Speaking tips for OET PDF

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Summary

helpful for OET speaking section of the exam...

Description

•

If you follow these criteria, you will pass: 1.

Active listening -

While the interlocutor is talking, you need to say: mmmm, hmmmmm, yeah, I see, wow, ohhhh.

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Repeat what the interlocutor just said, such as: “you mentioned nausea, what about vomiting?” Or “I understand you are worried because of the side effects of the drug but …….”

2.

Topic change is clear = signposting  check below.

3.

Avoid medical jargon “terminology” such as CT, ECG, colonoscopy, arthritis. You can say these words but you must explain them.

4.

Open (what, how, etc..) then closed question (does, is, are, etc..): How are you?  You mentioned pain, is it steady? Tell me more about your headache  Did you talk any medications for it?

5.

Check understanding frequently  check below.

6.

Avoid compound (do you have hypertension or diabetes?)/leading questions (you have headache, right?).

7.

Establishes what the patient knows  check below in blue. Ex: side effects, the definition of a disease, possible causes, benefits of exercise, poor life style (smoking, coffee, diet), or why a drug is not needed.

8.

Organize your explanation (firstly, secondly)

9.

Ask: What else concerns the patient:  Is there anything else bothering you? Ask this question in the beginning after asking about other symptoms first. What else you can do:  Is there anything else you would like to ask me? Ask at the end.

=============================================================================================== - Tips: 1.

If you found this word “Routine check-up” = you know the patient  Hi, X. How have you been since the last time?

2.

Emergency? Start as follows;

 Hi, I am Dr X, you are Y, right? I know you are in a lot of pain but could you tell me more about that? 3.

If the context “background information” contains “On examination”, “You examined”  You can start with:

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Thanks for letting me to examine you.

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OK, X, do you like to know the possible causes of your condition? But DON’T start with the introduction “Hi, I am Dr X, could I confirm your name, please?”.

4.

“Could I confirm your name, please?” and “What is your name?” are better than “How can I address you?” The 1st one is the best in my opinion.

5.

Don’t say Mr/Ms/Mrs X but call the patient by the 1st name directly (i.e. Mohamed, Ahmed, John, etc..).

6.

If the card is about a patient diagnosed with a disease by another doctor and the patient came today to ask you more about the follow-up, management, and to know more details about his/her condition.  You should not start the card with “How can I help you?” Ex: The myocardial infarction/asthma cards here. https://www.occupationalenglishtest.org/preparation-portal/free-sample-tests/speaking-sample-test-1/ Instead, you need to tell the patient something like “How are you since your hospitalisation? Or I understand how anxious you are because of your last …., but could you tell me more about what you understand now about your condition?

7.

In each card you have the context “background information”, NEVER ask the patient anything from the background. Because it is your background information and you need to build on it. Ex: If the card is “this patient came because of his/her pain in the abdomen which started two days ago”  Never ask about the location or the duration but ask other things such as radiation or associated symptoms (nausea, vomiting),

etc.. Another ex: “a patient came to see you and has a history of hypertension”  don’t ask about this history. ============================================================================================= •

Some sentences to help you:

- What seems to be the problem? What brought you today? How can I help you? - Open question: Please tell me more about your headache? - Do you know the causes of ….? Causes of ….. include the presence of a family history, hormonal disturbance, unhealthy diet, stress, excessive smoking and drinking. - You mentioned nausea. Have you vomited as well? - You say insomnia. Do you mean that you cannot sleep at all or you sleep but wake up often? - How would you rate your pain on a scale of 0 to 10, if 0 is no pain at all and 10 is the worst pain you can imagine? - How long does/did it last? How long have you experienced it? - Is it steady or does it come and go? - Can I ask you, everything is OK? At home, at work? (asking about psychological issues/well-being). Are you under any stress at home or at work? - After asking about symptoms; Is there anything else bothering you? =========================================================================================

