OET Medical speaking
1. Commencing the Discussion
1) Read the setting: If you're in the hospital you introduce yourself but if you are a GP you don't. - Hello I am Michael your doctor / I'm one of the doctors on duty today. - Hello, I am your doctor today I'm Dr. XX one of the GPs at the clinic. - Hello or Good morning Hello, Jim. It's good to see you again
4. Always check understanding/opinion of patient
1) Whenever after explaining something - Does that make sense? - Is that clear (so far)? or Is it clear to you? - Would you like me to repeat anything? - Are you following me? - Do you understand so far? - Do you have any questions? - Are there any questions so far? - Do you want me to clarify it more? - Do you want me to continue? [breaking bad news] 2) after suggesting something - How does that sound? => after explaining positive things - Is that all right? - Are you happy with that? - Do you think you can do that? [after advising] - How do you feel about that? - Just to check that I've been clear, can you tell me what our plan is? - Considering you are in the range of high risk, I recommend that you should start taking lipid-lowering medication. How does that sound? - Do you think your family would be supportive of that? 3) Before starting the explanation - Are there any other concerns you would like to discuss? Is there anything else I can help you with? - Do you know what types of risks you can have when you have increased cholesterol? - How much do you know about PTSD is? Have you ever considered seeing a psychiatrist? - You look worried/stressed. Are you worrying about something? What is your concern? Remember Chunk and Check
3. Empathy
I'm sorry to hear that but there is a solution to every problem I see....It sounds horrible. I'm sorry to hear that. It must be difficult. You must have been really scared at that moment. I'm glad to hear that at least you didn't hurt yourself at the accident. That must be uncomfortable I see. All right That's great because you are doing something for your stress I can understand it is a concern for you Oh, that would be hard
Assume that you don't know background information except for the obvious things (e.g test result). - How can I help you [if you don't know the reason for the visit] - What brings you here to see me? or So, what brought you here today? - What seems to be the problem? - How do you feel today = How are you feeling today?
If the patient expects you to know the reason: - blood test result: you are here for your blood test, aren't you? - You are here regarding your test result, aren't you? - You are here to have your stitch removed, aren't you is that correct?
7. Conclusion - Prepare something simple for ending
Is there anything else you want to speak about today? Please come back if there is any change in your condition Bye for now. Take care now I'll come back and check on you later. I'm here for the whole day, if you need any further information do not hesitate to ask me. If there is any change I am always here to help you so if you have any more questions or doubts feel free to call me or make an appointment with my receptionist. Take care and see you next time If you have any questions, please feel free to ask me. Do you have any questions at this point? I believe you made the right decision. I'll see you in a week/In a week's time/in two month's time. All right, here is your prescription and I would like to see you in a month's time to see how you are progressing [how you are getting on]. This is my phone number. If you have any queries, don't hesitate to call me. Thank you for coming to me today. All the best. Goodbye. See you again in two weeks after you have received an echocardiography result My receptionist will help you to book your next appointment or I'll ask a receptionist to book it for you. My receptionist will give you the prescription for your medication It was good to see you . I hope you get well soon. Take care. I'm going to make a referral to your physiotherapist Please make an appointment with reception to see me in a week Please come and see me again in a week's time to see how you're progressing vs in two weeks' time I would like to see you in two months' time I'll come back and check on you later today If there is any change in your condition, please let me know You are most welcome. Thank you for coming to me today. All the best. Goodbye
2. Asking questions
Plan 2-3 questions beforehand by turning provided information into questions For e.g Could you tell me a little bit more about the condition/treatment? I'm going to ask some questions to find out more about it, is that okay with you? Would you mind if I ask you some questions so I can understand your situation better? May I ask a few questions to understand what you are experiencing? *To get a better understanding of what you are experiencing, I need to ask more questions about your medical history. I know it is a delicate matter, but I need to ask more questions about your relationship with your daughter. Would that be all right? If you don't mind, could you tell me exactly what happened? I know it is a difficult/sensitive topic, but I need to ask more questions about it. Is that okay?
