OET SEEKERS

Speaking
Think about whether the
language you currently
use is the best
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…
OI don’t like this new medication. It makes me feel dizzy → I’m sorry to
hear that you’re experiencing some side effects.

Appreciate is a good
alternative to understand
I appreciate this is difficult for you

Empathy. Can you get it

right?
it means to put yourself in someone else’s shoes.
Direct empathy
Sometimes, you can literally put yourself in someone else’s shoes
because you have experienced the same thing.
In these 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
you have not experienced it for yourself.

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.
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.
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Do you know what it
means to ‘soften’ your
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.
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.
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..
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.”

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Is this one of your queries
about the Speaking test?
I’m worried about the patient’s name in the role-play.
Do I need to ask the interlocutor for a name?
The answer is: No, you don’t.
Instead, what you can do is one of 3 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.
Of course, you can ask the patient their name during the role-play but
remember you have a time limit. OET recommends not spending time on
this minor detail but rather to give as much time as you can to completing
the tasks.
Give the assessor proof of your ability
The communication criterion for Speaking, relationship building, requires
you to demonstrate that you can initiate the conversation appropriately
you can start each role-play in a different way e.g.
 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?
 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?
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Communicate with patient
in their words
Mobilise vs. Walk

This is another example of a verb which is common to healthcare

professionals but not to patients.

taken out
Take out is a common phrasal verb used with parts of
the body including tonsils, teeth and the appendix.

It’s great to use when speaking to patients as it’s a phrase they will be
familiar with.
In a formal letter, it would be more appropriate to use ‘remove’:
Removing Sam’s tonsils was recommended as the
best course of action.
How would you modify: “we need to intubate” into
patient language?

we need to put a tube in his air pipe

If you work in surgery or an emergency ward, this verb will be one you are
familiar with.
It is not something the patient or, perhaps more importantly, their family
are likely to be familiar with. If you were to say to the family the sentence
in the image above, they would probably understand the urgency of the
situation because of the word crashing. They would not understand what
you mean by ‘intubate’.
It’s important to modify your language when talking to patients and their
families so that you are providing clear communication.

spend a penny(do number 2) = to

urinate
under the weather= they feel ill
tickled pink(tickled to death))=very pleased:
lah-di-dah= old-fashioned informal

higgledy-piggledy=mixed up and in
no particular order:

My clothes are all higgledy-piggledy in my drawers spick-and-

span=very clean and neat
back passage=polite expression for rectum specialized
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How familiar are you with
the different meanings of
tested?
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Would you know what this
patient’s cause of
embarrassment was?

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?
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Why you don’t have to be

afraid of using this phrase
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

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it.

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‘On the mend’, a great
natural expression to
boost your vocabulary
‘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.

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Did you get the flu shot/
jab this year?
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.
____________________________________
Have you ever bewildered a patient?
patient: I am sorry. I’m feeling
bewildered. I wasn’t expecting this.

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.
Check out the previous post on stunned.
How does a stunned person feel?
I am having twins?
wow! I am stunned.
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.

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Speak in a way your

patients will be happy
with

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.
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An expression for breaking
bad news
“Okay,” I said. “We have a lot to talk about. If you don’t mind, can you tell

me what you understand is happening. It’s always helpful for me to hear,

to make sure I don’t leave anything unanswered.”

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When swapping words is

the best idea
Seizure is a difficult word for many non-native speakers to pronounce. It
can come out sounding like scissors \ ˈsi-zərz \.
If you find a word difficult to pronounce in English, your natural response
is to avoid using it or to become anxious when you are about to say it.
This can cause you to say the problematic word very fast or slow as
compensation.
A better idea is to find an alternative word you can pronounce
easily and confidently.
‘Convulsion’ is one alternative as well as ‘spasm’ and possibly ‘fit’,
although the other options are more medically accurate.
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Did you know ‘funny’ can
have a serious meaning?
(I felt a bit funny this
morning)
mean strange or ‘not quite right’.
If your patient is saying this to you, it’s because they are concerned about
their symptoms and are looking for some empathy from you.
A good response would be:
That’s not good. Can you describe how you’re
feeling to me?

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Have you ever cared for a

squeamish patient?
(I can’t look. I am squeamish)
easily upset or shocked by things that you find unpleasant or that
you do not approve of:
She's really squeamish and can't stand the sight of blood.
Do you have any idea how a squeamish patient is feeling?
What about if you know the context is a nurse cleaning a deep leg wound
after the patient tripped and fell at work. Removing the bandage there is
a lot of blood.
Squeamish patients are easily shocked.

