This week's sessions
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- The criteria in practiceRead this week's lesson, then do the clinical communication set below. Say the best answer for each question aloud, in your own words.
- Three role-play cardsDo the role-play cards below with the timers, starting with the one closest to your profession. Record each one, then compare with the sample lines and the checklist.
- Signposting and teach-back phrasesRead the role-play guide and pick five phrases you don't use yet. Record one card from this week's set again, using all five.
- A medicine letter to a GPWrite the discharge letter to the GP: 5 minutes reading, then 30 minutes writing. Mark the case notes keep or cut first, and make the medication change easy to find. Compare with the model.
- Plain words for symptomsGo through the symptom words and choose ten you'd say to a patient instead of a medical term (for example, 'short of breath' rather than 'dyspnoea'). Say each one in a sentence.
This week's lesson: the four clinical communication criteria
The Speaking target is 360. OET Speaking is marked on language criteria (intelligibility, fluency, appropriateness of language, and resources of grammar and expression) and on clinical communication criteria. At C+, many candidates speak reasonably well but treat the role-play as a list of tasks to get through. A B performance sounds like a real conversation with a patient.
1. Relationship building
Start well and stay respectful throughout.
- Greet the patient, use their name, and say who you are: "Good morning, Mr Hale. I'm Priya, one of the nurses looking after you today."
- Open with a question about them: "How are you feeling this morning?"
- When the patient shows worry or frustration, name it before you move on: "I can see this is really worrying you."
2. Understanding the patient's perspective
The interlocutor will often give you a concern, a fear or a belief. This is not an obstacle; it's part of the task.
Patient: "My neighbour had the same exercises and ended up worse." C+: "Everyone is different, so that won't happen to you." B: "That sounds worrying. Can you tell me a bit more about what happened, and what you're most concerned about?"
Find out what the patient thinks, worries about and expects, and then use it in your explanation.
3. Providing structure
Signposting helps the patient follow you, and it helps you cover every task on the card.
- "First I'd like to ask a few questions, and then we can talk about what to do. Is that OK?"
- "Let's talk about the injections first, then about help at home."
- Summarise before you close: "So, to recap…"
4. Information gathering and giving
Gathering: start open, then narrow down. "Can you tell me about the cough?" before "Is it worse at night?" Ask one question at a time, and avoid leading questions such as "It's just a cold, isn't it?"
Giving: explain in short, plain chunks, and pause between them. Replace jargon: "high blood pressure", not "hypertension", unless you explain it. Then check understanding with teach-back:
"Just to make sure I've explained it clearly, could you tell me how you'll give the injection tomorrow?"
"Do you understand?" almost always gets a "yes", so it tells you very little.
When the patient disagrees
Don't give up on the task, and don't frighten the patient. Accept their view, ask permission to explain, and offer a shared decision: "I can see you feel well. Can I explain why high blood pressure often has no symptoms, and then we can decide together?"
Using your 3 minutes of preparation
Read the card and plan the order of the tasks. Write one open question to start, one empathy phrase you might need, and your teach-back question. Don't write a script: you'll need to respond to what the patient says.
This week
Do the criteria set, then the three role-play cards. Record each one. Listen back once for each criterion, and compare your lines with the sample lines.
Practice for this week
The criteria in practice
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Three role-play cards
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Weekly check: Two role-play cards, recorded
Record two cards you haven't done this week. Listen back once for each clinical communication criterion: relationship building, the patient's perspective, structure, and gathering and giving information.
When you finish, come back to your plan home: your dashboard updates with the new score.
Answers, explanations and transcripts
Finish the test first, then open each section to check your answers. Every answer has an explanation.
