Understand the format, assessment criteria, and strategies. Practise with sample dialogues and expert tips for the nursing role-play.
The OET Speaking sub-test is profession-specific and designed to reflect real workplace communication scenarios. For nurses, it consists of two role-play scenarios that simulate typical interactions you would have with patients, their families, or colleagues in a healthcare setting.
Each role-play assesses your ability to communicate effectively in English within a nursing context. Unlike general English tests, OET Speaking evaluates both your language proficiency and your clinical communication skills - how you build rapport, explain medical concepts, show empathy, and achieve your professional objectives.
The speaking test takes approximately 20 minutes in total and is recorded. You speak with an interlocutor who plays the role of the patient, relative, or colleague. The interlocutor follows a script to ensure consistency across all candidates.
Understanding the exact structure of the speaking test will help you feel confident and prepared:
The interlocutor introduces themselves and asks general questions about your professional background. This is NOT assessed but sets a comfortable tone. Answer naturally and use this time to adjust to speaking.
You receive a role-play card detailing the scenario, your task, and patient information. Use this time to plan your approach and identify key information you need to gather or convey.
You interact with the interlocutor in character. Initiate the conversation, work through your tasks, and respond to the patient's concerns and reactions.
You receive a second role-play card and have 3 minutes to prepare.
The second role-play begins. This may involve a different type of interaction, such as speaking to a relative or dealing with a difficult patient.
Your performance is assessed against nine criteria grouped into two categories: Linguistic and Clinical Communication. Understanding these criteria helps you focus your preparation effectively.
| Criterion | What It Measures | Band 350+ (B) |
|---|---|---|
| Intelligibility | Pronunciation, stress, rhythm, accent | Easy to understand; minimal interference from first language accent |
| Fluency | Speed, flow, natural pauses | Natural pace; appropriate pauses; minimal hesitation |
| Appropriateness of Language | Register, politeness, formality | Consistently appropriate language for the context |
| Resources of Grammar and Expression | Grammar accuracy and vocabulary range | Wide range of structures; accurate grammar; effective paraphrasing |
| Criterion | What It Measures | Band 350+ (B) |
|---|---|---|
| Relationship Building | Rapport, empathy, respect | Consistently demonstrates empathy; shows genuine interest; creates trust |
| Understanding and Incorporating Patient's Perspective | Listening, acknowledging concerns | Actively elicits and responds to patient's concerns and feelings |
| Providing Information | Clarity, checking understanding | Explains clearly; chunks information; checks understanding regularly |
| Gathering Information | Questioning skills, clarifying | Uses open and closed questions effectively; follows up appropriately |
| Initiating the Interaction | Opening, setting agenda | Confident opening; clearly states purpose; sets appropriate agenda |
The role-play card contains all the information you need for the interaction. Learning to read it efficiently during your preparation time is crucial.
Setting: Where the interaction takes place (e.g., Medical Ward, Discharge Clinic)
Patient: Name, age, and brief context
Your Role: Your position and what you need to do
Tasks: 3-5 specific objectives (e.g., explain diagnosis, address concerns, provide advice)
Patient Information: Medical history, current condition, concerns, emotional state (what the interlocutor knows)
The tasks are your objectives. You must complete as many as possible within the time limit. Prioritise them mentally during preparation.
Use your 3 minutes wisely with this structured approach:
Read the setting, patient details, and ALL tasks. Underline key medical information and the patient's emotional state.
Decide how you will introduce yourself and start the conversation. Note 2-3 key phrases you will need (e.g., explaining a procedure, reassuring a worried patient).
Consider how the patient might respond. What concerns might they raise? How will you respond empathetically? Think about potential questions they might ask.
Clinical communication skills are unique to OET and account for a significant portion of your score. Master these techniques:
- Use the patient's name throughout
- Make appropriate eye contact and show engaged body language
- Express empathy: "I can see this has been difficult for you."
- Show warmth and professionalism from the first moment
- Ask open questions: "How are you feeling about this?"
