MY OET SPEAKING

Reflective listening skills and paraphrasing for clarification

"If I hear you right, you conveyed that...?" Is that correct? "If I heard you right...?" or "If I understand you correctly...?" "If I understand you right, you're saying that...?" or "... you believe that...?" or "... you feel that...?" You mean. So, to put it another way, you believe/feel that... To rephrase what you said,... So, what you are saying is....Is that correct? Let me see if I have everything we talked about? So it sounds like..... In other words..... It looks like..... So what you are saying is....You mean............ It seems that......

Use a closed-ended question when you already know the reason for patient's visit, or it's a follow-up visit?

Am I right in thinking that you have been referred by your doctor to discuss regarding your weight/smoking/hypertension? (Depending on the cue card) Am I right in thinking that you have come here about your arthritis? Am I right in thinking that you are here to talk about your hypertension?

Use polite expressions to give advice:

Are you willing to...? Would you be willing to...? Would you at least give me time/a chance to suggest some ways to manage your condition? I will outline some things you can do... You could consider... Another option is.... • • • • • • • • • • • To begin with, I would suggest..... I would like to start by suggesting.... Have you thought about...... What I would like you to do is........ (ensure compliance with medication/healthy diet/eat more fruits and vegetables) Why not.... (try healthier alternatives ?) Let's consider some ways by which you can incorporate healthier changes in your life. Would you like to try and quit smoking? There are medications and support groups available for people who want to quit smoking. If you like, I can get you some information about it. I'd like you to focus on what we can do now to improve your health. Have considered giving up smoking? I'd like to talk with you about your diet. Exercise will benefit in maintaining good health. I know it might be little difficult at first but it will have a profound impact on your health in the long run. I think you could start by walking 15 minutes every alternate day and gradually increase the duration

To ask permission before moving to the information gathering stage.

Can I start with questions about your lifestyle before discussing treatment options? May I ask you some questions about your family history? I am going to ask you some questions about your lifestyle. Is that ok? Is it OK if I ask you some questions about your lifestyle?

Step 3:

Complete the tasks on the cue card

Step 4:

Concluding the role play.

When the patient talks for too long

Could I just interrupt you there for a second? So what I have understood so far is that.............. Is that right?

Using positive words in OET SPEAKING

Definitely I will definitely make sure that it gets sorted.../ the concern is shared with the doctor/Ward Manager (conflict resolution) Absolutely I absolutely agree... (To empathize with patients).... Certainly Small changes in your lifestyle will certainly help in making a big difference to your health in the long run. Fantastic That is fantastic (to motivate your patient)

To outline the sequence of the consultation

First, I'll ask you some questioning about your complaints Then, I will explain the likely cause of your symptoms After that, I will take you through some treatment options and things you can do to manage your condition... Following that/Finally, you can ask me any questions that you may have.

introducing yourself

Hello, my name is (your name here), and I will be your attending nurse today. Hello, my name is (Your name here), and I am one of the Registered Nurses in this facility. Hello, my name is (Your name here), and I will be looking after you today.

Showing courtesy in OET SPEAKING

I am sorry for the inconvenience that this has caused. I am sorry that your pain is so high. I apologize that you had to wait for so long.

What if the patient says something that is confusing or unclear?

I am sorry to interject, but I am not sure I understood that completely. Could you repeat it? I am sorry to interrupt; I missed the last few words you said. • • • • • • • • • • • • • • • • I didn't quite follow that. Can you say it again, please? Sorry, could you repeat that for me, please? Can you please clarify what you mean when you say......? Do you mean.............? Sorry, I don't understand what you mean. I am sorry, I am not sure I understand what you mean by.... Sorry, I am not sure I know what you mean.

Empathetic Phrases

I can see that must have been hard for you. Can you bear to tell me just how you have been feeling? Thank you for telling me how you have been feeling. I appreciate you telling me this. It helps me in understanding the situation much better. Have you told me enough about how you are feeling to help me understand things? I think I understand now a little of what you have been feeling. Let's look at the practical things that we can do together. I can see that this has been very difficult for you to cope with. I can appreciate how difficult it is for you to talk about this (here, appreciate means to understand) I can sense how angry you have been feeling about your illness. • • • • • • • • • • • • I can see that you are quite upset I can understand it must be frightening for you to know the pain might keep coming back. That must have been (past)/must be (present) very difficult/tiring/Frightening/Painful/Emotionally draining for you. I know how you must be feeling. I am sorry to hear that! Aww, it's a pity to hear that! I can perfectly understand how difficult that must for you to cope with. It can be quite distressing, but there are ways to help manage it. I can appreciate that it's difficult to follow these instructions or I can appreciate that it's difficult to make these changes in your lifestyle. However, it is imperative that you do this to ensure good general health or to ensure a complete recovery. I have noticed that you seem a little uncomfortable with this suggestion. Having said that, this would be very beneficial for you or this would improve your health. I can understand why you feel that way, and it can be overwhelming. I am sorry to hear that.

