the nurse and begin to complain about the food.
-‐ Say that you don’t want the nurse to leave any lunch with you because you won’t eat it and
it’s a waste.
NURSE
An elderly patient is recovering from a hip operation. He/she is expected to stay for another 2
weeks. You are delivering lunch but notice that his/her breakfast plate is still full. Skipping meals
and eating small amounts has been a regular occurrence for this patient.
Task
-‐ Greet the patient in a warm and friendly manner.
-‐ Mention that his/her breakfast plate is still full and he/she needs to eat more to recover quickly.
-‐ Remain friendly and explain that you are unable to change the hospital menu
-‐ Leave the lunch tray with the patient.

PLACE: Hospital
PATIENT: You are a 56-year-old smoker who has been admitted to hospital with bronchitis. The
nurse is collecting information from you.
-‐ You live in your own home with your wife/husband, who is 50 years old, and you have three
teenage children living at home. You have smoked for 30 years and often had chest
infections.
-‐ You would like to give up smoking but have tried several times and have not succeeded.
Task
-‐ Answer the nurse’s question about your family situation, and ask for advice about how to
give up smoking.
NURSE: You are talking to a 56-year-old patient, a heavy smoker who has just been admitted
with bronchitis.
Task
-‐ Find out about the patient’s general background: family, habits and general health.
-‐ Also respond to the patient’s questions about giving up smoking. Give advice in a positive
and friendly way.
Anaphylactic shock
Setting: Emergency Department

PATIENT
You were on a bush-walk with four other friends – the walking party stopped to take in the view
and have a drink. You sat down on a log – and as you were sipping your tea, you were bitten
on the ankle by a bull ant - the ant had bitten right through your thick explorer sock! You
brushed it away – and killed it (crushed it with your boot) – the smell attracted an army of ants
who quickly crawled up your boots and started biting your ankles with ferocity! One of the
hikers helped you get back to your car. The two of you drove to the hospital.
Task
-‐ Your heart is now racing; both ankles are red, itchy and throbbing – they feel like they
are on fire; you are a bit dizzy and you are having trouble breathing.
-‐ You are scared that perhaps you are dying. Nothing like this has ever happened before.
NURSE
Patient is 35 y.o. man/woman who has sustained many bull-ant bites while hiking. His/Her
ankles are swollen, red, and itchy. The patient’s breathing is becoming more laboured – and the
patient is getting agitated. You suspect patient is in shock and there is no time to waste
TASKS
-‐ Try to calm the patient down
-‐ Administer an Epi-Pen antihistamine injection (.15mg epinephrine) to the upper outside
thigh area
-‐ Check ankles for any stingers left in the ankles (there are none)
-‐ Apply Benadryl cream to relieve itching
-‐ You notice that the patient is becoming less agitated and ankle swelling is starting to go
down
-‐ Ask if patient is alone – how is he/she going to get home?
-‐ Advise patient to get plenty of rest for the next few hours, drink plenty of fluids and keep
applying the Benadryl cream
-‐ If things have not normalised within 12 hours they are to see their Doctor
65

Mild concussion
Setting: Suburban community health centre

THE PATIENT – bump on the head
• You have come to see the Community Nurse – with your son
• Your son (8 year old boy) fell off his new 2-wheeler bicycle
• There is bruising on his forehead
• He was “out to it” for about 15 seconds – he hit the gate post
• He’s now very pale, listless
• You are very anxious about your son.
• You believe he has concussion and needs to be hospitalised
• Keep complaining that you would like your son to get a CT scan
• Ask the nurse what you should do now
NURSE:
Mother has brought in her 8 y.o. son, No blood loss - however bruising on forehead is evident
Child has fallen off his new two-wheeler bicycle, Now has a large bump coming up on his
forehead.
Hit a gate post – was not wearing a helmet, Child is very quiet, Pale, lethargic
TASKS
• Get a history of what happened - was unconscious for 15 seconds
• Now very pale – lethargic
§ Examine patient - you diagnose mild concussion
§ Explain the mother what she should do (observe the child 24 hours)
§ Stress the importance of child wearing a helmet whenever cycling
§ Explain why you think a CT scan is really not necessary
§ Child should “take it easy” for the next 24 hours
§ If headaches persist – if child feels nauseous - or pupils are dilated -
mother should contact a doctor immediately
§ Ask the mother to ring you tomorrow to give you a progress report
SETTING: COMMUNITY HEALTH