- Invite questions: "What concerns do you have?"
- Listen actively and acknowledge: "I understand why you'd be worried about that."
- Avoid interrupting when the patient is speaking
- Break information into small chunks
- Check understanding after each chunk: "Does that make sense?"
- Use simple language and avoid jargon when possible
- Use analogies: "The pacemaker works like a tiny conductor keeping your heart in rhythm."
- Start with open questions, then narrow with closed questions
- Clarify and summarise: "So what you're saying is..."
- Show you are listening by picking up on cues
- Prioritise information based on clinical importance
Study these sample dialogues to understand the level of communication required. Note the clinical language, empathy markers, and structure.
Scenario: Explaining discharge plans to a patient who is anxious about going home
Nurse: "Good morning, Mr. Henderson. I'm Sarah, one of the registered nurses on the ward. How are you feeling today?"
Patient: "Morning. I'm a bit better, but I'm quite worried about going home, to be honest."
Nurse: "I completely understand your concerns, and it's very natural to feel that way after being in hospital. I'm here to talk through your discharge plan and make sure you feel confident and well-supported. Do you have any specific worries you'd like to discuss first?"
Patient: "Well, I'm worried about managing my medications. There are so many now."
Nurse: "That's a very valid concern, and I'm glad you brought it up. Let me explain your medications one by one. First, you'll continue the metformin for your diabetes, one tablet twice daily with meals. Does that match what you were doing before?"
Patient: "Yes, I've been on that for years."
Nurse: "Good. The new medication is rivaroxaban, which is a blood thinner to prevent clots. You'll take one tablet every evening with food. It's important not to miss any doses. I've arranged for the pharmacist to provide you with a blister pack that organises everything by day and time. Would that be helpful?"
Patient: "Oh yes, that would make things much easier."
Nurse: "Excellent. Now, I've also referred you to the district nursing team. They'll visit you at home tomorrow and then twice weekly to check your wound and monitor your recovery. You'll also have a follow-up appointment with your GP in one week. Is there someone at home who can support you?"
Patient: "My daughter lives nearby. She said she can help."
Nurse: "That's wonderful to hear. Having family support makes a real difference. Before you leave, I'll give you a written discharge summary with all this information, plus our contact number if you have any concerns. Do you feel a bit more reassured now?"
Scenario: Speaking to a patient's daughter about a change in her father's condition
Nurse: "Mrs. Clarke? I'm Nurse Williams. Thank you for coming in. Would you like to sit down? I'd like to talk with you about your father's condition."
Relative: "Is something wrong? The phone call sounded urgent."
Nurse: "I can hear that you're worried, and I want to be completely honest with you. Overnight, your father's breathing became more difficult, and we've had to increase his oxygen. The doctor has assessed him this morning, and there have been some changes in his condition that we need to discuss."
Relative: "Is he... is it serious?"
Nurse: "I won't hide from you that we are concerned. His lungs are working harder than we'd like, and the infection appears to have progressed despite the antibiotics. The medical team is now considering transferring him to the intensive care unit for closer monitoring. I know this is a lot to take in. How are you feeling right now?"
Relative: "I'm scared. He seemed okay yesterday."
Nurse: "I can only imagine how frightening this must be. It's important to know that we're doing everything we can. The ICU team has excellent expertise in supporting patients through this kind of situation. The doctor will be along shortly to explain the medical details in more depth, and you can ask them any questions you have. Would you like me to stay with you until they arrive?"
Relative: "Yes, please. Thank you."
Nurse: "Of course. Is there anyone else you'd like me to contact? Would you like a cup of tea while we wait?"
Scenario: A patient has not been taking their antihypertensive medication regularly
Nurse: "Hello, Mr. Patel. I'm Nurse Johnson. I'm here to do your routine blood pressure check and have a chat about your medications. How have you been?"
Patient: "I've been alright, nurse. A bit tired maybe."