Often it’s the sight of blood or the thought of having an injection that can

make them feel this way. They are likely to make a face and turn away

when they think or know either of these situations are likely.

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Do you know there

________________

are different meanings of

‘sick’?
1-In the UK, ‘sick’ describes the action of vomiting.
(I have been sick every morning this week)

2-Americans and Australians would say, in the same situation,:

‘I’ve vomited every morning this week.’
This is another example of how English is used differently in English
speaking countries.
Americans use ‘sick’ to explain the way they are
feeling.
For this meaning, British English speakers would say ‘ill’ or ‘unwell’.
Australians, on the other hand might say ‘crook’.
Isn’t it confusing!
Here are 3 examples to help:
_American. Jacquie has phoned in sick. She has a
bad cold.
_British. Jacquie is unwell today. She has a bad
cold.
_Australian. Jacquie is crook. She has a bad cold.
Can you think of other ways of saying someone is sick, unwell or crook?
There are lots of alternatives.

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Do you worry about the

topic of the Speaking
test? Don’t!
Remember OET is a test of your English not your
healthcare knowledge.
1. In the test, you can invent details about the roleplay situation or
treatment without penalty. For example, if you are discussing
treatment for conjunctivitis with the parent of a child with the
condition and one of the tasks is:
 explain how the parent can avoid the infection
spreading.
You could mention: preventing the child touching the eye area, washing
hands before and after bathing the eye/ applying ointment. However, you
could also tell the parent that the child should wear swimming goggles to
prevent the infection spreading to the other eye. Ludicrous? Yes, it might
be from a healthcare point of view, but if it’s said in perfect English it will
be good for your score.
The key is to remember that you are trying to demonstrate your
communication skills in English. Good preparation is always recommended
but once you are in the test, focus on communication rather than
healthcare accuracy.

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Is it sometimes easy to forget that your patient is going through
something for the first time that you have been part of many times?
What’s the best way to reassure patients who feel like this?
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How much do you know
about the interlocutor?
Here are some other key facts about the role of the interlocutor:
 You can ask them questions during the preparation time. For example,
if there is anything you do not understand on your role card, you can
ask for a definition.
 They will tell you when to start and stop the role play.
 If the interlocutor does not understand something you have told them
about their treatment, they will ask you for clarification.
 They may not be a native speaker but will have excellent English and
a clear voice that you will find easy to understand.
 The interlocutor will tell you their name when they welcome you into
the test room. You can use this name when starting the role
play, you can ask them to repeat their name during the
preparation time or, you can ask them their name once the
role play has started.
 They will record the role plays. The recordings are then sent to
Melbourne for marking by highly trained assessors. The interlocutor
cannot give you any indication of your grade at the end of the
Speaking test as they are not trained to do this.

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petrified

Petrified is an extreme adjective patients may

use to say they are extremely scared of
something.
Is my son going to be OK? I was so petrified when
the police said he’d been involved in an accident.
We can use petrified in the following combinations:
petrified + of – to express we are extremely scared of something in
particular e.g. needles, spiders etc.
petrified + when – to express the time when we felt extremely scared.
petrified + about – to express a situation we are extremely scared about

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Record yourself speak
and then listen to the
results
What to listen out for
Once you have the recording, here are some things you can do with it:
• Listen to the speed at which you spoke. Was it appropriate for the
situation? Was it similar to the speed of the person you were talking to?
• How many times did you say um, er or other hesitation phrases? [It’s OK
to use these sometimes, everyone does, but it’s best not to use them too
often] • Did you frequently self-correct yourself? This can be quite
confusing to listen to. It’s better to say it as you started and then correct
at the end of the sentence or if your listener asks for clarification.
• Does your intonation match the emotion of your vocabulary? For
example, if you are describing something good does your intonation
sound positive? Or, if you are trying to show empathy, does your
intonation sound concerned?
• Did you respond appropriately to the other person in the conversation?
If they asked you a question, did you answer it? If they told you some new
information, did you use an appropriate phrase in response? What
responses did the other person give you?
• Were you giving the other person chance to share their opinions and
ideas or, alternatively, were you simply responding to what the other
person said rather than making any of your own suggestions?
• Listen to the vocabulary you used. Was it appropriate for the situation
and person you were talking to? Was it varied or could you have included
some more interesting words?
The possibilities are endless but should be directed by what you already
know to be your speaking weaknesses.
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I have lots of
freckles.

Freckles are the little brown spots that appear

on the skin.