PATIENT
You have come to the local Community Health Centre to get checked over by a health
professional – doctor or nurse – you don’t really care. You have been having a lot of fainting
episodes lately – in fact, you fainted about 10 minutes ago while waiting in the Centre’s Waiting
Room. You experienced a similar episode 3 months ago but on that occasion, you didn’t seek
medical attention. You were hoping that the problem would clear up by itself but now you are
worried that it might be something serious. You have been feeling a little dizzy.You are a real
estate agent and work long hours. You have important, work-related commitments and won’t be
able to take time off to see specialists.
TASK
-‐ You want medication to control a possible reoccurrence.
• You can’t wait around to see the Doctor because you have just started a new business
and you have very important business deals happening later on today.
• Ask the Nurse to explain what he/she thinks is wrong with you
• Insist that the Nurse prescribes some medication to “sort out” your low blood pressure
• Eventually you agree to wait another 30 minutes to see a Doctor.
66

NURSE
This middle-aged person has been waiting in the Waiting Room and fainted about 10 minutes
ago. They have come into the Community Health Care Centre because he/she is worried that it
might be something serious and they want to have their health checked to stop it happening
again.
TASK
• Ask the patient about their general health and specifics about what they were doing at
the time of their black-outs.
• The patient occasionally feels dizzy but otherwise has no ‘suspicious’ symptoms and is
generally healthy.
• After examining the patient, you find that their blood pressure is a little low
• You want them to see the Doctor.
• Reassure them and explain why it is best to wait and see a Doctor
SETTING: General Ward

PATINENT:
You are a 72 year old. You are in hospital. Tomorrow morning you will be having your hip
replacement surgery. You are extremely worried about the anaesthetic: you are quite sure you
won’t survive. You want the nurse to arrange for your son to come and collect you and take you
home.You have been waiting for 2 years, and now – you don’t want to go through with it.
TASK
-‐ Ask the nurse for facts and figures:
-‐ How many patients have died under anaesthetic in this hospital?
-‐ How long will you be ‘under’ ?
-‐ How long does it take to get the anaesthetic “out of the system” ?
-‐ Your asthma when you were a child – does this make a difference? You have not
suffered from asthma for the past 50 years.
-‐ Eventually you agree to stay in the hospital – but you are refusing to take a sleeping pill.
NURSE
The patient is a 72 year old female, booked in for a hip replacement tomorrow. The patient is very
anxious. Vital signs: BP 160/90; Pulse 75. Patient is well. No respiratory problems or varicose
veins. BMI is 27. Patient is extremely worried about having the anaesthesia.
TASK
• Explain the risks (if any) involved
• Suggest she consider the bigger picture
• Perhaps take a sleeping pill to help her sleep
• Try and calm the patient down

PATIENT
• 3 weeks ago you were discharged from hospital after a bowel operation
• You are now back home – living alone
• You are on a high fibre diet (which you do not like) and are told to drink plenty of fluids
(and you are drinking lots of tea and coffee – not much plain water)
• You came home using a walking frame – and you are supposed to try and do more
walking without the frame but you don’t – you are not confident about this – in fact, you
67

prefer to sit and watch TV all day long

• You are not “getting out” – social contact is very low – occasionally you chat to next door
neighbour
• You get constipated for 2 or 3 days at a time – eventually things start moving again but
only after 3 or 4 Nulax – which you know is not the best.
NURSE:
Patient suffering from loneliness – and constipation

You are a district nurse working for the local Council
Today you are visiting one of your regular patients (62 year old) to monitor his/her progress
following a bowel operation
Patient reports continuing constipation
Patient not doing enough exercise
TASKS
• Suggest how she/he might improve matters
• Remind the patient she/he must stick to the high fibre diet and to keep taking Nulax as
well as eat plenty of stoned fruit: nectarines, peaches, plums
• Suggest she/he join in activities at local community centre (board games like Scrabble,
Mah Jong, Monopoly) indoor bowls – to improve social contact

THE PATIENT - SINGLE MUM / DAD SUFFERING FROM VARICOSE VEINS
You are a single parent – struggling financially - just “getting by”

•
You know you are overweight – too many carbohydrate foods – but life is tough enough
•
– you have lots of problems
• You are finding life pretty hard – you are the sole parent of a 6 y.o. who has just started
school
• You have a part time job in a restaurant – you stand on your legs most of the day
• For the past 2 months your right leg has been giving you a lot of trouble – really throbs
and aches at night
• You know you have varicose vein problems on your right leg
• You are visiting the nurse to see what can be done to help with the pain
• Resist all suggestions from the nurse as to what you can do to make your life (and leg)
more manageable
• Finally – after a lot of resistance – you give in – and agree to follow the nurse’s
suggestions
NURSE:
PATIENT IS SINGLE MOTHER /FATHER SUFFERING FROM VARICOSE VEINS.

