Two role-plays, nine criteria, and a patient who is worried.
OET Speaking is not a discussion and nobody asks your opinion. You are handed a card, given three minutes, and then you do your job in English with an interlocutor playing your patient. Two assessors listen to the recording afterwards, once for the English and once for the clinical conversation. This page is the format, both sets of criteria with their sub-skills, a phrase bank for each clinical criterion, and the three minutes that decide the five.
Why this matters. Candidates with good English fail this sub-test every session, and they fail it on the criteria they did not know existed. The four linguistic criteria are the IELTS Speaking criteria under other names, and everything on this site’s Speaking pages applies. The five clinical communication criteria are new, and they are what a good clinician already does in a consultation: greet, find out what the patient fears, signpost, ask open questions before closed ones, check understanding. The test wants that in English, in five minutes, with a stranger. Method turns it from luck into habit, and the twelve role-play cards are where the habit gets built.
About twenty minutes, five of which are marked twice.
Speaking is a separate appointment from the other three sub-tests, one to one with an interlocutor, recorded, and marked later by two assessors who never meet you.
The warm-up
A few minutes about you and your work · not assessed
The interlocutor checks your identity and asks about your professional background. Nothing here is scored. Use it to settle your voice and to start speaking in full sentences before the clock matters.
Answer in two sentences, not one word. It is a rehearsal the test gives you for free.
The card
Setting, your role, the patient, the task bullets
Each card sets the scene in a line, tells you who you are and who the patient is, then lists four or five things you must do. The interlocutor holds a different card with the patient’s side: their worry, what they will say, and how they will behave.
The bullets are the content. The patient’s worry is on their card, not yours, which is why you have to ask.
The three minutes
Read, plan, ask about any word you do not know
Three minutes with the card before each role-play. You may take notes and you may ask the interlocutor what a word means. Section 04 below is how to spend them.
Three minutes is long enough to write five lines. It is not long enough to script a conversation, and you must not try.
The role-play
About five minutes · profession-specific · twice
You are yourself at work; the interlocutor is the patient, a relative or a carer, or an animal’s owner in veterinary science. They will bring a worry, and often a difficulty: reluctance, anxiety, a wrong idea from the internet. Your job is the job.
Five minutes is shorter than it sounds. A role-play that opens with information rather than a question runs out of time before it gathers anything.
The recording
Two assessors, nine criteria, later
The interlocutor does not mark you. Two trained assessors listen to the recording and score the four linguistic criteria from 0 to 6 and the five clinical communication criteria from 0 to 3. Those scores become your 0 to 500 result.
The assessors cannot see your face. Warmth, structure and empathy have to be audible.
Four criteria, scored 0 to 6, that you have met before.
These are IELTS Speaking’s criteria wearing a uniform. If your IELTS Speaking sits at Band 7, you are already in Grade B territory here, and the pages under Speaking apply without change.
| Criterion | The IELTS cousin | What a Grade B run sounds like |
|---|---|---|
| Intelligibility | Pronunciation | Easy to follow throughout; stress and intonation carry meaning; the occasional slip does not make the patient ask you to repeat. The word stress rules are the fastest lever. |
| Fluency | Fluency and coherence | A normal conversational pace with only occasional repetition or self-correction. Hesitation while you think about the patient is fine; hesitation while you hunt for a word is what costs. |
| Appropriateness of language | No direct cousin | Plain English to a patient, professional English to a colleague, and the judgement to know which the card is asking for. Every medical term explained in a plain clause as you use it. |
| Resources of grammar and expression | Grammatical range and accuracy, lexical resource | A range of structures used accurately and flexibly; the errors that remain do not get in the way. The grammar pages are the work. |
The consequence. Appropriateness is the one criterion here that IELTS never trained. Candidates who talk to a frightened patient in the register of a case conference lose it without noticing. The habit is one plain clause after every technical word, every time.
Five criteria, scored 0 to 3, that decide the sub-test.
