Use the correct tense to write

about ‘today’s visit’

12 July 2019Grammar and Punctuation, Language Tips

One of the most common questions we are asked is which tense to use to report events from
‘today’s visit’ with the patient. Similar to when writing about relationship statuses, it is important
to use the right tense.
When discussing ‘today’s visit’, you are reporting on a completed past event. However, you may
not necessarily report all details from the visit using the past tense.
While this may sound confusing there are some tips you can follow to help. Here are some that
can help you decide which tense is the right one:
1. Past tense
For details such as test results or vital signs, which were accurate at the time of the visit, the past
tense is appropriate.
Example:
 On examination, the abdomen was tender on palpation.
2. Present tense
For details such as lifestyle choices, the present tense is appropriate
Example:
 Despite previous advice, Mr Hoskings is still smoking 20 cigarettes a day.
3. Present perfect
For details which describe unresolved situations such as improvement or deterioration in the
patient’s condition, the present perfect tense is appropriate.
Example:
 Since her last visit, Mrs Baxter’s pain levels have reduced from an 8 to a 4.
It is fine to use more than one tense within the paragraph describing the visit. But always make
sure you use the correct tense for the meaning you intend so as not to confuse the reader.
Adverbs can be used to modify sentences to give a general feeling about the
information within it. Take a look at this example:
 “Interestingly, adverbs are not something many candidates feel confident about.”
The use of ‘interestingly’ at the start of the sentence tells us how the writer or
speaker feels. Alternatively, if the writer or speaker found something to feel regret
over, they would have used regrettably or if they felt frustrated with adverbs they
would have used ‘frustratingly’.
Adverbs are super useful when speaking to patients as they give them an
understanding about what is coming next. They can prepare them for good news,
bad news etc.
Take the quiz!
Can you complete these sentences with the correct sentence adverbs? Choose from:
unfortunately, hopefully, happily, generally, honestly.
 
1. Happily, I can give you a quick diagnosis by completing a urine dipstick test.
2. Honestly, I think it’s unlikely that the consultant will be able to see you next week, but I
can check if she has a cancellation.
3. Unfortunately, I’ve noticed a mole on the back of your leg. I’d like to book you in for a
biopsy.
4. Generally, most patients don’t experience any negative side effects from this medication.
5. Heopefully, the itching will reduce in the next 24-48 hours which will give you some
relief but if not, please come back.
If you want to test your knowledge of the English language, make sure you check out
other language quizzes on the OET Preparation Blog. You will also find articles, blogs
and whitepapers
 

Hands up who’s tired? Everyone?

Due to the long working hours, many healthcare professionals often complain of
being tired. Patients also talk of tiredness as a symptom of not feeling well.
Tired has many adjectives, some which mean a little tired and others which mean
extremely tired. Can you rate these tired adjectives from 1-5? (1= a little tired and 5 =
extremely tired)
 weary
 drowsy
 exhausted
 sleepy
 drooping
Answers below, don’t peek!
5. pǝʇsnɐɥxǝ
4. ʎɹɐǝʍ
3. buıdooɹp
2. ʎdǝǝ‫ן‬s
1. ʎsʍoɹp
Some English words have multiple meanings which, while confusing, can also be
quite funny. It’s important to understand the difference between commonly
confused words.
Let’s look at an example below.
Stool, not stool
Take the word ‘stool’.
While healthcare professionals know this can also mean faeces, in a non-medical
situation, a stool is a kind of seat, often low to the ground without a back.
Can you see the problem here?
Getting the word wrong or using a word with a multiple-meaning in the incorrect
context can have funny or unfortunate consequences.
Take the multiple-meaning challenge
Can you complete these sentences with words common to the medical profession
but used here in non-medical contexts?
Use these words to choose from: calf, patient, rash, tender.
1. It’s hard to be patient when you are waiting for an important phone call.
2. My company is starting a tender process to find a new partner to increase our social media
presence.
3. A calf is the name for a young cow.
4. You need to think more before you act, that was a really rash decision which I think you
will regret.
Can you choose one of the words and use it to write a medical sentence in the
comments below?