To ask personal questions or questions on sensitive topics

I have to ask you some personal questions if that's OK. If it's alright with you, I need to ask you some personal questions. If you don't mind, I'd like to ask some questions about your sexual history. Do you mind if I ask some questions about your lifestyle?

Reassuring statements

I hear what you are saying. You are concerned about your health. It's ok to cry when you feel like it. I can wait for you. I appreciate that you are worried. Is there anything I can do for you? I know you are concerned that your progress is slow, but you are making steady progress and would recuperate soon. You did the right thing coming to the hospital. We have experienced doctors and the latest equipment to treat your condition. It's okay to feel sad. It's ok to cry. I will do everything I can to make you feel comfortable during your stay. Would you like me to contact the social worker to talk with you about any services that might be available for you while you recover your strength? With rest, the right medication, and a stress-free mind, you will feel better.

Use statements like to check's patient agreement

I hope I have cleared up/assuaged your worries? Does that make you feel a bit better? Is that okay? How does that sound? Are you happy with that? I appreciate what you are saying, and It's your right to get discharged/refuse treatment with an informed understanding of the risks involved in this decision. Can I explain something the risks associated with getting discharged against medical advice/refusing medication or treatment? Would that be okay? I understand that the final decision is up to you. However, you must understand the risks involved with this. Is it alright okay if I can discuss that with you?

Showing Empathy

I know how you must be feeling I understand your concern I understand how you are feeling I can relate to that. I understand how you feel. That being said........(give advice) I understand why you have this concern. Having said that......(give advice) I understand/see why you are worried. However.......(give advice) I am sorry to hear that! Aww, it's a pity to hear that! I can see that you are not happy with this suggestion. I do see your point I do understanding your perspective I do understand where you are coming from I can see how worried you are about making changes to your lifestyle, but you must consider the long-term effects.... I can see you are anxious about making changes to your routine. Nevertheless,. • If I were you, I would react in the same way It's a reasonable reaction. Your reaction is just lified It is indeed quite hard to accept something we are not ready to do. I completely understand that it must be very difficult for you, considering the stage you are in, it must be overwhelming! I understand it is challenging for you to cope up with this situation. And it is a reasonable reaction. Your concerns are understandable. It's not unusual for people to react in this way. I understand you dislike this idea. It's common for people to feel this way. I can understand your worries/concern. I completely understand that it must be very difficult for you, considering the stage you are in, it must be overwhelming! I understand it is challenging for you to cope up with this situation. And it is a reasonable reaction. Your concerns are understandable. It's not unusual for people to react in this way. I understand you dislike this idea. It's common for people to feel this way. I can understand your worries/concern. I know how you are feeling. With that said... I can understand how you feel. That being said........ I can see why you have this concern. Having said that...... I understand/see why you are worried. However,

Acknowledge the patient's perspective before outlining the risks

I understand that it's not easy, but if you continue like this, it will make your condition worse! I know it's not easy, but it's imperative that you adhere to this advice to recover from your illness. I can see you have concerns regarding this. That being said, it's vital that you follow my advice to ensure good general health. I can understand it's difficult for you. I can appreciate that it's going to be difficult making these changes. I understand it's not easy, and it's tough to make changes to a busy schedule, but as I see it- there's no alternative. If not make some changes now, you run the risk of......

Acknowledging a patient's feelings

I understand your perspective. I understand where you are coming from. "I realize this is difficult" This is effective in terms of acknowledging the patient's problem without voicing any personal thoughts on the matter. "Now that I'm aware, I will ensure that your concerns are taken care of, and you don't face any inconvenience." I can appreciate this is difficult for you.

Let the patient know what happens next

I will review your progress after two weeks. (include a timescale, if mentioned on the cue card) What I will do for you right away is...... (as suggested on the cue card)

Negotiating

I'd like to propose that... I recommend/suggest... How do you feel about

Ask the patient if there is anything else that they can be helped with.

I'm glad that I was able to help today. Is there anything else I can help you with? Is there anything else that you would like to ask? Before we finish, is there anything more you want to ask?

Explaining risks to their health in case they refuse the treatment or advice

If you do not comply with my advice, it can have adverse effects on your health The results of not getting the treatment can be detrimental. If you do not take your medication on time, it might delay the recovery time. If you do not modify your lifestyle, your disease may progress. Your condition might exacerbate if you discharge against medical advice.