Each criterion is a bundle of things the assessors listen for, and the official descriptors name them. The sub-skills below are those names. A Grade B run shows most of them in most of the role-play; it does not have to be perfect.
Relationship building
Initiating appropriately · attentive and respectful · non-judgemental · empathy for feelings and predicament
Greet, introduce yourself and say what the conversation is for. Then keep the respect audible: no interrupting, no telling off, and a genuine response when the patient shows a feeling.
The habit: your first three sentences are greeting, name and purpose. Your fourth is a question.
Understanding and incorporating the patient’s perspective
Eliciting ideas, concerns and expectations · picking up cues · relating explanations to the concerns you found
Ask what they think is going on, what worries them and what they were hoping for. When they drop a cue, follow it. When you explain, connect the explanation to the worry they told you.
The habit: say the worry back to them in your first minute, before you give a single instruction. This is the criterion candidates lose most.
Providing structure
Sequencing purposefully and logically · signposting changes of topic · organising techniques in explanations
A conversation with a visible shape. Say what you will cover, say when you move on, sum up before you close. Explanations come in numbered parts, not one long stream.
The habit: “Can I move on to…” every time you change topic. Say it aloud; the assessors cannot see you turn a page.
Information gathering
Active listening, minimal interruption · open questions before closed · no compound or leading questions · clarifying vague statements · summarising and inviting correction
Open first: how has it been? Then close in: worse at night? Never two questions in one breath. When the patient says “a lot”, find out how many. Sum up what you heard and ask what you missed.
The habit: one question, then silence. The silence is where the information is.
Information giving
Establishing what they already know · pausing and using the response · encouraging reactions · checking understanding · discovering what else they need
Find out what they know before you tell them. Give it in pieces and stop after each piece. Ask how it lands. Have them tell you the plan in their own words. Ask what else they need before you close.
The habit: never “OK?” as a check. “Could you tell me what you will do tonight?” is a check.
One phrase per move, and the move it is doing.
Organised by the five clinical criteria, so that every phrase earns something. Learn the moves, not the sentences: the assessors reward saying the patient’s own worry back to them far more than any stock phrase, and a phrase repeated three times in five minutes stops being language and starts being a script.
A. Relationship building
Greeting, purpose, respect, empathy. The first thirty seconds, and every time a feeling appears.
| The move | Say | Not this |
|---|---|---|
| Open, and say what this is | Hello, my name is Adam, I am one of the nurses on the ward. I would like to talk about how you are getting on today. Is that all right? | Starting on the first task bullet with no greeting and no purpose. |
| Acknowledge a feeling | That sounds really difficult. · It is completely understandable that you feel that way. · I can see this is worrying you. | “I understand your concerns” a third time. Once is empathy; three times is a script. |
| Stay non-judgemental | A lot of people find that hard to keep up. · It is very common to feel like that after an operation. | “You should have told us.” “Why did you stop taking it?” |
| Ask permission | Is it all right if I ask you a few questions about that? · Would you mind if we go through it together? | Firing the questions without asking. |
B. The patient’s perspective
Find the worry, follow the cue, say it back, and let it shape what you explain first.
| The move | Say | Not this |
|---|---|---|
| Find the worry | What is worrying you most about this? · What have you heard about it? · What were you hoping we could do today? | Assuming the worry from the card and never asking. |
| Pick up a cue | You mentioned you did not sleep. Tell me a bit more about that. · You said “it might come apart”: can I ask what you mean? | Letting the cue pass because it is not on your list. |
| Say it back | So what worries you most is the pain at night. Is that right? · If I have understood you, you are frightened of damaging the joint. | Moving to the explanation without showing you heard. |
| Tie the explanation to the worry | You said you were worried about the pain, so let me explain what we can do about that first. | Explaining in the order on the card rather than in the order of the patient’s fears. |
C. Providing structure
Say what is coming, say when you move, sum up before you close.