Get more answers right in Listening Part C by simplifying

the answer options
For each recording in Listening Part C, you have 6 multiple-choice questions to
answer.
You will not be able to guess the correct answer before the recording time starts.
The recordings are chosen to be accessible to all healthcare professionals and to
ensure everyone has the same chance of success regardless of their experience or
expertise. This means that all the answer options could be right for this situation.
You should use the reading time to understand the key differences between the
three options, which will help you identify the correct one when the listening starts.
Simplifying Listening Part C answers
39. Because Ted seemed uninterested in treatment, Anna initially decided to focus
on:
 What he could achieve most easily.
 Allowing him to try and help himself.
 Making him come to terms with his injuries.
The highlighted section shows what is the most important part of the question. One
way to approach this is to put the section into your own words as you read (i.e. Anna
started with).
If you look at the three answer options, we can see that A and B are different to C.
Specifically, A and B focus on things Ted can do while C focuses on a psychological
aspect of Ted’s recovery process. Again, it may be helpful to simplify C to something
like ‘helping Ted accept his injuries’.
Looking at answers A and B, A’s keyword is ‘easily’ while B’s is help ‘himself’. If we
simplify these options, we can say that A is easy improvements while B is
encouraging independence.
Putting this all together we now have this simplified question and answer options:
Anna started with:
 Easy improvements
 Encouraging independence
 Helping Ted accept his injuries
Getting the gist of Listening Part C 
If we look at the script for this section of the recording:
Ted showed little interest in receiving treatment. Some colleagues at the hospital took the
view that if he stubbornly refused to help himself, there was little they could do, it was his
right, they said. But I didn’t agree. Since Ted couldn’t use his legs or right arm, I made
sure we concentrated on what he could do with his left hand. For example, I worked on
strategies to help him dress himself, and things like that. We even worked on fine motor
skills, like writing with his left hand. I wanted to make sure that even if he didn’t ever
regain use of his right arm, I could at least get him to function by whatever other means
were open to him.
We can see that there is no mention of encouraging independence or working with
Ted to accept his injuries. Instead, the gist of this section is on improving the range
of activities Ted can do by himself:
 “we concentrated on what he could do with his left hand; help him dress himself,
writing with his left hand; get him to function.”
 Lists are a great way to organise and communicate information clearly to the
reader. When writing about a patient’s medication, a list is the perfect writing
technique.
 Writing clear and effective lists
 When the information you are writing into a list is simple, you can use
commas to separate individual items.
 For example: “he takes metformin, lisinopril and atorvastatin”.
 This sentence is clear because the information conveyed is simple, with
commas separating the three different medications.
 However, as the information you need communicate becomes more complex,
simple comma base list can become unclear. You might need to provide the
reader with extra detail, such as the dosage and frequency of the medication.
 For example: “he takes metformin, 1000mg with his evening meal, lisinopril,
10 mg and atorvastatin, 20 mg both once a day”.
 This sentence loses clarity because of all the commas, 4 in total, which means
the individual medications no longer stand out as they do in the first
sentence.
 Swap commas for semi-colons
 The simple solution to this in the second sentence is to use a semi-colon at
the end of the description of each individual medication. The commas
separating the name of the medication from its dosage can remain as they
retain their useful function. The second sentence will then read:
 He takes metformin, 1000mg with his evening meal; lisinopril, 10 mg and
atorvastatin, 20mg both once a day.
Create a patient timeline with ‘following’ and ‘followed’
Creating an easy-to-follow patient timeline in your writing can help your reader keep
track of events.
The words ‘following’ and ‘followed’ might sound similar, but they can have a major
impact on how you present information. Let’s start with two examples:
 Mrs Sood mentioned a headache in the morning followed by nausea and aversion to
bright lights in the evening.
 Mrs Sood mentioned nausea and aversion to bright lights in the evening following a
morning headache.
While the events in these two sentences might be the same, the link between them
changes the timeline of events. Let’s look at why.
Writing to a patient timeline
If we call the headache A and nausea and aversion to bright lights B then we can see
that in the first sentence A is first (in the morning) and B is second (in the evening).
If we use the same letters for the second sentence, we can see that B is written first
and A second, but the order of events in time is still the same because of the
word following.  A happened first (in the morning) and B happened second (in the
evening).
When we use followed by  the event before the link happens first chronologically and
is written first. The event after the link happens second chronologically and is
written second. But, when we use following, the event before the link happens
second chronologically but is written first and the event after the link happens first
chronologically but is written second.
Take the quiz below
Use following or followed by to complete these sentences:
She was admitted to hospital _______ a fall.
He will undergo an MRI scan at 10:00 ________ a chest x-ray at 15:00.
When you speak to patients, they might be anxious, distressed or even in pain. At
such times, they are unlikely to be able to speak as clearly and fluently as they would
in other situations.
Patients may present you with information and details in a jumbled order or be
unable to answer the questions you have.
As healthcare professionals, it is always important to get the correct information
from your patients. Without this, you might struggle diagnosing or providing the
correct care to them.
Clarifying patient information
Reflecting real scenarios, the Speaking test’s clinical communication criteria requires
you to clarify information the patient tells you.
You might not have understood something, perhaps because of the way the patient
was speaking. Or, you might need to check your understanding of what they have
said is correct.
Try these clarifying expressions
There are several useful expressions that can help you clarify what the patient has
said. We have provided some examples below to get you started.
 Sorry, please can you explain what you mean by _____.
 You’re doing really well to explain what has happened but I don’t understand ______.
 Can you tell me more about _____.
If you want to check you have understood the patient correctly, you could say:
 To recap what you have told me, _______
 Thank you. I just want to check I have understood you correctly. To summarise ______.
Prepositions are an easy way to boost your Writing grade
Sometimes the smallest things can have the biggest impact.
It’s no different in English, where commas, full stops and words can have a huge
effect on the meaning and readability of your sentence.
Let’s look at the preposition ‘to’ and see how it can be correctly used.
Small preposition, big impact
‘To’ might be a small word but it can have a big impact on the accuracy of your
writing.
It is a preposition which has various uses. One of these is to show movement (e.g. from
home to work).
Some of the common mistakes students of English make with ‘to’ can be split into 2
groups:
Group 1: Including to when it is NOT needed
 We do not say or write to home or to me.
Incorrect example:
 Mrs X will be discharged to home today.
 Mr Y presented to me at the clinic this morning.
Correct example:
 Mrs X will be discharged home today.
 Mr Y presented at the clinic this morning.
Group 2: Adding the when it is not needed
We do not say to the hospital.
Incorrect example:
 Mr Z was admitted to the hospital in severe pain.
Correct example
 Mr Z was admitted to hospital in severe pain.
Understanding and correcting the small mistakes that you make will add up too
much more accurate writing. It’s worth spending the time to correct them as your
OET score will increase as a result.
We asked our OET Experts for some common mistakes made in the Writing sub-test.
Are you guilty of these top three?
1. Using ‘rule out’ to mean ‘confirm’
Rule out means to eliminate or exclude something which is impossible. However,
sometimes people make the mistake of switching the meaning around.
Example
 The case notes say: pneumonia – ruled out (X-ray).
 The letter written by the student reports: The patient has pneumonia.
In the example above, the X-ray reveals the patient does not have pneumonia i.e.
the exact opposite of what the student wrote.
2. Using ‘complaint’ instead of ‘compliant’
This mistake might be because of a typo as the spelling of the two words is very
similar.
Example
  The case notes say: medication – taking regularly as per instructions.
 The letter written by the student reports: the patient is complaint with their medication.
This sentence gives the suggestion that the patient is unhappy with their medication
because of the misspelling. With the correct spelling, the sentence would explain
that the patient is taking their medication correctly.
3. Using ‘advice’ instead of ‘advise’
This mistake could also be because of a typo but more commonly because the
student is not familiar that one is a noun and the other a verb
Example
 The case notes say: smoking – methods to quit discussed.
 The letter written by the student reports: The patient was adviced to quit smoking.
Here, it should be a verb ‘was advised’ to be grammatically accurate.
As a adjective compliant
 is willing to comply; yielding; bending; pliant; submissive; willing to do what someone
wants.

As a noun complaint is
 a grievance, problem, difficulty, or concern; the act of complaining.

Are you aware that changing the prepositions you use in a sentence can change its
whole meaning?
Prepositions are words that show the connection between a noun (or pronoun) and
some other element in the sentence.
Take this example of a result (for example blood test) and a normal range for this
patient:
 The result is above the normal range
 The result is under the normal range
 The result is within the normal range
We’ve put together a quick quiz to help you understand how the use of prepositions
with common medical verbs also changes the meaning of their sentence.
Take the quiz below
Match up the correct parts of the phrase, left and right.
examined by                    a dermatologist
examined under              anaesthetic
examined for                   abnormalities
examined in                     the pathology lab
examined on                    Tuesday