• Reassuring and correcting wrong beliefs/reluctant patients - I totally see your concern that you want…. but I would like to confirm that several pieces of information on the internet are not up to date and are not based on evidence-based medicine or recent guidelines. - I completely got your point that you want…. I am here to relieve your worries. So, please allow me to mention that recent research studies of high-quality demonstrated that this drug/surgery/procedure is very effective/diagnostic and safe (has a very high success rate). - I understand your worries that you ….. - It is completely understandable that it is very concerning to you because you want…. but please allow me to mention that recent upto-date guidelines according to evidence-based medicine revealed that the risk of recurrence/malignancy (in the presence of a family history) is extremely low, it is only 0.5%. - Please note that we follow the up-to-date guidelines which weigh the anticipated benefits against any possible risk of interventions/procedures and I believe this intervention/surgery/procedure has more benefits/risks than risks/benefits. - I understand how worried you are because you …. but let me reassure that your child, X, will grow out of asthma, recent guidelines demonstrated that most children grow out of asthma by the age of …. - I wish I could prescribe this medication to you but I am sorry because it could lead to some side effects. Do you know these side effects? - If I were you, I would take this medication/I would stop smoking because smoking cessation leads to …., do you know other benefits of smoking cessation? - I got your concern that you want…. but the hair loss is temporary and you could put a wig or any headwear until your hair grows again. - Addiction is both mental and physical reliance on sleeping pills/barbiturates/pain killers. Addiction causes people to act irrationally when they don’t have sleeping pills/barbiturates/pain killers. On the other hand, dependence is the mild form of reliance on sleeping pills/barbiturates/pain killers and it has only physical reliance on sleeping pills/barbiturates/pain killers. Apart from dependency (side effects), do you know other side effects of …? There are other serious side effects such as ..... and .... - It is very understandable how anxious you are because you want…. but let me reassure you that this type of investigations takes more time because it is repeated at least twice for better accuracy.

- What the consequences of ignoring this advice could be; I understand how worried you are because you don’t want to …. but please note that there is a high chance of having complications and future attacks which could be more intense and longer than the last/current one. - If you don’t mind, you could come again so I review/re-evaluate your condition after one week (in reluctant patient who thinks that he is sick or who wants a medical certificate). • A Patient wants a medical certificate but otherwise healthy? -

I can give you a pamphlet to understand more about stress and how to manage it.

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I strongly suggest that you do your favourite hobbies at the weekend such as going to swim or reading.

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• Recommendations - Make topic changes clear! Signposting So, we have discussed your current condition, what I would like to do now is to discuss how we will manage it, can I? We have talked about the necessary investigations and now I would like to discuss the management plan. - Fortunately, we have detected it early and the good news is that we have a number of options that we can do. Firstly, we will try to solve this with …This will take the pain away. - Doing exercises, eating healthy diet with low salt and sugar levels, losing weight, smoking, and drinking ==>

- What would make a lot of difference to your health is to cut down on how much you smoke. Is this something you could try? Do you think you can do that? Do you feel comfortable about my advice? Is this something that might work for you? Would you like to do that? Do you think you could give it a go? - Eating vegetables, fruits and healthy food with low salt and sugar levels will …. Do you know other benefits of healthy food? They are …. Is this something that you like to try? -

- And there is a support group I would like you to contact. - You may need to take a week off work. =========================================================================================

• Breaking bad news - 2nd visit chat (before breaking bad news); Thanks for coming back today. How have you been since the last visit? OK, so, we are here to discuss the results of your tests and I preferred to talk in this calm room to avoid being interrupted. Would you like to know the results now? - But first may I ask you if you came alone or you came with someone? - Or Do you want someone to attend with you? - So, X, I am afraid I don't have very good news today (a 1-second pause), unfortunately your results demonstrated that you have .... (a 1second pause) I am sorry for that. - We are going to support you through this and be with you in every step. We will address any symptoms you have. We are also going to be available for your family if they need any help (in cancer or serious diseases). - In my team, there is a social worker available to you and your family if you have any issues. - All of us are here to support you in any way that we can, no matter what happens. We will provide you with the best medical care.