It is a good idea to provide a rationale or reason or asking the question

If you don't mind, I want to ask some questions about your medical history. It will help me to assess your condition in a better way.

Checking patient's agreement

Is that acceptable to you? Does that sound reasonable to you? Does that seem realistic to you? Will you agree to this? Can you agree to that? Do we have an agreement?

Checking patient's acceptance:

Is that okay? How does that sound? Are you happy with that? How do you feel about what I am proposing? How do you feel about that?

Always clarify whether what you have paraphrased is accurate by asking

Is that right? Is that correct? Would you like to add anything to that? Is that an accurate summary? Have I understood that correctly? Is there anything else?

Signposting language when explaining treatment and giving advice to patients

Let me explain what you can do to recover from this condition. Firstly, .....Secondly,............., Next,......... That brings me to the next point........ Moving on to the next option..../next advice....... Another thing you can do is.......... There are three things you need to consider. First of all, you should lose weight. Then, you must cut down...... Finally,....................... Let me briefly outline what you can do to ensure good general health. There are a couple of things I want to advise you. I want to suggest a few things which you can do to ensure a full recovery. Basically/Briefly, I have three things to say. I'd like to begin/start by ... Let's begin/start by ... First of all, I'll... ... and then I'll go on to... Then/Next ...

Some of the settings commonly used in OET role plays are

Medical Centre Community Health Centre General Practice Emergency Department of a hospital Home visit to a patient's house Hospital outpatient department School

What not to say or do in OET SPEAKING?

Multiple questions Leading questions

demonstrate that how you understand the patient

My impressions of what you said is .... is that right?

To move from one topic to another

Now that we've discussed some treatment options, I'd like to know about any questions or concerns that you have on your mind. What I'd like to do now is to discuss some ways you can manage your present condition. Before I can discuss the treatment options, I'd like to summarize your symptoms to ensure I have accurate information Thank you for answering my questions. I have all the information I need, and now I'd like to suggest some lifestyle modifications to improve your health.

Transitioning from the introduction to history taking

OK, before proceeding further, I'd like to ask you some questions about your pain. Is that alright? I'd like to start by asking some general questions to understand your condition. To give me a better understanding of your situation, is it okay if I can ask you some questions. If you don't mind, I am just going to ask you a few questions about your lifestyle. Would that be okay?

Step 3:

Plan the execution of the role play depending on the tasks mentioned in the cue-card.

Do not forget to obtain the patient's agreement while doing this.

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 would 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?

To justify a specific line of questioning

Since this condition can be hereditary, I'd like to ask some questions about your family history. If you don't mind, I want to ask you some questions about your sexual partners and sexual practices. I can appreciate that these questions are very personal, but they are crucial for the examination.

Reinforcement should follow the above explanation

So, I hope you understand why it's vital for you to stick to the diet/undergo the tests/take the pills/not to smoke/to get plenty of rest and so on. This is the reason why you need to get admitted/undergo this treatment For this reason, you need to............

Offer a patient-information leaflet, if mentioned on the cue card

Thank you. Here is a patient information leaflet which you will find useful. If you have any additional questions, please do not hesitate to contact me. (if mentioned on the cue card)

Step 1

The first step is introducing yourself and your role in a confident and friendly manner.

Prioritizing Interests

The most important issue for us is... We intend to ensure that you recover completely. For this,... Our main priority is your health. For this, If you do not follow this advice, your health might exacerbate... If you do not comply with my treatment advice, your condition might deteriorate.

The next step would be to reassure the patient to manage their anxiety, fear or worries.

This Clinic/This hospital has an excellent reputation, and your health and safety is our utmost priority There is no need to be alarmed. The staff here is very competent and will look after you diligently. I am a qualified nurse with good nursing experience. Please do not worry at all Of course, the final decision is up to you. However, the sooner it will be done, the better! There is nothing to be alarmed about I am afraid there is no other way. Believe me; if there were another way, I would have told you. This is the best option, I assure you. There are no two ways about it. It's your health at stake here. We will be here to help you. We will be here to look after you. or We are here to look after you. Try not to worry about. I assure you there is nothing to worry about. I am certain that staying in the hospital is in your best interests. Please relax; we are here to help you and to suggest how to manage. I understand your concern; however, following my advice is imperative to your well-being Believe me; if there were another way, I would have told you. This is the best option, I assure you. There are no two ways about it. It's your health at stake here. We will be here to help you. We will be here to look after you.

Concluding the role play.

To reiterate, you will gradually cut down on the number of cigarettes daily and join a smoking cessation program. To summarize what we have discussed today, Just to go over what we have discussed today, Now, if you wouldn't mind going over the advice, I have just given? Now, if you won't mind, can we go over the advice I have just given?