-‐ You are the nurse on duty
- 28 year old woman comes to see you
- She is very overweight
- Has been experiencing pain in right lower leg
- Leg is disfigured with varicose veins
TASK
- Suggest treatment – ways to ease the pain
- - offer to give her a pair of FREE sample pressure stockings
- You would like to review this woman in one week’s time
68

SETTING: HOSPITAL WARD

PATIENT
• You are in the maternity ward, having recently had a caesarean to deliver your third child
• You never wanted a caesarean – no-one asked you
• You have only ever had normal deliveries – you are very healthy – why did this happen?
No-one has explained anything to you!
• You don’t want to breastfeed your third child – after all, it is the baby that is causing your
depressed feelings
• You don’t particularly want to talk to anyone – you just want to be left alone
• Resist the nurse’s suggestion you see a psychiatrist
• Eventually you agree to let the psychiatrist come and see you later on today – who
knows, it might help. (But you doubt it!)
NURSE
Patient suffering from post partum depression
• You are a Hospital ward nurse at the Melbourne Maternity Hospital

• Patient was delivered of her third child – 5 days ago
• Patient is refusing to breast feed
• Has been shocked since learning she had been sedated and a caesarean section was
done to deliver the third child (which was necessary otherwise she would have died)
Tasks:
• Try and get her to talk about her feelings
• Suggest she see the Hospital psychiatrist
• You will arrange for the psychiatrist to come and see her later on today
• Offer to get her a cup of tea / a magazine to read – to take her mind off things.
SETTING: Outpatients Department – Major Hospital

PATIENT
You are Pat Collins (the parent) accompanied by 5 y.o. girl:Jody Collins
Patient is Jody Collins. Jody recently developed asthma-like symptoms yet has never suffered from
asthma before. Jody is a happy child. One week ago Jody received a new friend - a German
Shepherd dog called Fido. Fido is only 3 months old and very cute. Fido is living inside the house
as well as outside. Fido and Jody have become very close friends.
Jody’s other symptoms include red itchy eyes, runny nose, lots of sneezing.
You are not going to give away the dog
You want some anti-allergy medication.
NURSES
A parent comes into the Outpatients Department anxious to see someone who can help her.
Parent is accompanied by 5 year old child.
Child is coughing and wheezing.
TASKS
• Find out about the child’s home life – living conditions – eating habits
• Any carpets or rugs in the home?
• Suggest ways to cope with his/her allergy
• Perhaps the family should find another home for the pet
69

Patient History Questions:

Identifying Data: Age, Gender, Marital Status

Chief Complaint:
What brought you to the hospital?

HPI:
When did it start?
Where did it start (physically)?
What does it feel like (characterize pain)?
Can you rate pain on scale of 1-‐10?
How often, How long, How many?
What setting did this occur (surrounding environment/context)?
Does anything make it worse/better?
Did you notice anything associated with primary symptom?

Medications-‐
What meds?
What dose?
What route?
What frequency?
Supplements? Birth Control? Herbals/Botanicals?

Allergies-‐
Are you allergic to any medications/ever had a reaction to any medication?
Any food/environmental Allergies?

Tobacco/Alcohol/Drugs-‐
(Can be asked here or in personal/social hx)
Do you smoke? How long? How much? How often?
Can you tell me about your drinking habits?
Do you use illicit drugs?

Past History:
Childhood-‐
Did you have any major childhood illnesses (mumps/measles/chicken pox)?
Any chronic childhood illnesses?
Adult-‐
Medical: Have you been diagnosed with any illnesses as an adult (diabetes, hypertension,
hepatitis etc.)?
Surgical: Can you tell me about any major surgeries you’ve had? When? For what? What
type of operation?
Ob/Gyn: Any pregnancies?
Can you tell me about your menstruation history? Onset, describe cycle? How’s
your sexual function?
Psychiatric: Any history of psychiatric illness? (Diagnosis, hospitalization, treatment)
Have you gotten your immunizations (tetanus, polio etc)
Tb, Pap smear, mammogram, cholesterol?