Once you finish your OET, your papers are sent back to Australia and then graded by
trained OET Assessors! Your answer booklets are assigned to the assessors at
random to avoid any conflict of interest, while Parts B and C of Reading and
Listening are computer scanned and scored automatically.
We believe that fairness and reliability are essential to the assessment of your OET
performance, which is why we take extra precautions. For instance, we:
 Do not provide your background or demographic information to assessors to avoid
conflicts of interest.
 Double mark your answers to make sure your final scores are accurate
 Grade your tests in a single location to prevent regional variation.
Our assessors also use a marking guide for the Writing and Speaking sub-tests that
help them score your answers accurately. What you might not know is that you can
also use them to help you study!
Have you read the Writing and Speaking assessment
criteria?
To grade your Writing and Speaking papers, OET assessors use a series of marking
criteria. Reading and understanding what the assessor is looking for will really help
you to practise this as you prepare AND produce this on test day.
There are six assessment criteria for Writing:
 Purpose: Whether the reason for the letter is apparent from the start and developed
throughout the course of the letter
 Content: Whether the required information is included in the letter and is accurate for
the reader
 Conciseness and Clarity: Whether the letter omits relevant information and is an
effective summary for the reader
 Genre and Style: Whether the register, tone and use of abbreviations are appropriate
for the reader
 Organisation and Layout: Whether the letter is organised and well laid out for the
reader
 Language: Whether the accuracy of the grammar, vocabulary, spelling and punctuation
communicates the necessary information to the reader
For the Speaking sub-test, there are two types of assessment criteria: Linguistic
criteria and Clinical Communicative criteria.
Linguistic Criteria includes:
 Intelligibility: The impact of your pronunciation, intonation and accent on how clearly
your listener can hear and understand you
 Fluency: The impact of the speed and smoothness of your speech on your listener’s
understanding
 Appropriateness: The impact of your language, tone and professionalism on your
listener’s understanding and comfort
 Resources of Grammar and Expression: The impact of your level of grammatical
accuracy and vocabulary choices on your listener’s understanding.
Clinical Communicative Criteria includes:
 Relationship-building: The impact of your choice of opening to the conversation and
demonstration of empathy and respect on your listener’s comfort
 Understanding and incorporating the patient’s perspective: The impact of
how fully you involve the patient in the conversation on your listener’s understanding and
comfort
 Providing structure: The impact of how you organise the information you provide
and introduce new topics for discussion on your listener’s understanding
 Information-gathering: The impact of the type of questions you ask and how you
listen to the responses on your listener’s understanding
 Information-giving: The impact of how you provide information and check this
information is being understood on your listener’s comfort and understanding
Assessors do not count how many mistakes you make. Instead, they assess your
Writing and Speaking against how closely they match these criteria. The Linguistic
criteria contribute more to your final grade than the Clinical Communicative criteria.
You can download and view both the Writing and Speaking criteria from our website:
 Writing criteria
 Speaking criteria.
For more helpful tips like these as well as videos, preparation tasks and practice
tests, make sure to check out the Preparation Portal. It’s a great place to study for
OET and build your understanding of the test.
Did you know that dashes are informal punctuation?
When writing a formal letter or another kind of document, you should always try to
avoid informal punctuation symbols. Dashes are one example; exclamation marks are
another.
You can avoid informal punctuation by replacing with a more formal punctuation
alternative. Dashes can be replaced by several other punctuations including
commas, colons and brackets.
How to replace dashes in your writing?
If we start with the example in the image, we can think about alternatives. A comma
or even a colon could replace the dash that separates ‘mother’ and ‘Sofia’.
 Max was accompanied by his mother, Sofia.
A colon is also a better option than dashes when writing a list of items. It’s also
possible to reorder the planned sentence.
Or you can do both, for example:
 Mr Erikson’s current medication – warfarin and Pulmicort – need review
at his next consultation.
 At his next consultation, Mr Erikson needs a review of his current
medication: warfarin and Pulmicort.
Remember, dashes are different from hyphens. A dash – is longer than a hyphen -.
Hyphens are used in compound nouns such as check-up or to show the link
between multi-word phrases e.g. self-induced hyperglycemic episode. Hyphens are
appropriate in formal writing.

“I’m worried about the patient’s name in the role-play. Do

I need to ask the interlocutor for a name?”
The above question is commonly asked during our Facebook Q+A Live events and
also through messages sent to Facebook and our Helpdesk team.
The answer: No, you don’t.
Instead, what you can do is one of three things:
1. Use the interlocutor’s name which they tell you when you meet them in the
Speaking test room.
2. During the preparation time before the role-play, ask the interlocutor which name
they would like you to use.
3. Choose a name for the patient and use it at the start of the role-play. The
interlocutor will accept this and respond to it.
If it’s clear from the role card that you have met the patient before, then using one of
the three options above will demonstrate to the assessor that you have understood
your relationship with the patient.
If you have a role-play which is your first conversation with this patient, then briefly
introducing yourself and checking the patient’s name is appropriate as part of
setting up rapport.
Give the assessor proof of your ability
Relationship building is a communication criterion for Speaking sub-test that requires you
to demonstrate you can initiate the conversation appropriately.
This means showing your ability to start the conversation in a way which is suitable
for the setting and your familiarity with the patient. It shows good variety to the
assessor if you can start each role play in a different way.
Take a look at the examples below:
1. You are speaking to a patient who underwent a colonoscopy last week and
has returned for the results
[This situation is likely to be non-urgent and suggests you have met the patient
before]

“Hi Dawn, thanks for coming back for your results today. How have you been this last
week?”
2. You are speaking to the parent of a 3-year-old admitted an hour ago with
breathing difficulties.
[This situation is likely to have caused anxiety for the mother and you are unlikely to
have met him/her before]

“Hello Steph, my name’s Greeta, I’m one of the nurses who’s been caring for your
daughter. I’ve come to give you an update but also to find out some more background
information from you. Is that OK?”