| The move | Say | Not this |
|---|---|---|
| Signpost the whole | There are two things I would like to cover: first how you are feeling, and then the plan for today. | A conversation with no visible shape. |
| Signpost a change | Can I move on to the pain relief now? · Before we talk about the plan, can I check a couple of things? | Changing topic without warning. |
| Sum up so far | So, to sum up so far: the pain was bad last night, and you are worried the joint is not strong yet. | Reaching the end with no summary. |
| Organise an explanation | There are three things that help. The first is timing. The second is the exercises. The third is what you tell us. | One long unbroken explanation. |
D. Information gathering
Open before closed, one at a time, clarify the vague, summarise and invite correction.
| The move | Say | Not this |
|---|---|---|
| Open before closed | Can you tell me how the night was? · then: Was the pain worse when you moved, or all the time? | Starting with yes/no questions and never widening. |
| One question at a time | How would you describe the pain? (pause) · And where is it worst? | “Is it sharp or dull and does it wake you and have you taken anything?” |
| Clarify the vague | When you say “a lot”, how many times a night? · When you say “terrible”, what did it stop you doing? | Accepting “a lot” and “terrible” as data. |
| Summarise and invite correction | So, if I have got this right, the pain wakes you two or three times, and it is worst when you bend the knee. Have I missed anything? | Summarising and moving on without “have I missed anything?” |
E. Information giving
What do they know, then pieces, then a check that is not “OK?”.
| The move | Say | Not this |
|---|---|---|
| Find out what they know | What do you already know about why we get people moving so soon? | Explaining from zero to someone who already knows. |
| Chunk, then pause | Let me explain the first part, then I will stop and see if that makes sense. | Delivering the whole explanation in one breath. |
| Gloss every medical word | The physiotherapist, that is the person who will help you with the exercises, will come at ten. | A term the patient does not know, left standing. |
| Check understanding | How does that sound to you? · Could you tell me in your own words what you will do before she arrives? | “OK?” and taking silence as yes. |
| Invite reactions | How do you feel about that plan? · Is there anything about it that worries you? | Ending on the plan with no room to object. |
| Find the next need | Is there anything else you would like to ask me? · Would it help if I explained what happens tomorrow? | Closing because your bullets are done, not because theirs are. |
The rule under the whole bank. One acknowledgement, then a question. Never two acknowledgements in a row, and never an acknowledgement that is not followed by something that uses what the patient just said.
Five lines on the paper, and the first thirty seconds decided.
The preparation time is where the clinical criteria are won. Candidates who use it to rehearse sentences arrive at the role-play with a speech and no plan. The plan is five lines.
Read for the worry
The setting and the patient line first
Before the bullets, read who the patient is and what state they are in: reluctant, anxious, in pain, misinformed. That is the worry you will have to find and say back, and it tells you what your first question is.
Line one: the patient’s probable worry, in your words.
Sort the bullets
Find out, get across, agree
Every bullet is one of three things: something to find out, something to get across, or something to agree. Mark each. The find-outs come first in the role-play, whatever order the card lists them in.
Lines two to four: what I must find out, what I must get across, what we must agree.
Write your first sentence
Greeting, name, purpose, and then the first open question
The only sentence worth scripting is the first one, because it sets the register and buys the relationship-building marks before anything else has happened. Line five is that sentence and the open question that follows it.
“Hello, I am the nurse looking after you today. I would like to talk about getting up and moving, if that is all right. First, can you tell me how last night was?”
The card, the first ninety seconds, and why it is a B.
A nursing card, invented for this page, then the opening of a role-play I wrote against it. Ninety seconds is where the five clinical criteria are set up or lost; read it for the moves, not the words.
The candidate’s card
A model I wrote, at Grade B · the first ninety seconds
NurseGood morning, Mr Hale. I am the nurse looking after you today. I would like to talk about getting up and moving this morning, if that is all right with you. But first, can you tell me how last night was?
PatientAwful. The pain was terrible, I hardly slept. I would rather just rest today, to be honest.