Role Play Card
Read Carefully & Ask Questions
6. What should I do if these symptoms get severe? [reassurance]
Rest assured [=don't worry] Let me reassure you that if we can strictly control glucose levels..... I understand your worries but as long as you follow my advice and receive proper treatment, the symptoms won't get severe. I understand that worries about work must be a concern for you. I can assure you that it is treatable and will get better with time. In the meantime, I wonder whether you have anyone at home to help you out [how are you managing your pain / with the pain]? It is very unlikely and a rare complication but if it happens we have enough experience to deal with it properly. Please don't worry, you are in safe/good hands. I can see why you are concerned. Although it is hereditary in some families, it doesn't mean that you will get it. I see you have some doubts about taking these medications. I understand how you feel. It is not easy to change your lifestyle immediately. But you can always start from small things. It is difficult in the beginning but try gradually to reduce your fast food and alcohol intake and gradually introduce healthy foods to your diet. There are support groups and programs that can help you. How does that sound? I see you are frustrated I see that you are feeling anxious. It is common to feel that way. I assure you, if a room becomes available I will let you know straight away. I can see that it must be difficult for you to manage Try to be positive. if you follow my advice you will soon turn the corner and be back in good health [begin to improve] before you know it. There is no cause for alarm. Now I'm going to explain to you how to relieve the pain. I can see you are concerned It must be difficult for you. I see you are feeling hot and cold and aching. Is that right? It must be tiring/difficult to manage all these situations I understand some people might feel reluctant to /scared to take a new medication. Let me reassure you, this medication is very important to improve your condition. I can see that, especially when you look after Jill full time. How is Jill? I understand your concerns. I understand what you mean. I understand that it is not easy for you. You must have lots of pressure on your shoulders I'm very sorry for what Jill is suffering from. Do you understand what I mean? Unfortunately, the causes are not known at this time, which means it couldn't be prevented. Let me assure you that no one could have done anything to avoid this. Is that clear?
Getting agreement
Shall we start with... and then we will discuss the treatment options later. Is that okay with you? Before proceeding further, I would like to ask you some questions to get a detailed picture of your situation. Would that be okay? Would it be okay if I can ask you some questions about your........and then discuss some things you can do to manage your condition? So, here's what I am going to do. First, I will ask you some questions about your lifestyle. Then, I will suggest some things you can to do to manage your condition. And later/after that, I would be happy to answer any questions that you might have. May I proceed? Before I take you through the treatment options, I'd like to ask you some questions about your condition. Is that all right?
Settings commonly used in OET role play.
Suburban Medical Centre; Community Health Centre; General Practice; Emergency Department of Hospital; Home visit to a patient's house; Hospital Outpatient Department; School
What is your role? What role is the examiner (interlocuter) playing: patient, parent/son/daughter, carer? Where is the conversation taking place? What is the current situation and how urgent is it? What background information are you given about the patient and the situation?
What are you required to do? What is the primary purpose of the conversation [e.g., explain, find out, reassure, persuade]? What information do you need to find out? What information do you need to give the patient?
You are speaking to a patient who underwent a colonoscopy last week and has returned for the results "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. "Hello Steph, my name's Greeta, I'm one of the Doctors 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?
5. Provide structure - How much history to take - How much information to provide, - When to change the subject, - When to end the consultation
[When you want to finish] Is anything else you would like to speak about today? Bye for now [Before bad news] I am afraid to tell you that.... I am sorry to tell you that Let me explain a few things to you now, is that okay? To deal with PTSD, I have a couple of suggestions for you. Based on my examination, you have a condition known as epilepsy. Have you ever heard about it? Shall I explain to you? When you explain things, - PTSD is ..... - it happens after... - Regarding symptoms, - In summary, Signposting - first/first of all, secondly, thirdly and finally..... - This means that.....for this reason.... - The reason why.... - Therefore.... So....However, .....Now,....In addition.... - It is also important to ... It is also necessary to... It's a good idea to... - let's move on to, - let's have a look at some possible reasons for this. Now, let's talk about how we can manage your symptoms. Let me explain that now. Now, I would like to talk about treatment options
Probing questions [to get more details or precise information]
you mentioned that you're suffering from PTSD. Just to make it clear, have you ever been diagnosed with PTSD? What do you mean by that? Where exactly is the pain? You look a bit anxious. Is there anything else that is troubling you? Can you explain exactly why you are worried? When did you last eat? I noticed that you ate 3 hours ago, didn't you? Isn't that right? Have you eaten in the last 4 hours? Have you had any medical or psychological illnesses? Have you ever had an MRI before? Is there any other concern -> do you have any other concerns? what are your concerns today? May I ask you if you don't mind why you insisted on taking antibiotics? I understand you're dissatisfied with your doctor's decision not to prescribe antibiotics for your influenza, do you mind explaining to me why? Do you have any idea about your illness? Could you tell me whether you have taken any remedies in order to ease the symptoms of influenza before? Can I ask why you think the antibiotic will help with the virus influenza? Have you had any medical condition -> do you have any medical condition? what your health concerns are Any + complaints How have you been feeling recently? it must be stressful for both of you. could you tell me more about it? Could you tell me if your son has any medical condition? Did you apply any first aid treatment? Is it the first time it happened?