assist with showering

demonstrate an exercise

dress a wound

test reflexes
take a medical history

Understand cultural differences when talking to patients

Teaching OET for a number of years to students from many different countries has
taught me that different cultures show empathy in healthcare differently and give
information to patients in different ways.
In some countries, it is normal for bad news about a patient’s health to be delivered
to their family to pass onto the patient. In other countries, healthcare professionals
talk and tell, while patients simply listen and do what they are told.
Where OET is recognised, in Australia or the UK for example, communication is
patient-centred. This has not always been the case. In fact, it has probably been
changing to this state during the last 30-40 years. However, increasingly, patients are
having more say in their healthcare and treatment options. This can prove
challenging for professionals unused to this open communication between
themselves and a patient.
The meaning of empathy in healthcare
One key area where patient-centred communication is especially important is in
showing empathy to your patient. But what exactly is empathy in healthcare? A
dictionary will tell you that empathy means:
 “the ability to understand how someone else feels because you can imagine what it is like
to be them.”
In other words, it means to put yourself in someone else’s shoes; to think and act
from someone else’s perspective.
Direct empathy
Sometimes, you can literally put yourself in someone else’s shoes because you have
experienced the same thing. For example, a midwife who is also a mother can put
herself in an expectant mother’s shoes because she has experienced pregnancy.
Another example could be a physiotherapist treating a patient with tennis elbow
having experienced tennis elbow themselves.
In this case, you can use direct language to show empathy:
 I understand your concerns about choosing whether to opt for pain relief during labour. I
faced the same decision myself before I was due to give birth.
Or:
 In my experience, the best relief for the symptoms of tennis elbow is complete rest from
the action which caused the injury in the first place.
Indirect empathy
Sometimes though, you can’t so easily imagine what it must be like to be in that
person’s shoes because you have not experienced it for yourself. You might have
treated other patients with similar conditions and prognoses but it’s not the same as
having the experience personally. For example, a doctor who needs to tell a family
that they have not been able to save the life of a family member involved in a car
accident. Or a dentist treating a homeless person with a large number of rotten
teeth.
These situations, therefore, require different more indirect language to show
empathy:
 I can’t begin to imagine how you are feeling to receive this news. Please know we did
everything we possibly could to save your family member.
Or:
 I can only appreciate it must be a low priority for you to care for your teeth when you are
homeless. Before you leave, I will give you a toothbrush and toothpaste to keep you going
for a while.
It can be a small difference such as the replacement of ‘understand’ with
‘appreciate’. Understand suggests knowledge of something while appreciate is
simply awareness that something is possible.
Making patients feel important
It is human nature that we like to feel that our problem is unique to us. Being
spoken to like we are just one of a crowd has the impact of making us feel
insignificant and unimportant. Choosing the right empathetic phrase can avoid this
for your patient.

The need for clarity

Do you ever find that you have given instruction but it isn’t being followed as you
had expected?
For example, you ask a colleague or patient to do something and you find out later
they’ve done something different.
Here are a couple of extreme examples:
 A patient you prescribed an inhaler to while describing it as being ‘for your chest’, returns
to say it’s not helping their breathing. On questioning the patient, you discover they have
been spraying the inhaler onto their chest rather than into their mouth.
 A patient who has been prescribed an anal suppository returns to complain of pain and
discomfort. On questioning the patient, you discover they have been inserting the suppository
still in its foil wrapper.
These may sound extreme but they are real examples of what can happen when the
communicated message is not clarified.
Try out this communication challenge
Here’s an example you can try with your friends or colleagues. You will all need one
piece of paper – preferably the same size and shape to begin with. You will need to
read the following instructions to them but they should have their eyes closed.
a. Pick up the piece of paper and fold it in half. Rip off one of the corners.
b. Fold the piece of paper in half again. Rip off one of the corners.
c. Fold the piece of paper in half again. Rip off one of the corners.
d. Finally, fold the piece of paper in half one last time. Rip off one of the corners.
You can now ask everyone to open their eyes and unfold their pieces of paper. I
guarantee they will all look slightly different. This is despite everyone being given the
exact same materials to start with and the same, clear instructions to follow Why?
Because we all interpret things in a slightly different way.
While it is obvious to you how to use an inhaler or insert a suppository, for these
patients who have never used one before, it is not.
How to improve your clarity
This means two things become really important. Firstly, that you remember the
instructions you are providing your patients (and colleagues) are clear and
unambiguous. Avoid medical jargon, speaking quickly without pause or presenting
two much information in one go. Even though you may be giving the same advice to
the patient as you have provided to hundreds before, it’s best to imagine this is the
first time you have ever given this advice.
Secondly, check your patient’s understanding and not just at the end. There are a
number of ways you can do this. You can:
 ask them if they have understood? (this is of limited use because if they say yes, but
haven’t, you won’t know)
 ask them to repeat back to you what has been agreed or the instructions you provided.
 get them to demonstrate what they are going to do or practise the action together.
Using one or more of these methods of clarifying understanding should help avoid
the problems discussed in our extreme examples but also more routine situations.
Can you tell me three things you learnt from reading this?
Formal English vs. informal English
When it comes to healthcare professionals, you can generally speak to other
healthcare professionals or patients. A question we get asked a lot is: whether you
should use the same kinds of words for both audiences?
Speaking to colleagues
When speaking with colleagues or writing, it is best to use formal English, such as
technical and formal verbs. You can do this because you more likely have the same
knowledge as your audience.
Talking to patients
However, technical verbs may not be very familiar to your patients or seem overly
formal. Instead, you need to adapt your speech to the audience on hand.
Patients will not have the same background knowledge in healthcare. To make sure
they understand what you’re saying, you need to use the right language. One way to
do this is by using phrasal verbs, which is a type of informal English.
Phrasal verbs can sometimes be tricky for English speakers, however, they are a
super valuable tool to have at your disposal.
1. Can you match the formal verb to its matching phrasal verb?
2. Can you make a sentence using one of the phrasal verbs which are new to you?

extract                 take out

anaesthetise       put under
lower                    bring down
contract               pick up
vomit                    throw up
If you want to learn more about grammar and vocabulary, you can find a whole
range of articles on the OET Blog. We also have a range of guides for each sub-test
as well as the skills you will need to succeed.
A common problem for students of English is when to use ‘a’ or ‘an’ and when to use
‘the’.
In the example above, ‘the’ should replace ‘a’. This is because there are many kinds
of diet: low-fat, high-protein, pureed, etc. If the recommendation is for one particular
diet, we write ‘a low-fat diet’.
The use of articles can be confusing, even for native English speakers.
We write ‘the’ when there is only one of something e.g. the Emergency Department
or when the writer and the reader are clear which one is being discussed e.g. the
local council will provide a home-care nurse.

Request statements
‘Could you please arrange a follow-up visit’ is perfectly grammatically accurate. It is a
request for a colleague to do something for the patient. The difficulty is, because it is
phrased as a request with a question mark at the end, the implication is that your
colleague could say no.
Often when making requests of colleagues on behalf of patients we do not see them
as optional. We want or even need them to happen. Rather than phrasing them as
request questions, it is better to write them as request statements.
For the example above, this would change the question to:
Please arrange a follow-up appointment for him.
The request statement is still polite but now it is clear to the reader that you expect
them to complete the action.
Here are a couple more examples:
Would you be able to contact his next of kin?  →   Please contact
his next of kin.
Can you please provide a second opinion?       →    It would be
appreciated if you could provide a second opinion.
What do your patients call cigarettes?
I’m sure you’re all very familiar with the word but are you so familiar with the slang
forms? Patients may use these instead of the full form. For example: fags, smokes,
ciggies and even rollies which describe the self-rolled cigarettes.
When speaking to your patients, it’s best to use cigarettes initially but, if your patient
calls them something else, you can switch to mirror their language. This is a way to
build a relationship with them.
Some countries refer to ‘sticks’ e.g. he smokes 20 sticks a week but this is not a
common expression in British, American or Australian English.
Do you know any other slang expressions for cigarettes?