Family Hx:
Can you tell a bit about your father’s health (age, or cause of death)? Diagnosed with anything?
70

How bout your mother?

Brothers?
Sisters?
Grandparents?
Grandchildren?
Any history of hypertension, stroke, diabetes, thyroid/renal disease? Arthritis, TB, Lung disease,
mental illness (suicide), substance abuse?

Personal/Social History:
What do you do for a living?
How far along in school did you get?
What is it like at home?
Any significant others? How is the relationship?
Any significant sources of stress (immediate/ on-‐going)?
Religious/spiritual beliefs?
Activities of Daily living (especially elderly)?
Do you exercise much?
What is your usual daily food intake? Caffiene?
Any alternative health care?

Review of Systems (Tons of questions! Start Broad-‐>Narrow it Down):
General-‐ What is your usual weight? Have you had significant loss/gain?
Any recent weakness, fatigue, fever?

Skin-‐ Have you noticed any changes in your skin (rash, sores, lumps)?

HEENT-‐ Head: How’s the old noggin? Any headaches, dizziness, light-‐
headedness?
Eyes: How is your vision? Any changes? Any pain, redness,
double/blurred vision? What about glaucoma… any cataracts?
Ears: How is your hearing? Any changes? Any ringing, earaches,
infection? Do you use hearing aids?
Nose: Do you have any nasal/sinus trouble? Frequent colds, stuffiness, nosebleeds,
hayfever?
Throat: How is your teeth and gums? When was the last time you went to see the dentist?
Any soreness/ sores? Sore-‐throats?

Neck-‐ How is your neck, any recent pain or stiffness?
Breasts-‐ Have you noticed any recent abnormal changes in your breasts? Pain,
lumps, discharge?
Respiratory-‐ How is your breathing/lungs? Have you had any recent trouble? Any cough, sputum
(color, quantity), shortness of breath, wheezing? Any asthma, pneumonia, emphysema,
TB?

C.V.-‐ How’s your ticker? Any heart trouble? High blood pressure? Any recent
chest pain, palpitations? Have you had a recent EKG or other heart test?

G.I.-‐ Let’s talk about you stomach and bowels. Any recent trouble with your
stomach? Chronic heartburn? Any changes in appetite? Nausea… trouble swallowing?
How are your bowel movements? Are they regular? Any changes in frequency? Diarrhea
or constipation? Gas? Any blood in stool? Trouble with hemorrhoids?
Do you have any abdominal pain? Noticed any food intolerance?
71

Any liver/gallbladder trouble (jaundice/gall stones/hepatitis)?

Urinary-‐ How is your bladder? Any recent changes, recent problems? Do you have
any problems holding it? Do you go frequently (characterize)? Any
pain/burning with urination? Any recent infection? Have you noticed any blood? Reduced
force of stream? Any hesitancy, dribbling?

Genitals-‐ M: Ohh the things we get to ask as physicians. How is your bait and
tackle/ nuts and bolts?
(Seriously) Have you had any changes or problems recently with your penis or
testes? Any sores or recent discharge? Hernias? Any history of Sexually
Transmitted Infections? Condom use? Sexual habits? Any functional problems?
Any recent changes with your testes (swelling, tenderness)?

F: Have you had any recent problems in your vagina/uterus? Any
recent problems/concerns with your periods? Age of first
menarche? Can you describe your menstrual cycle (frequency,
duration, amount)? Any changes? Any bleeding between periods or after
intercourse?
If appropriate: when did you begin menopause? Any menopausal symptoms (hot
flashes etc).
Have you noticed any vaginal discharge or abnormalities of your vagina (sores,
itching, STI’s)?
Any pregnancies (#, and type of delivery). Did you have complications? Birth
control? Any abortions (spontaneous/induced)?
What is your sexual preference? Interest/function?

Peripheral Vascular:
How is your circulation? Any problems with your veins (varicose/clots)?

Muscoloskeletal:
How are you muscle/joints feeling? Any pain or stiffness? Any back pain? Any swelling, redness,
tenderness, loss of motion? Can you elaborate? Any trauma?

Neurologic:
Have you had any recent fainting spells or seizures? Any paralysis or loss of sensation or tingling?

Hematologic:
Any recent changes in terms of bruising or bleeding? Any history of anemia? Any past transfusion?