Communicating with patients on sensitive or embarrassing topics

Use probes to investigate a concern further Examples: I hope you don't mind me asking, but ... Would you like to talk about...... Is there anything else you'd like to tell me about this? Reassure the patient that the consultation is confidential and that they can openly share their information without anyone else finding out Example: Everything that you tell me in here is completely confidential. Justify - provide a rationale for asking questions: explain why certain questions are relevant to the discussion Examples: This question will help in getting a detailed picture of your condition. It's important that I ask you some questions about your sexual history. I know it's personal, but it will help me in assessing your situation much better. Acknowledge - validate that you have understood what the patient has said and thank them for providing information. Examples: I can understand that this was hard for you to tell me, so I really appreciate your honesty. Thank you for telling me about that. Thank you for answering my questions. I know this wasn't easy. What you've told me is really helpful.

if you are meeting the patient for the first time, use the following open-ended questions to open up the discussion.

What brings you here today? What would you like to discuss? How can I help you today? How may I assist you today? I see that you rang the buzzer. What can I do for you? (When the patient is admitted to the hospital).

Use the notes on the role card to guide the role-play

What is your role? What role is your interlocutor playing patient, parent/son/daughter, carer? Where is the conversation taking place? What is the current situation? How urgent is the situation? 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 other elements of the situation do you know about? What information do you need to give the patient? Take the initiative to start the roleplay yourself. Don't worry if the interlocutor stops the role-play after five minutes -there is no penalty for not completing all the elements on the role card.

Eliciting information: Communicating with challenging or withdrawn patients

You seem very low in yourself. Can you tell me what's going on? You appear very distant - why is that? You seem very sad - can I ask what you are thinking? You look quite disturbed- what's on your mind? I can see that you look very anxious- would you mind telling me what is bothering you? You seem upset- do you mind telling what's the problem? I understand this is very difficult for you talk about it. That must be very challenging for you. I can understand it's hard as it's a big change in your life, and it's natural to feel overwhelmed. Having said that, I am here to assist you. I know this must be distressing you. That being said, I am here to help you. (validating a patient's concern who is anxious, concerned or upset) You seem very far away! (used in case the patient is withdrawn or unresponsive) Please tell me what is on your mind. How are you feeling at the moment? • • • • • • • • • • • • • How do you feel right now? I appreciate (appreciate here means to understand) the problems this has caused you. I can understand your frustration, but this is the only option we have at the moment to ensure that you remain in good general health. (used to persuade a patient) I am sorry that you feel........................ I can assure you it wasn't intentional. (if the patient is angry)

Persuading reluctant or difficult patients

Your weight is not in the ideal range, and I am concerned about the long-term effects on your health. Your weight is higher than it should be, and I am concerned about your health. I understand what you are saying, but you must consider the long-term effects it can have on your health. I know it's hard, but I am afraid there's no other way. If you do not make these changes, you run the risk of.... It is imperative that you lose weight, else it can make you susceptible to serious complications for the future It is necessary that you comply with the treatment advice It is essential that you heed my advice. It is vital that you consider making these changes to your lifestyle. It is paramount....... It is indispensable...... It is crucial......... The most important thing is to... It would be beneficial if you can..... It is a good idea to include portions of fruits and vegetables in your eating habits. It would be helpful... It is strongly recommended that... It is important for you to start doing some kinds of exercise for at least 20 minutes every day. I am concerned about your health and want the best possible outcome for you. It is necessary for you to cut down on some of the foods in your diet • • • • • • • • • • • • • • • • • • • • that are not particularly healthy. For instance, fried foods or foods rich in cholesterol. It is recommended that you try changing your lifestyle. It is imperative that you take your medicine regularly. It is paramount that you reduce your alcohol intake. It is indispensable that you quit smoking or at least try to cut down on the number of cigarettes you smoke per day. It is crucial that you reduce your weight to avoid adverse effects on your health. In cases like these, the first thing to try is changing your lifestyle. I suggest that.... I advise that..... I strongly recommend that..... It would be beneficial if you I am afraid it is extremely important/essential/imperative/critical/for you to... It's really important that you... I strongly suggest/urge/advise you to... It is essential... This might not be what you were hoping to hear but the best way to improve your health is....

demonstrate that how you understand the patient

if I understand you correctly, you are saying

demonstrate that how you understand the patient

let me if I have understood you correctly.

demonstrate that how you understand the patient

let me see if I understood you correctly

demonstrate that how you understand the patient

so you mean that so you believe that so you think that so you are saying that

Step 2

the opening statement or question should match the background information on the cue card.