The importance of opinions

Part of the testing focus in Listening Part C is to check your understanding of
opinions. In your work day you will hear many different opinions from both
colleagues and patients. Often the presentation of one opinion will lead to a
response with a second opinion which may agree or disagree with the original
opinion. To interact confidently in the English-speaking healthcare environment, you
will therefore need to be able to identify when an opinion is being given and what
the opinion is.
There are clues in the questions which require you to focus on an opinion. These can
be quite obvious clues such as:
In Dr Gibbens’ opinion,…
Or, the clues can be slightly less obvious e.g.:
How does Dr Gibbens feel about…?
Other words used in questions which give clues that an opinion is the focus are:
believe, think, view, impressed
When listening for the answer to the question, listening out for the person’s name
can be useful although the answer may not be said right after the name.
Additionally, if it’s a presentation and the opinion you are listening for is provided by
the main speaker, then they won’t say their name at all. You will also need to listen
for synonyms of other important words in the question and answer options.
Example question
Dr Robson thinks the short-term priority in the fight against
Chagas is to
A increase efforts to eliminate the insects which carry the parasite.
B produce medication in a form that is suitable for children.
C design and manufacture a viable vaccine.
Here is the script for this question:
Plenty. Researchers are working on improved drugs to treat it, and
a vaccine, none currently exists, but it takes at least ten years to
supply a new drug. Another idea is to develop the existing drugs
in tablets of different sizes. That could and should be done almost
overnight. What’s currently available is designed for adults, even
though infants often have the disease. There are also some very
important programmes using insecticides and other methods to
wipe out the bugs that transfer Chagas to humans, but initiatives
like those take decades rather than years.
Short-term is a really important word in the question. In the text we can see ‘at least
ten years’ ‘almost overnight’ and ‘decades rather than years’. Only one of these
‘almost overnight’ is a good synonym for short-term.
The three different ideas (answer options) are:
working on improved drugs and a vaccine – takes at least 10 years [this is answer
option C];
develop existing drugs in different size tablets – almost overnight; [see below]
wipe out the bugs that transfer Chagas to humans – take decades [this is answer
option A].
Answer B is correct and we can hear this by listening before and after the words
relating to short-term, the part mentioned above but also – what’s currently
available is designed for adults, even though infants often have the disease.
Pins and needles is a common expression for patients
It describes a tingling sensation. Most commonly, people feel pins and needles in
their hands and feet, often after the release of pressure in these areas. It’s quite a
descriptive expression as it feels like multiple small sharp points are stabbing the
area.
Can you explain the medical cause of this sensation?
Starting the right way leads to successful communication
I’m not sure about you but talking to strangers is not something I’m very fond of. In
particular, starting the conversation, especially when the person was not expecting
to speak to me, is something I worry about. I often think through various options in
my mind of what I might say and how the person might respond before I even
approach the person.
Why am I telling you this? Well, because I know many of you worry about the same
thing when starting to speak to a patient. In your working day, you can speak to
many different patients in different settings and to discuss very different healthcare
situations.
You can’t start every conversation exactly the same way. If you do, you will sound
rehearsed and the patient will struggle to trust what you are saying.
Different ways to start a conversation
At a basic level, how you start a conversation with a patient you have met before (1)
should be different to a patient you are meeting for the first time (2).
1. Hello Mr Jamieson, it’s good to see you again. How have
you been feeling since I last saw you?
2. Hello Mrs Patel, my name’s Janet, one of the nurses here.
I’m going to talk to you today about insulin injections.
There are also other things to consider, for example if the patient is visiting you for a
routine situation (3) or due to an urgent healthcare issue (4).
3. Thanks for coming in today, George. I understand you’ve
been experiencing some pain in your left calf, is that right?
4. Hello Helen, I can see you’re in a lot of pain. I can give you
something for that but first I need to ask you a few questions.
Is that OK?
For each of these 4 groups, you can then further divide your conversation opener
based on whether the patient is expecting good news (a) or bad news (b)
a) Hi Mr Minghella, I have some good news for you about your
recent test results.
b) Thanks for coming back today for your test results Mrs Vu. As
you know we took a biopsy from the lump under your armpit. Are
you ready for me to tell you what we found?
Getting the start of the conversation right can really
impact on how well the rest of the conversation goes.
Consider this scenario:
You are talking to a patient (Mario) who is due to have a hernia operation today. The
scheduled time for his operation was 1pm. It’s now 4pm. Mario has been nil by
mouth since 6am. Nobody has spoken to him about the delay. You arrive to give him
an update.
How do you think the conversation will go if you start with:
Hi Mario, my name’s Emilia, one of the ward nurses. How are you
feeling?
It’s unlikely to go well. Mario is likely to respond angrily about the fact they have
been waiting for 3 hours, nobody has informed him what is going on and that he is
feeling anxious and hungry.
What about if you started with:
Hi Mario, I’m so sorry you’ve been kept waiting for your
operation. My name’s Emilia. I imagine you’re feeling unhappy
about the delay. I’ve come to update you about what’s going on.
Mario is still likely to be frustrated but is unlikely to be so angry as he feels he has
been shown understanding and empathy.
There are many ways to start a conversation. Thinking about how your patient is
feeling, the purpose of your visit and their expectations of you in the conversation
are a good place to start. This information will help you to choose the best language
to start which will give both you and the patient confidence for the conversation
ahead.
What is a hyphen (-)?
 A hyphen is a punctuation mark that primarily joins words or parts of words
 You can use hyphens when writing compound modifiers when it comes before the word
it’s changing
 Dictionaries are the best place to find out whether a word needs a hyphen or not!
Are you using hyphens?
The primary use of hyphens during formal writing is to show that the linked words
should be read together as one unit of meaning.
We call these compound modifiers and they help avoid confusion for the reader.
Here are some more examples:
 self-induced
 well-established
 10-minute intervals
 check-up
Choosing when to you a hyphen can be complex and involves quite a few rules. 
When to use a hyphen?
Compound modifiers are two words that work together to change the meaning of
the noun that follows. Let’s look at an example:
 Incorrect: In six days, we will move you to 10 minute sessions.
The sentence above is unclear: Does it mean 10 sessions, one minute long or
sessions 10 minutes long?
 Correct: In six days, we will move you to 10-minute sessions.
By adding the hyphen, the compound modifier becomes clear to your audience!
When should I not use a hyphen?
Compound nouns such as ice cream, lifestyle and even weekend have lost their
hyphens over the years to become two separate words or one combined word.
These are called closed and open compound words.
Here are some examples of closed compound words:
 Notebook
 Waistcoat
 Fireman
 Healthcare
Here are some examples of open compound words:
 Sweet tooth
 High school
 Dinner table
 Coffee mug
Numbers are often hyphenated as well, especially before a noun such as ‘a 59-year-
old male’.
How can I practise using hyphens?
It’s super easy to practise using hyphens. You can do this when you’re reading or
take some time to work on it specifically.
Hyphen usage is something to notice when you are reading. Make note of words
which are written with a hyphen and build up a list you can refer to for reference.
You can also use a dictionary to check the spelling of particular words.
How to avoid ‘I understand your concerns’
While grammatically this is correct, it is an overused phrase. When said multiple
times in one conversation, it loses any impact. When a patient tells you something
that is worrying them, try to say something in response that relates to what they
have just said e.g.
I’m worried that I won’t be able to manage by myself when I’m discharged → It’s very
natural that you would be worried about that…
OR
I don’t like this new medication. It makes me feel dizzy → I’m sorry to hear that you’re
experiencing some side effects.