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- Fortunately, we have detected it early and the good news is that we have a number of things that we can do. =========================================================================================

• Checking understanding - Check if the patient understood?  So, could you please repeat what I have just said? - So is it clear, Mr X? So, how much medication should you take? =========================================================================================

• MPOA - Let me first explain what medical power of attorney means, it means that there is someone who makes medical decisions for a person when that person lose the capacity to make those decisions. Secondly, it is up to you to appoint a MPOA and you can appoint anyone you want. Are you following me? - Alright, no one can appoint themselves as medical power of attorney for another person. You must have the capacity to understand the implications and consequences of appointing MPOA; otherwise, it is not legally valid. - MPOA cannot arrange euthanasia or refuse palliative care and you will be supported during your illness. - The good news is that we can arrange for an advanced care plan to ensure that you have a will and to discuss the issues which you might have in the future and how to address them according to your wish such as if you have heart failure, do you need us to resuscitate you or not and so on. Am I clear? - We are going to support you through this and be with you in every step. We will address any symptoms you have. We are also going to be available for your family if they need any help (in cancer or serious diseases). - In my team, there is a social worker available to you and your family if you have any issues. - All of us are here to support you in any way that we can, no matter what happens. We will provide you with the best medical care. - It may be a good idea to talk to someone about this. Do you have any relatives or close friends who can help you and provide support? =========================================================================================

• Relatives/spouse want to know the condition (e.g. sexually transmitted) of a patient; - I cannot do that without her/his consent because it is confidential information. - No one can access the medical records of patients without their consent. The doctors themselves cannot access their records without their permission. - It may be a good idea to talk with your partner about that and discuss any problem together. =========================================================================================

• Mention a reason for everything; - Stop smoking to reduce the risk of future attacks and that will make a lot of difference at the long-term. - Eat healthy foods to decrease the intensity of any future attacks and it will also improve your mood. - Exercise regularly to reduce the duration of future attacks and to reduce the risk of complications and it acts as natural painkillers. - Nicotine Patches and nicotine gums= nicotine replacement therapy. It works by providing nicotine to your body to decrease the withdrawal symptoms you face when stopping smoking. ========================================================================================= • Workforce health check - Hello, I am Dr ….. I am here to conduct a work health check. May I confirm your name, please?

- Nice to meet you, X, tell me more about your general health/how can I help you? .

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- Pretending to be sick may have consequences if your boss should question the medical certificate. - No one can access your medical records without your consent. The doctors themselves cannot access your records without your permission. - Health checks support a healthier and safer workforce with many benefits such as improved productivity and reduced workplace injuries plus personal benefits including individuals learn more about their own health because we give regular classes about common diseases and how to detect them early. ========================================================================================= • Side effects of a drug (steroids); - It will be used for short-term/a short period of time only. - I will give you a very small dose which will not cause any side effects. - Recent guidelines demonstrated that ….(steroid) is associated with very good outcomes and improved quality of life in …..

• Reassure the patient, who is anxious that people will think differently of him/her if they find out about his/her condition: -

• (if the patient is busy and reluctant)= I can understand that you have a busy lifestyle but something is better than nothing. Half an hour of daily walking will greatly help you in (managing your weight/reducing risk factor of heart diseases). • (A relative died?): My sincere condolences to you. - If the patient suspects a certain disease or cancer you have to ask why because they might mention an important relevant information such as a family history. - In chronic diseases such as DM in the conclusion you can’t say I hope you have a speedy recovery. - In conclusion: when you ask about any concerns and the patient stated his/her concern. Ask again about concerns until the patient say no. - Don’t assume things especially if the patient didn’t mention it even if it is in the card: for example in one of the cards the patient wanted to quit smoking using a certain medication that counter act with his antiepileptic’s medications as he has epilepsy so don’t directly say this med will affect your antiepileptic’s, you should ask first do you have chronic illness? Then what meds are you taking for it? - One of the cards was asking to ask about suicidal thoughts and its impolite to immediately ask it but you can say:

- Patient refuses the diagnosis and wants to repeat the test again? 

- Want to see another doctor/specialist instead of you? It is completely up to you but I would like to mention that we follow the same guidelines ……. - If the interlocutor is silent and does not respond or he/she does not understand something; Would you like me to repeat the question?

I can see that you are worried, would you like to tell me what is on your mind?

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• Ending - If you would like more information on insomnia, I can give you a pamphlet/leaflet. And there are useful websites that offer good advice, as well. - Is there anything else you would like to ask? - Let’s recap what we have just discussed, OK?  You need to take his/her permission first. - Still have time? - Patients asked about something you don’t know?  I will give you a leaflet at the end of our consultation which contains detailed information about that. ========================================================================================...