Endocrine:
Have you had any thyroid trouble? Any changes in temperature intolerance? Recent excessive
sweating or thirst?

Pyschiatric: May have already discussed
How is your mood? How would you describe yourself (how would people close to you describe
you)? Any increase in anxiety? Suicide attempts?

72

How to take a history

Start by putting the patient at ease:
• Greet the patient by name: "Good morning, Mrs Jones"
• Introduce yourself and explain that you are a nurse (hospital/community).
• Shake the patient's hand, or if they are unwell rest your hand on theirs.
• Ensure that the patient is comfortable.
Standard history taking

General questions to ask the patient:
• Tell me what seems to be the problem.
• How long have you been unwell?
• When did the symtoms start?
History of presenting complaint

If the history of the presenting complaint includes pain, ask about it using the mnemonic SOCRATES
• Site - where exactly is this pain?
• Onset - when did the pain start, did it start suddenly or gradually?
• Character - describe the pain - sharp? knife-like? gripping? vice-like? burning? crushing?
• Radiation - does the pain spread anywhere? To the arm, jaw, groin etc?
• Associations - is the pain accompanied by any other features?
• Timing - does the pain vary in intensity during the day?
• Exacerbating and relieving factors - does anything make the pain better or worse?
• Severity - does the pain interfere with daily activities or with sleep?
Questions to ask about previous medical history

General question:
• Have you suffered from any previous illness?
Medical
• Ask about childhood illness and immunization
• Have you had TB or whooping cough?
• Have you ever been found to have high blood pressure?
• Have you had rheumatic fever?
• Have you ever suffered from epileptic seizures?
• Do you get asthma (episodic breathlessness, usually with wheeze)?
• Have you suffered from anxiety or depression?
• Do you have diabetes?
Surgical
• Have you had any operations in the past?
Obstetric (where appropriate)
• Have you had any pregnancies?
• Were they normal?
73

• Were there any complications such as hypertension and toxaemia, diabetes, Caesarian section?
You may find the mnemonic THREAD helpful:
• Tuberculosis
• Hypertension (myocardial infarction and strokes)
• Rheumatic fever
• Epilepsy
• Astham, anxiety and arthritis
• Diabetes and depression
Systems Enquiry
Questions to ask patients about their general health:
Cardiovascular and respiratory function

• Do you have a cough?
• Do you cough anything up?
• Have you ever smoked? If so what, how many, and for how long?
• Do you get short of breath?
• Do you wheeze?
• Do you get any chest pain?
• Do your ankles swell?
Gastrointestinal function
• Has there been any change in your appetite?
• Has there been any change in your weight?
• Have you suffered from nausea or vomiting?
• Has there been any change in the character or frequency of your bowel movements?
• Has there been any change in the colour or consistency of your stools?
• Have you had any bleeding? - while vomiting (haematemesis) or rectally?
Genitourinary function
• How often do you pass urine?
• Do you have pain or burning on passing urine?
• Do you have pain in the small of your back (renal angles)?
• Is there any blood in your urine (haematuria)?
• Do you have any sexual problems?
Specific questions for men
• Do you have any penile discharge or venereal infection?
• Do you have any difficulty starting to pass urine (hesitancy or urgency), maintaining the flow
of urine (poor stream), or stopping the flow of urine (terminal dribbling)?
Specific questions for women
• Do you have any vaginal discharge?
• When did your periods start?
• Are your periods irregular?
• How often do your periods occur and for how long do they last?
• Do you have heavy bleeding (menorrhagia) or do you pass clots during your period?
• When did your periods stop (menopause)?
• Have you had any bleeding since your periods stopped?
• How many children have you had and when did you have them?
• Did you have any complications during any pregnancy?
Musculoskeletal function
• Have you any weakness in your arms or legs?
• Do you have any stiffness in your joints or spine?
• Do you have pain in your joints or spine?
Neurological function
74

• Do you have any headaches?