Soften your language to show empathy

to your patient
Empathy is a key part of patient-centred care and can be shown through the
language you use. Because OET is tied to real healthcare practices, it assesses your
ability to show empathy through your communication.
One of the ways test-takers will often fail to show empathy is by using overly hard
language. In this article, we will look at why you need to soften your language when
talking to patients and how to you can do this.
What is soft language?
In English, we often try to soften language to avoid offence or discomfort. In
healthcare, it’s important to be able to make your patient feel safe when they’re with
you.
Soft language tends to involve two specific aspects: Non-judgemental language and
softening words.
Take a look at the example in the image above. While the sentence above might be
accurate, it is also overly harsh to the ears of your patient. Using softer language
would help you build a stronger relationship with your patient.
How can I soften my language?
Softening your language involves two actions:
1. Choose language which is not judgemental e.g. overweight, rather than too
fat or obese.
At the core of soft language is using non-judgmental words and phrases. It can be
hard to determine what is and what is not judgmental.
One way to approach this conundrum is by using neutral language that doesn’t
make assumptions or make accusatory statements.
However, the best way to approach this is to treat your patient as a human being. 
More you ask a patient what they think, the better off you will be.
2. Add words that soften the meaning e.g. a bit, quite, just, please,
should/could etc.
It is common for both non-native and native speakers to be as short and precise as
possible. Unfortunately, this can lead to blunt and unempathetic conversations.
One way to overcome this is to introduce words that cushion the meaning of the
sentence or conversation. This is particularly important when you talk with patients
about their lifestyle choices.
On a more general level, these types of words can help you avoid framing
statements and sentences in absolute terms when you don’t mean too.
Examples:
In place of the two sentences in the image, you can soften your language and sound
empathetic by saying:
“You are quite overweight. You need to try to lose some weight.”
We can also go beyond this by adding a whole softening phrase before the first
sentence e.g.
“I know this is not something you want to hear but, you are quite overweight…”
If you are able to listen to native speakers talking, listen to how they soften the
language of unpleasant or uncomfortable content.
Here’s another example:
Why haven’t you taken the medication as instructed?
The type of language used in this sentence makes it sounds a sentence. Instead, you
could ask a question or make a statement that elicits more information.
“Please, can you explain how you have been taking your medication?”
(patient’s response)
“It’s just that it’s important to take the medication as prescribed if it is going to
work effectively.”
The above is a really good example of suspending judgement until you obtain more
information.
There are no hard or fast rules when it comes to hard and soft language. However, it
is a good aspect of language to keep an eye on in all contexts, not just healthcare
ones.
Mobilise vs. Walk
This is another example of a verb which is common to healthcare professionals but
not to patients. You may be familiar with discussing a patient’s mobility and need to
mobilise but the patient themselves will find this verb strangely formal. Patients will
talk about walking rather than mobilising. For really successful and meaningful
communication, you should prioritise using language the patient is familiar with over
medical jargon.
The skill of answering multiple-choice questions
Listening and Reading Parts B and C are multiple-choice question tasks. This means
that you need to work on improving these skills to help you feel calm and confident
about them on test day.
Listening Parts B and C are three-option multiple choice questions meaning that for
each question there are 3 possible answers: A, B, C. Reading Part B is also three-
option but Reading Part C is four-option meaning that there are 4 possible answers
for each question: A, B, C, D.
Of course, the beauty of multiple-choice questions is that the answer is on the page.
Compared to other question types where you have to pick out the answer from what
you hear or read, with multiple-choice questions you don’t; it’s given to you.
The downside to this is that some test takers take quite a simple approach to
multiple-choice questions believing it will be easy to spot the correct answer from
the incorrect ones. With skill and strategies such as the ones below, it can be
possible to consistently select the correct answer BUT it takes practice. After all, a
pass grade at OET is providing proof to regulators and employers that you have
proficient English skills in Reading and Listening.
Strategy 1 – understand the question
The question contains a lot of essential information to help you choose the correct
answer option but you have to read it carefully. There are two types of question
used by OET:
1. A short answer question e.g. What is being described in this section of the guidelines?
2. A sentence completion question e.g. If vaccines have been stored incorrectly,
Some students find the second type of question more difficult to understand
because it is not phrased as a question. The idea is that you read the start of the
sentence with each of the options to decide which is the best way to complete it.
It may be helpful to turn the incomplete sentence into a question so you feel clearer
about its meaning e.g.
If vaccines have been stored incorrectly… → What is the result of
incorrect storage of vaccines?
Strategy 2 – understand the options
In Part B answer options, read the verb in the question and focus on both what this
verb means but also how it is different to the verbs in the other options e.g
 reported
 disposed
 sent back
Put the verbs into your own words as this makes sure you really understand them. It
is also likely that you will hear or read synonyms rather than the exact same words
which are written:
 tell someone else, perhaps a manager
 throw in the bin
 return to where it came from
Strategy 3 – keep concentrating
I don’t know about you but when I take an OET practice test, I’m always surprised by
how quickly I lose concentration. This is particularly true when I’m listening. I think
I’m focusing on the question and answer options but then, suddenly, I realise I’ve
been thinking about dinner and I’ve missed most of the recording for that answer.
It’s easily done even when you’re a native speaker. You will have to be vigilant on
your concentration. Do not let your mind wander. For this reason, we recommend
you don’t practise using headphones as most test venues don’t provide these on test
day. If you are only familiar with listening through headphones, you are likely to find
yourself distracted by the noises of what’s going on around you. This is how it’ll be in
real life when you’re listening to patients and colleagues so it’s best to stop using
headphones now to prepare for both the test and the workplace now.
Strategy 4 – move on
All of the multiple-choice questions are independent. This means they don’t require
you to get the previous question correct to be able to get the next question correct.
If you find you have missed an answer in Listening or you can’t easily answer a
question in Reading, move on. If it’s Listening, make a guess based on your
understanding of what you heard. For Reading, also make a guess so you have the
answer on the paper within the time limit but perhaps come back to it if you have
time at the end for a second check.