The criteria in practice
Answer key (6 answers)
| # | Question | Answer | Why |
|---|---|---|---|
| 1 | Nursing role-play. You're meeting a patient for the first time on the ward. Which opening is best? | B. Good morning, Mr Hale. I'm Priya, one of the nurses looking after you today. How are you feeling this morning? | B greets the patient by name, introduces the nurse and her role, and opens with a question about how he feels. C fires three closed questions at once; D dismisses concerns before hearing them. |
| 2 | Physiotherapy role-play. The patient says: 'My neighbour had the same exercises and ended up worse. I don't see the point.' Which response is best? | C. That sounds worrying. Can you tell me a bit more about what happened to your neighbour, and what you're most concerned about? | C acknowledges the worry and invites the patient to explain it, so you can address their actual concern. A and D brush the concern aside; B criticises someone the patient knows. |
| 3 | Medicine role-play. After greeting the patient, which sentence best signposts the conversation? | B. First I'd like to ask a few questions about your headaches, and then we can talk about what might be causing them and what we can do. Is that OK? | Signposting tells the patient what will happen and checks they agree. It's part of the 'providing structure' criterion, and it keeps you on track through every task on the card. |
| 4 | Pharmacy role-play. A customer wants something for a cough. Which question is the best way to start gathering information? | C. Can you tell me about the cough: when it started and what it's been like? | An open question first lets the customer tell their story. Then use closed questions to check details. A is leading, B asks three things at once, and D jumps to a sensitive question without context. |
| 5 | Nursing role-play. You've explained how to use a blood-thinning injection at home. What's the best way to check the patient has understood? | C. Just to make sure I've explained it clearly, could you tell me how and when you'll give the injection tomorrow? | C is the teach-back method: the patient explains it in their own words, and you can correct any mistake. 'Do you understand?' almost always gets a 'yes'. Putting the responsibility on yourself ('I've explained it clearly') keeps it respectful. |
| 6 | Medicine role-play. The patient says firmly: 'I'm not taking blood pressure tablets. I feel fine.' Which response is best? | C. I can see you feel well, and that's good to hear. Can I explain why high blood pressure often has no symptoms, and then we can decide together what to do? | C accepts the patient's view, asks permission to explain, and offers a shared decision. B frightens the patient; A and D give up on the task on the card. |
Three role-play cards
Model answer: Role-play (medicine)
Setting: general practice. Patient: a 54-year-old office manager whose recent blood test showed high cholesterol. They've read online that cholesterol tablets cause muscle pain and don't want to take them. Task: find out what the patient knows and what worries them; explain the result in plain language; discuss options (diet, physical activity and medication); respond honestly to the concern about side effects; agree a plan and a follow-up appointment.
Sample lines (the patient's replies will vary): "Thanks for coming back to talk about your blood test. Before I explain the result, can I ask what you already know about cholesterol?" … "It sounds like what you've read has really worried you. What exactly did it say?" … "Your cholesterol is higher than we'd like. Over time, that can narrow the blood vessels and raise the risk of a heart attack or stroke." … "You're right that some people get muscle aches with these tablets. Most people don't, and if it happens, we can change the dose or try another one." … "There are also things you can do yourself, like more vegetables, fewer fried foods and a walk most days." … "How would you feel about trying the diet and exercise changes for three months and then repeating the test? If it's still high, we can talk about tablets again." … "Just so I know I've been clear, what will you try first?"
Model answer: Role-play (nursing)
Setting: orthopaedic ward, the day before discharge. Patient: a 67-year-old who had a knee replacement and lives alone. They're anxious about managing at home and about giving their own blood-thinning injections. Task: find out what is worrying them most; explain the injection plan simply (once a day, same time, how long, where to put used needles); explain the support available (a community nurse can visit at first, and the ward phone number); check understanding with teach-back; reassure without making promises you can't keep.
Sample lines: "You look a bit worried about going home tomorrow. What's on your mind?" … "Living on your own after a knee operation is a big thing, so that's a very understandable worry." … "Let's talk about the injections first, then about help at home. Is that OK?" … "It's one small injection a day, at about the same time each day, for the next few weeks. You'll give it into the skin of your tummy, and the needle is very fine." … "Used needles go straight into the yellow container we'll give you, never in the household bin." … "A community nurse can visit for the first few days to help you, and you can ring the ward at any time if you're unsure." … "To make sure I've explained it well, could you show me how you'll give tomorrow's injection?"
Model answer: Role-play (pharmacy)
Setting: community pharmacy. Patient: a 41-year-old shift worker who asks for 'something strong to help me sleep'. They've been sleeping badly for about two months and are frustrated. Task: find out about the sleep problem (how long, routine, caffeine, shift pattern, stress); explain that sleeping tablets bought from a pharmacy are only for short-term use; suggest practical sleep habits; recommend seeing a GP because the problem has lasted two months; respond calmly to the patient's frustration.
Sample lines: "I'm sorry to hear you've been struggling to sleep. Two months is a long time. Can you tell me a bit about what's been happening?" … "What does a typical day look like, with your shifts?" … "How much coffee or energy drinks are you having, and when?" … "I can hear how frustrating this is, and I do want to help." … "The sleeping tablets I can sell are only meant for a few nights. They don't fix the cause, and they can make you drowsy the next day, which matters if you're driving to work." … "Some things that often help are a dark, quiet room, no caffeine in the six hours before sleep, and a wind-down routine at the same time after each shift." … "Because it's been two months, I'd really recommend seeing your GP. Would you like me to write down what we talked about to take with you?"
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