• Have you had any blackouts?
• Have you had any fits?
• Have you had any dizziness (feeling of instability or rotation)?
• Do you get ringing in your ears (tinnitus)?
• Do you get abnormal sensations or tingling in your hands or feet (paraesthesia)?
• Have you noticed changes in your sense of hearing, smell, taste, vision?
• Have you any incontinence of urine or stools?
• Do you get depressed?
• Do you get anxious?
Drug history and allergies

• What drugs, homoeopathic and herbal medicines and/or health foods do you take? - and in
what dose?
• What other therapies do you have? - Physiotherapy? Occupational therapy? Malaria
prophylaxis?
• Do you have any allergies?
• Have any medicines ever upset you?
Family history
• Are your father, mother, brothers, sisters alive? - If they have died, at what age did he/she/they
die? What did he/she/they die of?
• Do they have any current illnesses?
• Do any illnesses run in your family?
Social history
• Who is at home with you?
• Are you single, married, widowed or divorced?
• Is your partner healthy?
• How many children have you got?
• Are your children healthy?
• What is your occupation?
• Do you have any financial worries?
• Do you smoke? - If so, how may per day/week?
• Have you ever smoked? - Why did you give up?
• Do you drink alcohol? - If so, how many units per day/week?
• Have you been abroad? - If so, where?
• Do you have pets?
• If mobility is a problem: What is your home like? Do you have to manage stairs? What
facilities have you got?
75

Critical Care Nursing

Hints and Kinks for Nurses
PQRST Method for Pain Assessment
P = Provokes
a. What causes pain?
b. What makes it better?
c. Worse?
Q = Quality
d. What does it feel like?

e. Is it sharp?
f. Dull?
g. Stabbing?
h. Burning?
i. Crushing? ( Try to let patient describe the pain, sometimes they say what they think you
would like to hear. )
R = Radiates
j. Where does the pain radiate?

k. Is it in one place?
l. Does it go anywhere else?
m. Did it start elsewhere and now localised to one spot?
S = Severity
n. How severe is the pain on a scale of 1 - 10?

( This is a difficult one as the rating will differ from patient to patient. ) T = Time
o. Time pain started?

p. How long did it last?
Other questions to ask and look for....
q. Any medication or allergies?

r. Does it hurt on deep inspiration?
s. Activity @ onset?
t. Any history of pain?
u. Is it the same?
v. Different?
w. Any family history of heart disease lung problems, stroke or hypertension?
x. Check LOC.
y. Pupils?
z. JVD?
aa. Midline trachea?
bb. Any recent trauma?
76

Speaking Notes - Oet

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Speaking Sub-Test Overview

A typical roleplay structure is as follows:

Stage 1: Introductions and Opening Questions

OET SPEAKING COLLECTION BY RAMJI 1

Starting the Interview

At a clinic or health centre

At a nursing home or hospital ward

Taking the patient history contentment

Asking questions about the patient’s medical problem

Asking questions about the patient’s social history

OET SPEAKING COLLECTION BY RAMJI 2

Informing the patient

Describing the condition

Let me explain the three kinds of burns:

Reassuring the patient

Persuading the patient

Stage 3: Concluding the Roleplay

At a clinic or health centre

OET SPEAKING COLLECTION BY RAMJI 3

At a nursing home or hospital ward

What Where/When/Why How long How often How many/How

OET SPEAKING COLLECTION BY RAMJI 4

Introducing the Question Topic

Nurse: What brings you here today?

Nurse: I‘m sorry to hear that, please tell me more.

Nurse: Oh, it’s really not enough, is it?

Direct Question Embedded Question

OET SPEAKING COLLECTION BY RAMJI 6

Topic sentence Signposting Checking Understanding

Treatment and Advice

OET SPEAKING COLLECTION BY RAMJI 7

Here are some role-play scenarios which demonstrate successful communication

Nurse: Good morning Jane! How are you today?

Condition: Poor Nutrition

OET SPEAKING COLLECTION BY RAMJI 8

Nurse: Good morning David, how are you today?

OET SPEAKING COLLECTION BY RAMJI 9

Giving Practical and Personal Advice

Referring to other Health Professionals

OET SPEAKING COLLECTION BY RAMJI 11

OET SPEAKING COLLECTION BY RAMJI 12

How to Improve your Speaking Skills

OET SPEAKING COLLECTION BY RAMJI 13

How long does it take to reach this level?

Overall Communicative Competence

OET SPEAKING COLLECTION BY RAMJI 14

Be patient rather than card focussed

Talk to the patient rather than at the patient

Whose job is it to keep the conversation moving?

OET SPEAKING COLLECTION BY RAMJI 15

Listen and Repeat

Record your own Speech

OET SPEAKING COLLECTION BY RAMJI 16

How to Increase Fluency

Another sources of good spoken language is the website:

How to Decrease Fluency

Don’t be too Formal