These mistakes cost nurses their Grade B every single test session. Learn them, avoid them, and pass your OET first time.
Avoid OET MistakesThousands of nurses retake the OET because of avoidable mistakes. Each mistake on this list has caused a Grade C instead of a Grade B. Read carefully and ensure none of them appear in your test.
Impact: Using abbreviations like "BP" instead of "blood pressure", "BD" instead of "twice daily", or "mg" instead of "milligrams" is one of the most common reasons nurses fail the Writing sub-test. OET examiners penalise abbreviations heavily because a referral letter must be understood by all healthcare professionals, including those who may not know your shorthand.
How to avoid: Write EVERYTHING in full. "Blood pressure" not "BP". "Twice daily" not "BD". "Milligrams" not "mg". "Intravenous" not "IV". Before submitting your letter, scan specifically for abbreviations and expand every single one. Create a personal "no abbreviations" checklist and review it before every practice letter.
Impact: Many nurses simply copy the case notes into letter format without transforming them into professional prose. Case notes are abbreviated, telegraphic, and often incomplete. A letter written in case-note style reads as unprofessional and scores poorly on Language (up to 40% of the Writing mark).
How to avoid: Transform every case note into a complete sentence. "BP 150/90" becomes "Her blood pressure was elevated at 150/90 mmHg." "C/o chest pain" becomes "She complained of chest pain." Read your letter aloud — if it sounds like notes rather than a professional letter, rewrite it. Every sentence must be grammatically complete with a subject and verb.
Impact: Including every case note without selection makes the letter unfocused, overly long, and confusing for the reader. Examiners specifically look for your ability to select relevant information — a key clinical skill. Irrelevant information dilutes the letter's purpose and reduces your score for Organisation and Layout.
How to avoid: Before writing, read the task card to understand the letter's PURPOSE. Only include case notes relevant to that purpose. If the letter is a referral for chest pain investigation, the patient's history of a broken ankle 10 years ago is probably irrelevant. Ask yourself: "Does this information help the recipient do their job?" If not, leave it out. Less is more in OET Writing.
Impact: The opening line of your letter must clearly state its purpose. Failing to include a clear purpose statement ("I am writing to refer..." / "I am writing to discharge...") immediately limits your Organisation and Layout score. The recipient should know why they're receiving this letter within the first two sentences.
How to avoid: Always open with a clear purpose sentence that names the patient, their key details, and the reason for writing. Example: "I am writing to refer Mrs. Sarah Johnson, a 67-year-old woman, for specialist cardiac assessment following recent episodes of chest pain." This single sentence establishes the entire context of the letter. Memorise opening formulas for each letter type (referral, discharge, transfer, update).
Impact: The word count for OET Writing is 180-200 words. Writing fewer than 180 words suggests insufficient detail. Writing more than 200 words suggests poor information selection. Both errors affect your score. Many nurses write 150 words (too brief) or 250+ words (too long) without realising.
How to avoid: Count your words during practice until you develop intuition for the length. In the exam, quickly count after writing: average words per line x number of lines = approximate word count. Aim for 190 words — comfortably within the range. If you're under 180, add one relevant detail. If you're over 200, remove the least relevant information.
Impact: Nervous candidates often speak too quickly, which reduces clarity, increases errors, and makes them sound less confident. The OET Speaking criteria assess Intelligibility and Fluency — both suffer when you rush. Fast speech also uses up your 3-minute roleplay time too quickly, leaving tasks unfinished.
How to avoid: Consciously slow down your speaking pace. Aim for a moderate, natural conversational speed — the same pace you'd use when explaining something important to a patient. Pause between sentences. Breathe. Use your preparation time (2-3 minutes before each roleplay) to plan your approach so you're not rushing to think of what to say next. Practice with a timer to get comfortable with the 3-minute timeframe.
Impact: Each Speaking roleplay card lists 2-4 specific tasks you must complete during the 3-minute interaction. Missing even one task significantly reduces your score for Relationship Building and Task Fulfilment — two of the five Speaking criteria. Many nurses get absorbed in rapport-building and forget to address all tasks.
How to avoid: During your 2-3 minute preparation time, identify ALL tasks on the card and number them. During the roleplay, mentally tick off each task as you complete it. If time is running short (30 seconds remaining), prioritise completing unfinished tasks over extending rapport. The examiner is scoring you against those specific tasks — they must all be addressed.
Impact: In the Speaking sub-test, you're often speaking to a patient or relative who wouldn't understand medical terminology. Using unexplained jargon ("hypertension", "tachycardia", "oedema") demonstrates poor communication skills and reduces your score on Information Gathering and Providing Information criteria.
