YouTube Video 29 Nov, 2014
Hints for the OET Speaking Subtest
Hello. My name is Virginia Allum. I'm a medical English writer and also a Registered Nurse. I have written materials for online OET preparation as well as books and ebooks with hints on passing the writing and speaking subtests.
Today I'm going to focus on some of the problems candidates tell me they have difficulty with during the speaking test. I'll give examples for the nursing subtest but the hints apply for the role plays in all of the professions.
Timing is very tight, as you know. Five minutes to cover all the tasks. This means that you need to make a plan of the role play before you start. Think of it as if it were a writing task. You make a plan of what you will write about first, second and third and you work out the beginning and ending. It's the same for the role play.
The important thing is to get into the role play immediately. Under normal circumstances you would probably ask ' How are you today?' and follow with some small talk but in this case you don't have time.
You have two opening possibilities:
1. The patient starts talking first and tells you why they are there to see you. E.g. The setting is a workplace and a worker has come to see the Occupational Health Nurse. 'Hello nurse. I've cut my finger really badly so my manager sent me up here to see you.' In this case you would get into the role play straight away. It wouldn't be necessary to say ' Hello. My name is X. I'm the Occupational Health Nurse here.'
2. You have to start the role play. In this case you need to introduce yourself and find out what the problem is. Situation: Patient in A&E with a cut on the arm which is bleeding quite a lot. You say: 'Hello, I'm Virginia. I'm one of the RNs here. Can you tell me a bit about what happened?'
Looking at the tasks - If you have 4 tasks to cover, you have around a minute each. That leaves you with 1 minute to finish the role play off. That's not much time for each point so it's vital that you are in control of the conversation.
During the OET speaking test, you need to be doing the talking most of the time. Keep in mind that the purpose of the role play is to show how well you can communicate.
Aim to demonstrate as many communication skills as possible.
The basic skills you need to show are:
1. introducing yourself and opening the conversation
2. asking open questions to encourage patients to speak
3. taking turns in the conversation so that you speak as much as possible
4. summarising what you have said or what the ‘patient’ says
5. encouraging the ‘patient’ to change or try something
6. empathising - in difficult situations or aggressive situations
You can maximise the number of communication skills you use by grouping as many as you can together. For example,
Introducing yourself + asking an open question (to find out what the problem is) + confirming understanding ( 'OK, so you said that you've had the leg ulcer for three weeks ,right?)
Reassuring (You did the right thing coming into hospital) + Empathising (I can imagine that this is very difficult for you) + Advising (It would be a good idea to keep your leg elevated when you are resting)
2. Managing 'Difficult Patients'
During the role play be prepared for the 'patient' or 'caregiver' to be unco-operative, rude or even aggressive. These situations are quite difficult for candidates so it's important that you practise well before the test.
Unco-operative patients - may say things like 'No, I don't want to do that. I haven't got time for that.' or 'It's OK for you, you know what you're doing. I don't have a clue what you want me to do.'
Rude or aggressive patients or caregivers- Remember that aggression in hospitals often comes from fear of what is going to happen or from feeling isolated or left out of decisions.
The other reasons for aggression are drug and alcohol or Mental Health-related. You should not have to deal with these situations during the OET role play.
Think of some of the situations which might be included in the OET role play.
Situation 1. caregiver talking to a community nurse - angry about what she sees as poor care for her mother. You had been going to explain a change in dressings for her mother but were interrupted.
Situation 2. patient's relative in the ward - angry because patient says she hasn't been offered any pain relief that day. Relative says she can never find a nurse to talk to and has just walked up to you in the corridor.
Situation 3. caregiver or resident in a nursing home - says belongings have been stolen and no-one is doing anything about it. You haven't heard anything about the situation.
Situation 4. mother with sick child in A&E - angry because other people have been seen before her child. Her child has a minor injury but a patient with a severe injury after a car accident has just been brought in.
These are the sorts of situations which can take you off your plan for the role play. It's important to address the issue but at the same time you have to get the role play 'back on track'. Practise some of the ways you can do this so that the patient or caregiver doesn't think that you are 'putting them off'. For example,
Situation 1. (Empathise) I can see that this has upset you a lot. (Try to bring it back) I was going to explain about the new dressings your mother is starting on tomorrow. Would you like to talk about your concerns about her care first?
Situation 2. (Apologise to relative without making excuses) 'I'm sorry that you've had trouble finding a nurse to talk to. I can talk to you now, if you like. (Open question to find out about issue) Can you tell me more about what's happening?'
3. Ending the role play
If at all possible, keep an eye on the time. As it gets to 4 minutes into the role play start winding down. You need to signpost to the patient that the conversation is nearly over. Sometimes this seems difficult if you haven't covered everything you want to say. Some of the ways you can begin the 'ending process' are:
1. Summarise - particularly important if you have talked about something which needs reviewing in the future e.g.
' OK. We've talked about your concerns about your mother's care. I've explained the new dressings which we'll start tomorrow. I'll phone you next week to let you know how the dressings are going. If you have any other worries about your mother you can call me at the community health centre. Is that OK?'
2. Give the patient a Patient Information Leaflet and suggest they call the ward/community health centre etc if they have any more questions. PILs are available for almost every condition and provide information about treatment and aftercare.
' I've covered the important points with you but sometimes it's hard to take it all in. I've got a patient information leaflet here for you to take home. If you have any other questions you can ring the number on the leaflet and they'll help you.'
I find that these are good solutions to the ending of the role play. If you ask ' Have you got any questions for me?' , it can lead to ...more questions! And you don't have time. Again, this is different from an authentic conversation where patients often leave the real question they want to ask until they are almost out the door. Remember that the OET role play is like a small section of an entire conversation which could take 20 minutes.
January 6, 2014 OET Speaking: the structure of the role play