Some people are naturally freckly while others develop freckles after sun
exposure. They are rarely a sign of skin cancer.
Of course, being exposed to the sun without protection, which is what is
likely to cause freckles to develop, is not particularly safe.

Active listening makes

your patient feel
important.

Patient-centred approaches to healthcare are highly important in English-

speaking countries. A huge part of this is what experts call Active
Listening.
It can be hard to tell the difference between active and passive listening
techniques if you have not been trained on them.
Let’s take a look at both non-patient and patient-centred communication
as well as how to actively listen to your patients.
Non-patient-centred communication
Non-patient centred approaches to listening will lead you to ask closed
questions, such as:
 ‘have you had these symptoms before?’
 ‘did you take any medication to stop the pain?’
Patients are expected to respond with short answers which confirm the
diagnosis the healthcare professional has already decided.
Patient-centred communication
In countries where healthcare is patient-centred, healthcare
professionals ask open questions which allow the patient to explain the
situation in their own words and sometimes at length. Open questions
include things like:
 ‘Can you tell me more about your symptoms?’
 ‘Is there anything you think might have caused your current
condition?’
The healthcare professional might already have an opinion about the
cause but is prepared to have this confirmed or denied by listening to the
patient’s explanation.
How to actively listen to your patient
If this is unfamiliar to you, you may be unsure how to actively listen to
your patient. Here are four suggestions:
1. Give them your full attention. Look them in the eye. Turn your body
towards them and away from your computer screen or notes.
2. While the patient is talking, show them you are listening by using
appropriate gestures or ‘noises’: mmhmm, OK, I see, nodding or shaking
your head etc.
3. Don’t interrupt the patient. Allow them to finish so you don’t cut them
off from including anything important.
4. When they have finished, demonstrate you have been listening by
asking a follow-up question or making an appropriate response:
 ‘Did you talk to your family about how you were feeling?’; or
 ‘I’m sorry to hear that’.

Your patient knows if you’re not listening

It will be really obvious to your patient if you weren’t listening while they
are talking because you will likely say something inappropriate when they
stop e.g.
 Patient: I haven’t slept properly since my bag was stolen as I walked
home from work 2 weeks ago.
 Healthcare professional: Can you think of any reason why you’re
not sleeping properly?
The result of this type of exchange between patient and professional will
make the patient feel confused and unimportant.
OET Assessors want to hear you
demonstrate active listening
Active listening is something the assessor will be listening out for in the
speaking test. Candidates often struggle to listen actively to the patient in
the role-play because they are re-reading their role-card or planning what
they want to say next. That they haven’t been listening is then really
noticeable to both their patient (interlocutor) and the assessor and this
will affect their score.
Make sure you don’t fall into this trap.
Listen actively and show the patient that what they say is important to
you.
If you would like to know more about active listening or would like
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Have you ever been

confused by a patient
asking you this?
(will I be under for the whole
operation?)
The patient is actually referring to the level of anaesthesia they will
receive during the procedure.
In the past, the majority of operations were completed under general
anaesthetic. This meant the patient would be ‘asleep’ or unconscious
throughout.
To answer the question, you would need to know which type of
anaesthesia will be used. If it is general anaesthetic, then you can answer
yes. If it is local anaesthetic you will need to answer no and explain that
this type of procedure only requires local anaesthetic.
It might lead into a discussion about why this is the case, so it will be good
to have some ideas ready.
a patient who presents with a splitting
headache
This adjective is used to describe pain in one specific location: the head.
It is an extreme pain closer on the scale to 10
than 0, when 10 is the most painful.
It does not have to mean a migraine but a severe headache which makes
the sufferer feels like their head is splitting open.
Do you have an equivalent adjective in your language?
What advice would you give a patient who presents with a splitting
headache?
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_ You also need to be able to translate down medical terms to explain

them in words a patient will understand.
Let’s look at a few examples:
A patient, Mrs X, says to you:
“I can’t always get to the toilet in time.”
In a letter or when reporting this to a colleague you might translate this
up to:
“Mrs X is having problems with incontinence.”
On the other hand, you need to tell the mother of Dan this information:
“Dan needs to have a tonsillectomy”.
When speaking to Dan’s mother, you would translate this down to:
“Dan needs to have his tonsils out”
or
“Dan needs to have an operation to remove his
tonsils.”