NurseThat sounds like a really hard night, and I can see why you want to rest. When you say the pain was terrible, was it there all the time, or mainly when you moved?
PatientMainly when I moved. And I keep thinking, if I put weight on it, what if the new knee just comes apart?
NurseSo there are two things: the pain when you move, and a worry that the joint is not strong enough yet. Have I got that right? (Patient: yes.) Thank you for telling me, because they are both things we can do something about. Can I take the worry about the joint first, and then come back to the pain?
- A Greeting, name, purpose and permission in the first three sentences, then an open question. Relationship building is banked before the task begins.
- D “How was last night?” is open. “All the time, or mainly when you moved?” closes in on one thing. “Terrible” is not accepted as data; it is clarified.
- B The patient volunteers a cue, “what if it comes apart”, and it is picked up and said back, not stepped over. The worry the card only hinted at is now on the table in the patient’s own words.
- C A summary of two items, an invitation to correct it, and a signpost for the order the explanation will take. The conversation now has a visible shape.
- E Nothing has been explained yet, and that is correct. Ninety seconds in, the nurse knows what the patient fears and has asked which to take first. The information giving that follows will be tied to a worry the patient named.
- Language Nothing above is Band 8 English. Short sentences, one structure each, no idiom. Grade B in this sub-test is won on the moves.
What it tends to do here, and the one habit that fixes it.
Interference is predictable by language, which is the method this whole site is built on. These are tendencies, not verdicts, and one habit each is enough to start.
Turkish
Articles disappear, and the intonation flattens
Turkish has no articles and marks little with pitch, so the English comes out as “I check wound tomorrow” on a level tone that can sound abrupt to an English ear, which costs Appropriateness as well as grammar. The empathy phrases above are the counterweight, delivered with a falling tone.
The habit: a, an or the before every singular noun you name to the patient. The Turkish patterns →
Tagalog and other Philippine languages
He and she swap, and the past slips into the present
Tagalog does not mark gender in its pronouns or tense the way English does, so “he” for a female patient and “she take it yesterday” are the two errors an assessor hears first. Neither blocks understanding; both cost Resources of grammar and expression.
The habit: say the patient’s name in your head as “she, Mrs Cruz” before you speak, and put the time word first: “Yesterday she took it.”
Hindi, Malayalam and other Indian languages
Syllable timing, and the tag question
A syllable-timed rhythm gives every syllable equal weight, which flattens English word stress and makes a warm sentence sound clipped; “isn’t it?” as a universal tag and “only” in unusual positions are the grammar signatures. Intelligibility and Appropriateness are the criteria affected.
The habit: stress the content words and let the rest go quiet. The word stress rules are written for exactly this.
Arabic
P and b, and the article that goes the wrong way
Arabic has no p, so “pain” and “bain” merge, and it uses the definite article where English uses none, giving “the diabetes is common”. The present simple also stands in for the continuous: “I take blood now”.
The habit: a puff of air on every p, checked with a hand in front of the mouth; and “am doing” for anything happening now.
Spanish
The extra vowel, and the false friend
“E-stress” and “e-special” before an s-cluster, “explain you” without “to”, and “actually” used to mean currently. In a consultation the last one misleads: “actually you have an infection” means something else in English.
The habit: “at the moment” for now, and “explain to you” every time. The Spanish patterns →
The moves are learnable. The proof is a recording.
The twelve role-play cards each carry the patient’s brief for a practice partner and a sheet to mark yourself on all nine criteria, and the deck page reads a transcript of your run against the clinical criteria. In a lesson, I am the patient: we run a card live, I bring the worry and the difficulty the real interlocutor would, and then we mark the recording together, criterion by criterion.
Lessons are £20 for fifty minutes, one to one with a native British tutor, with a written report after each. The first lesson doubles as a full assessment of where your role-play actually sits against Grade B. The OET hub covers the other three sub-tests; the Writing page has the letter, worked and marked.