How to avoid: Always explain medical terms in plain English. "You have high blood pressure — that means the pressure in your blood vessels is higher than it should be." "Your heart rate is fast — we call that tachycardia." Check understanding: "Does that make sense?" or "Do you have any questions about what I've explained?" This is exactly what the OET Speaking test assesses — your ability to communicate effectively with patients.
Impact: In Listening Part A, you must write answers while listening to a consultation. Medical terms that are misspelled are marked WRONG — even if you heard them correctly. Common misspellings like "diabetes" (not "diabetis"), "pneumonia" (not "pnemonia"), and "hypertension" cost easy marks.
How to avoid: Build a personal list of commonly misspelled medical terms and review it regularly. During practice, write out medical terms repeatedly until the spelling is automatic. In the exam, if you're unsure of a spelling, write your best guess — a guessed spelling has a chance; a blank has none. Review the 50 most common medical conditions and ensure you can spell each one correctly.
Impact: Reading Part A has a STRICT 15-minute time limit. Unlike Parts B and C, which share 45 minutes, Part A is collected separately after exactly 15 minutes. Nurses who spend too long on Part A lose marks they can never recover. Many candidates fail to attempt the final questions because time runs out.
How to avoid: Practice Reading Part A with a STRICT 15-minute timer — never more. Develop a strategy: skim all 4 texts in 3 minutes, then tackle the matching questions first (usually quickest), followed by short-answer questions. If a question takes more than 1 minute, mark your best guess and move on. Speed is essential in Part A — practice until 15 minutes feels comfortable.
Writing is where most nurses lose marks. This section gives you targeted strategies for each aspect of the referral letter.
Before finalising your letter, run through this 30-second checklist: (1) Word count between 180-200? (2) No abbreviations? (3) Clear purpose in opening? (4) All relevant case notes included? (5) All irrelevant notes excluded? (6) Complete sentences throughout? (7) Appropriate closing request? (8) No spelling errors? This checklist catches 90% of preventable mistakes.
The Speaking sub-test assesses your professional communication skills. Avoid these common pitfalls to score highly on all five criteria.
Examiners can tell when you're reciting memorised phrases. While it's good to have opening phrases ready, your delivery must sound natural and adapted to the specific situation. Vary your language. Respond to what the simulated patient actually says, not just what you planned to say. The best OET Speaking candidates sound like they're having a real conversation, not giving a presentation.
In nursing scenarios, empathy is scored under Relationship Building. Many nurses focus so much on completing the clinical tasks that they forget to acknowledge the patient's feelings. Use phrases like "I understand this must be difficult for you," "That sounds really challenging," and "I'm here to help you through this." These empathy statements take 5 seconds but score significant marks.
At the end of each roleplay, check that the patient understood what you told them. Ask: "Does that make sense?" or "Do you have any questions?" or "Can you tell me in your own words what you'll do?" This Information-Gathering technique demonstrates patient-centred communication and scores highly. Many candidates forget this step entirely.
Although OET Speaking primarily assesses language, your tone of voice and body language influence how the examiner perceives your Intelligibility and Interactive Listening. Speak with warmth and variation in your tone. Maintain appropriate eye contact. Use natural hand gestures. Smile when appropriate. These non-verbal cues demonstrate professionalism and engagement.
Writing is the most commonly failed sub-test for nurses, followed by Speaking. Writing fails usually involve abbreviations, poor case note selection, or incorrect letter format. Speaking fails usually involve not completing all tasks on the roleplay card or insufficient expansion of answers.
The official OET guidance states that abbreviations should NOT be used in the Writing sub-test. Even one or two abbreviations can affect your score under the Language criterion. The safest approach is zero abbreviations. Write everything in full — always.
Absolutely. Many nurses who score Grade C in Writing have the English level for Grade B but lose marks through technique errors — abbreviations, case-note style writing, irrelevant information, and poor structure. Fixing these mistakes alone can raise your score by a full grade without improving your vocabulary or grammar.
Very strict. Part A answer sheets are collected after exactly 15 minutes, regardless of whether you've finished. You cannot return to Part A after moving to Part B. This is why timed practice is essential. Many nurses fail to finish Part A simply because they didn't practice under timed conditions.
Yes, memorising professional opening and closing formulas is highly recommended — it's not the same as memorising essay templates. Having a reliable opening structure ("I am writing to refer [name], a [age]-year-old [patient type], for [reason]") ensures you never forget the purpose statement. Have formulas ready for each letter type: referral, discharge, transfer, and update.
Complete ALL tasks on the roleplay card. During your preparation time, number each task and check them off during the interaction. Relationship building and rapport are important, but Task Fulfilment is a separate scoring criterion. A friendly nurse who doesn't complete the clinical tasks will not achieve Grade B.
Every mistake you prevent is a mark gained. Every mark gained brings you closer to Grade B and your UK nursing registration.
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