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Make the most of your

role card in the speaking
test

You keep the role cards for the whole time you
are using them.
During the preparation time before each role
play you can write on them.
Some things you might like to do in the preparation time include:
  Underline or circle important words such as the adjectives which tell
you how the patient is feeling
 Write notes of questions you want to ask or things you want to say
 Write the first thing you are going to say to start the role play
During the role plays you can look at the cards
whenever you like.
You can also read sections again and write more notes on it but
remember, stopping to read or write on the role card will affect your
fluency if you are speaking. It will also affect your ability to listen to the
patient (interlocutor) and then respond appropriately.
At the end of the 5 minutes, when the role play is complete, you return
the role card to the interlocutor.
You don’t get to see the patient’s card. When you’re practising, it’s good
to not look at the patient card either so you become familiar to
responding to unexpected details the patient might raise.
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Different types of
pain and how to
describe it
There are different types of pain.

 Acute pain starts suddenly and is short-term.

 Chronic pain is felt over a longer period of time.

 Neuropathic (nerve) pain can come and go.

 Visceral pain is felt when organs or tissues are damaged.

 Breakthrough pain occurs in between regular, scheduled painkillers.

 Total pain includes the emotional, social and spiritual factors that also affect a
person’s pain experience.
 aching

 tender

 sharp

 shooting

 hot

 burning

 nagging

 intense

 stabbing

 tingling

 dull

 throbbing.
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Are you familiar with this

meaning of ‘odd’?
Odd is an informal word to mean occasional or
now and again.
– My knee gives me the odd problem, but mostly
it’s fine
It is completely different to odd when the meaning is ‘strange’ or
‘unusual’ so it’s really important to understand from the context which
‘odd’ the patient means.
One way to tell it apart is that odd meaning occasional often comes in this
structure:
the odd (noun) e.g. pain, problem, difficulty.
Odd when the meaning is strange on the other hand often comes in this
structure:
a/an odd (noun) discharge, lump, feeling.
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Dizzy
Dizzy is an adjective that patients use when
they feel unsteady on their feet.
Sometimes it can lead to the patient fainting (losing consciousness). It
could be related to problems with the inner-ear, which can affect balance,
or caused by a migraine or even hunger. It’s also a symptom of drinking
too much alcohol. These are all things to consider when taking a patient
history.
 My mother has been having a few dizzy spells in the last month
In this example, dizzy is used with spells which is an informal expression
for an episode of something. The son or daughter is explaining that their
mother has had more than one episode of feeling dizzy in the last month.
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Are you making use of

‘sustain’ in your
communication?
Meaning of sustain in English
sustain
formal
to suffer or experience, especially damage or loss:
She sustained multiple injuries in the accident.
Sustain is a useful verb often used in more
formal communication to describe injuries and
how they happened.
 How did you sustain the cut on your hand?
 The driver of the car is in a stable condition after sustaining only
minor injuries in the accident.
Mr Johnes was treated for head injuries she
sustained in the accident.

Do you make the most of

 your Speaking test
preparation time?

During the preparation time before each role-play in the Speaking
test you can ask the interlocutor questions about the task. There is
no impact on your result from asking questions and having the
answer may even help you achieve a better score. Asking questions
will give you clearer understanding which will make you feel more
confident.
 Things you can ask include:
 How do you pronounce this word? [point at the unfamiliar word on
the role card]
 What does ‘concussion’ mean? [concussion is an example]
 What name shall I call you in the role-play?

___________________________________________________________

______________

Do you know how to

adapt speech to context?
It’s important to understand what makes two conversations may differ
due to the patient’s situation and how to adapt to the context you’re
speaking in.
Change how you speak to match the situation
The way you speak to a patient should change depending on a few things,
such as their:
 Emotions
 Medical situation
 Age
 Familiarity with you.
This means that you will change your vocabulary and language to speak
to a patient who is, for instance, upset or in an urgent situation compared
to one who isn’t.
You will also use different language to speak to a teenage patient
compared to an elderly patient.
Finally, language which is suitable for a patient you have treated for a
long time will be inappropriate for a new patient.
1. How’re things going, Jake? a teenage patient

2. Hello again Mr Singh. You’re looking a bit better today. a regular

patient

3. Hello Mrs Lopez. My name’s Dr Evans. I’ll be looking after you today. a

new patient

4. Hi Sophie, I can see you’re in a lot of pain. Can you tell me about it? an

emergency patient

5. What can I do for you today? a non-emergency patient

___________________________________________________________________________

______________

Make sure you clarify your

answers during the
Speaking test
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 ______.

-----------------------------------------------------------------------------------------------------------

Can I just check your

understanding, please.
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.

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.

___________________________________________________________________________

_____________

Successful communication
comes from starting the
right way.
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.

REGARDS : OET SEEKERS

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