Are you tested by tested?

Tested is a common verb used in healthcare. In combination with different
prepositions, it can have different meanings. Can you match up the correct start and
end of these phrases using ‘tested’?
tested in             a laboratory
tested by            a technician
tested for           sign of infection
tested with        the latest technology
tested under     a microscope
tested on            the next possible occasion
Does the term ‘relative clause’ mean anything to you?
Some of you will have put your hands up. Some of you might be thinking, ‘I’ve heard
of that but I can’t remember what it is’ and the rest of you will be thinking, ‘No, I’ve
never heard of that’. It’s OK. It’s an example of metalanguage, or words we use to
talk about language. Relative clauses are types of clause used in written English to
allow more complex sentences to be created.
Why am I telling you this?
Well, if you want your written English to be well-regarded, it needs to include
complex sentences as well as simple sentences.
First things first, what’s an example of a relative clause?
Take a look at the two examples of a relative clause below:

Example
one Mrs Singh, who was admitted yesterday via ambulance, will be discharged home today.

Example The wound on Miss Delarue’s leg, that has been treated with sulfasalazine dressings, is
two healing well.

These two examples are called ‘non-defining relative clauses’ because they add
some interesting but non-essential information to the rest of the sentence. To show
the information is non-essential, commas are at either end of the clause.
To know if you have put the commas and the information into the sentence
correctly, you should be able to read the rest of the sentence with the commas and
information removed and it will still make sense. In our examples, it would leave
these as the remaining sentences:

Example one Mrs Singh will be discharged home today.

Example two The wound on Miss Delarue’s leg is healing well.

There’s another type of relative clause to learn about

There is also a defining relative clause. This type of clause adds essential extra
information to a sentence. For this reason, there are no commas to separate the
extra information from the rest of the sentence.
Some examples include:

Example The Occupational Therapist who visited Mr Mahmoud’s home will provide you with their
one report.

Example The medication which the patient’s GP had previously prescribed has been changed
two following surgery.

In both of these examples, the defining clause is underlined and is providing more
information about the noun in front of it. The information helps the reader
understand this noun more clearly.
In the first example, the defining clause clarifies which OT the writer means. In the
second example, the defining clause clarifies which of the patient’s medication is
being described.
Relative pronouns
In all these examples you will notice certain important words called relative
pronouns: who, which and that.
 Who can describe people (Mrs Singh, the OT)
 Which can describe things (the wound, the medication)
 That can describe both things and people.
So when should you use relative pronouns?
The most effective use of relative clauses are to combine 2 pieces of information
into 1 sentence.
The first example I showed you came from 2 sentences:

First sentence Mrs Singh was admitted via ambulance yesterday

Second sentence Mrs Singh will be discharged home today.

By using a relative clause, you can avoid the repetition of Mrs Singh and provide the
information more clearly to the reader. Look out for information in case notes which
would be repetitive if you wrote it in 2 sentences and combine into 1 with a relative
clause.
Finally, a good understanding of relative clauses will make you a better reader as
you will be able to pick out when the writer is adding non-essential information to
the sentence, separated by commas and when the details need to be read together.
Did you know that dashes are informal punctuation?
When writing a formal letter or another kind of document, you should always try to
avoid informal punctuation symbols. Dashes are one example; exclamation marks are
another.
You can avoid informal punctuation by replacing with a more formal punctuation
alternative. Dashes can be replaced by several other punctuations including
commas, colons and brackets.
How to replace dashes in your writing?
If we start with the example in the image, we can think about alternatives. A comma
or even a colon could replace the dash that separates ‘mother’ and ‘Sofia’.
 Max was accompanied by his mother, Sofia.
A colon is also a better option than dashes when writing a list of items. It’s also
possible to reorder the planned sentence.
Or you can do both, for example:
 Mr Erikson’s current medication – warfarin and Pulmicort – need review
at his next consultation.
 At his next consultation, Mr Erikson needs a review of his current
medication: warfarin and Pulmicort.
Remember, dashes are different from hyphens. A dash – is longer than a hyphen -.
Hyphens are used in compound nouns such as check-up or to show the link
between multi-word phrases e.g. self-induced hyperglycemic episode. Hyphens are
appropriate in formal writing.

Verbs are so important to accurate English

It is important that you use the right combination of verb forms when speaking and
writing in English. All verb tenses in English (apart from present simple and past
simple) require two verbs to be correct.
 The continuous tenses (present, past and perfect) need the verb ‘be’ + the -ing form of a
verb e.g.
She was walking  home from work when she fell.
 The perfect tenses (present and past) need the verb ‘have/ has/ had’ + the past participle of
a verb e.g.
Graham has lost 6kg since admission.
 The passive (present, past and perfect) needs the verb ‘be’ + the past participle of a verb
e.g.
He will be discharged today.
Using an incorrect combination or omitting one of the verbs will not only sound
strange to your listener or reader but it will also demonstrate you have poor
accuracy in spoken or written English.
When saying ‘down below’ can reduce embarrassment
Patients often find it difficult to talk about conditions they feel to be embarrassing or
personal. This is particularly true for conditions relating to the genitalia.
To cover their embarrassment, patients will often use euphemism (everyday words
used to avoid more direct or shocking words). Down below is an example as well as
‘lady parts’ and even ‘my bits’. Euphemism is really difficult to interpret for non-
native speakers so it’s worth learning a few of the most common ones.
To reduce patients’ embarrassment, it’s best to repeat their euphemism when you
discuss the condition rather than to replace it with the correct medical or anatomical
term. For example, if your patient said the sentence in the image above, a sensitive
response would be:
How long have you had these problems down below?
Have you come across any other euphemisms at work?
ADLs is not a familiar abbreviation outside the healthcare
workplace
It’s easy to forget that the words we use at work everyday are not always familiar to
those outside of our workplace. When speaking to patients it’s good to use words
they know and avoid the ‘jargon’ of the workplace.
ADLs is a good example of this. It’s very common to healthcare professionals but to
a patient who has never had any problems with mobility or looking after themselves,
it can be unknown. A better option to the sentence in the image is:
A nurse will visit you at home to help you with daily tasks like dressing and
showering.
Use quotation marks to report the patient’s words.
Sometimes, it can be useful to directly quote the patient’s words or expressions in a
formal letter. Rather than trying to paraphrase the words, it can be clearest to simply
use the patient’s own words to convey their meaning.
To show the word or phrase is a quote, they should be within quotation marks.
Mrs Holbrook stated that losing weight was “not of interest at the
moment”.
Are you familiar with this use of ‘afraid’?
In this example, it doesn’t mean that the health professional is scared (the most
common meaning of afraid). Instead, in combination with I’m or We’re, it means
‘sorry’.
Appropriate use is when a patient is requesting something you understand is
important to them but which you can’t agree to. It demonstrates your empathy and
regret that you can’t meet the request.
Here’s another example:
Patient: Will I be able to return to playing sports by next month?
Doctor: It’s unlikely, I’m afraid. Even with regular physio.
There’s too much risk for a repeat of the injury.
In the second example, the doctor continues from saying ‘I’m afraid’ to provide a
reason. This adds to the empathy provided by the phrase and helps the patient to
understand your use of it.
‘On the mend’ is a useful phrase which you can use as a
healthcare professional.
It is also something patients may say to you, so it’s good to be familiar with it for that
reason too e.g.
How long do you think it will be before I’m on the mend?
Mend as a verb means to fix something which is broken. Some healthcare
professionals might assume it is primarily used to describe the healing of broken
bones. The two examples above show it can also be used more widely to describe
the improvement of a patient’s ‘broken’ health.

It will take approximately ten days before you are on the mend.
Flu shot or flu jab?
Do you say shot, jab, injection or vaccination? Maybe you use another word? These
words are one of many examples of local variation in English.
Shot is common in Australian and American English while jab is common in British
English. Injection and vaccination are more formal versions which would be more
common when written down.
Formal punctuation
Did you know that some English punctuation symbols have a level of formality?
Some symbols are neutral. These have to be used whenever we write such as full
stops, question marks and capital letters but even these can get missed off or used
incorrectly in certain types of informal writing. Colons and semi-colons definitely
belong to the formal types of writing while exclamation marks belong to informal
types of writing!!!
Brackets or parentheses are fairly neutral but are most regularly seen in informal
writing as a means of adding extra ideas to the main point. They can often be
replaced by commas.
In the example in the image above, the brackets can be replaced with commas:
Miss Wang is prescribed Amoxicillin, 1g twice daily, and
Omeprazole, 20mg twice daily.
Alternatively, as the frequency of the dose is the same, the sentence could be
improved further to:
Miss Wang is prescribed Amoxicillin, 1g, and Omeprazole, 20mg,
both to be taken twice daily.
What to do if your patient is bewildered
Sometimes, when you give patients unexpected news they don’t quite know how to
process the information they have received.
They might describe themselves as feeling ‘bewildered’. It relates to a previous word
of the week, stunned, but is not so strong: it is closer to confusion than stunned or
shocked.
If a patient describes themselves in this way, you might need to suggest they take a
break for a few minutes to collect their thoughts and then talk them through the
information again, slowly and carefully. Checking their understanding while you do
this will also help them to feel less confused.
Variety of English.
Hi Sally, how’s everything been going recently?
Hello Mrs Stevens. How are you feeling?
After reading these sentences, could you tell which patient is elderly?
Sally, we need to talk about your levels and the possibility of
insulin injections.
Sally, I need to discuss something called insulin with you as a way
of stabilising your blood sugar levels.
What about with these sentences. Can you tell which patient has had diabetes for
some time?
I’m guessing you answered ‘yes’ to both questions. That’s because, when we use
English to its full variety, it’s possible to speak respectfully to patients of different
ages and with different understanding of their healthcare condition.
Each patient is different and as such needs speaking to in a different way. Selecting
the most appropriate vocabulary is a really important part of this.
It’s not just about words
As well as choosing the most appropriate words for the patient you are speaking to,
you also need to consider the other aspects of spoken communication: your speed
and tone in particular.
Would you speak at normal speed or a slower speed to someone who :
 you are giving new information to?
 is experiencing an emergency situation?
 is attending an annual review of their medication?
Probably you answered ‘slower speed’ to the first two options and ‘normal speed’ to
the last. The speed you speak at makes a huge difference to your patient’s
understanding. Some non-native speakers mistakenly believe fluency = speaking
fast. Speaking fast can actually have the opposite effect in the wrong situation,
leaving your patient bewildered and upset.
Tone too can make a big difference to your patient. If you are negotiating lifestyle
changes with a patient who is reluctant to make them, you tone needs to be firm so
the patient understands how important you believe the recommendations you are
making to be. If you are giving the patient some bad or unexpected news, your tone
needs to be much softer to demonstrate empathy.
How can you practise?
A really good way to put all of this into practice is to replay conversations you have
had in the mirror or in your head (or with a friend if you can) but to change the age
or situation of the person you were speaking to. For example, if you have a
conversation at work with an elderly patient who needs a change in medication to
combat the side effects they are experiencing; later that day, replay the conversation
but this time make the patient younger and the medication new rather than
changed. It should make quite a difference to the language you choose, your fluency
and tone. There are hundreds of combinations you can try so do it as often as you
can to really expand and improve your spoken communication.
Complex does not have to mean complicated
Some students make the mistake of thinking that they need to turn each individual
case note into a sentence. They then combine a number of sentences into
paragraphs and paragraphs into a letter. This is not a good strategy.
To score well in OET, you need to demonstrate to the assessor that you can make
decisions about the case notes. Of course, you first need to decide which notes are
relevant to include and which ones to omit. After this, you need to decide which case
notes should be combined. Too many short simple sentences create a letter that
does not read very smoothly and cohesively as in these examples:
The patient is a lawyer. He is a heavy smoker. His diet is poor. He
often works on weekends.  He likes to play sport.
What would be better is to combine some of these to make more complex
sentences:
He is a lawyer and often works on weekends.  Despite enjoying
playing sport, he smokes and has a poor diet.
Complex doesn’t have to mean long and complicated. Instead, complex sentences
can easily combine ideas to clearly present the information to the reader in an
efficient manner.
How does a stunned person feel?
Patients may use the word stunned to show disbelief at some news they have just
heard. It is similar to shock but to understand the difference, it is good to
understand the other use of ‘stun’.
To stun someone means to knock them unconscious perhaps by a
blow to the head. They become temporarily unconscious.
When stunned is used as an adjective, it is giving a similar impression. For a few
seconds or even minutes, the person is motionless while they attempt to process
the news they have received. Stunned can be used for positive news as in the
example above but also negative news such as when you hear news of the
unexpected death of an acquaintance.