Nurse: "I'm sorry to hear you've been tired. Let me take your blood pressure first. [pause] I'm seeing that your reading is 165 over 95, which is higher than we'd expect given that you're on medication. Can we talk about how you've been managing your tablets?"
Patient: "Well... I do take them, but sometimes I forget. And I stopped the one that makes me need the toilet all the time."
Nurse: "Thank you for being honest with me, Mr. Patel. That really helps. Let me reassure you about the water tablet first - the frequent urination usually settles down after the first week or two as your body adjusts. Not taking it means fluid is building up, which makes your blood pressure rise. Would you be willing to try it again if I explain what to expect?"
Patient: "I suppose so, if it gets better."
Nurse: "It should do. For the forgetting, many patients find it helpful to link taking medication to something they do every day, like brushing their teeth, or to use a pillbox with days of the week. Would either of those ideas work for you?"
Patient: "The pillbox sounds like a good idea, actually."
Nurse: "Excellent. I'll arrange for one from the pharmacy. We'll also book you in for a medication review with our practice pharmacist next week to go through everything. Is there anything else making it difficult to take your tablets?"
"Good morning, I'm [Name], one of the registered nurses."
"Hello, I'll be looking after you today."
"I've come to talk with you about..."
"I can see this has been difficult for you."
"That sounds really challenging."
"I understand why you'd feel that way."
"It's completely understandable to feel anxious."
"Does that make sense?"
"Is there anything you'd like me to clarify?"
"Would you like me to go over that again?"
"Do you have any questions so far?"
"What concerns do you have?"
"Is there anything worrying you?"
"How do you feel about this?"
"What questions would you like to ask?"
"We'll make sure you're comfortable."
"You're in good hands."
"This is a routine procedure."
"We'll be with you throughout."
"Do you have any other questions?"
"I'll be back to check on you shortly."
"Here's the call bell if you need anything."
"Thank you for talking with me."
nausea, dizziness, shortness of breath, chest pain, palpitations, oedema, fatigue, lethargy, constipation, diarrhoea
blood test, ECG, X-ray, MRI scan, ultrasound, biopsy, catheterisation, wound dressing, suture removal, vaccination
dosage, frequency, side effects, interactions, contraindications, compliance, adverse reaction, prescription, generic, brand name
blood pressure, heart rate, respiratory rate, oxygen saturation, temperature, consciousness level, urine output
A&E, ward, ICU, HDU, outpatient clinic, community, rehabilitation, hospice, discharge, referral
mobility, hygiene, nutrition, hydration, pain management, pressure care, falls risk, infection control
Some candidates spend too long on one task and run out of time. Prioritise and manage your time within the role-play.
Rushing through tasks without building rapport or responding to the patient's emotions will lower your clinical communication score significantly.
The patient (interlocutor) is playing a layperson. You must adapt your language and explain terms simply. Check understanding regularly.
YOU must start the interaction. Waiting for the interlocutor to speak first will lose marks for "Initiating the Interaction."
Failing to elicit and address the patient's perspective is a major error. Always ask "Is there anything worrying you?" or similar.
OET Speaking is scored out of 500, with most UK nursing regulators requiring 350 (Grade B). You need strong performance across ALL nine criteria:
| Grade | Score Range | Nursing Council Requirement |
|---|---|---|
| A | 450-500 | Exceeds requirements |
| B | 350-440 | Accepted by most UK NMC, AHPRA, Irish NMBI |
| C+ | 300-340 | Below requirement for most regulators |
| C and below | 0-290 | Not accepted |
OET Speaking is profession-specific (nursing role-plays) and assesses clinical communication skills alongside language. IELTS Speaking is a general English test about personal topics. Many nurses find OET more relevant and achievable.
You should use professional language but adapt it for the patient. If you use a medical term, explain it in plain language. The interlocutor is playing a layperson and won't understand technical terms.
The interlocutor will signal when time is running out. Do your best to complete all tasks, but quality of communication matters more than quantity. A well-handled conversation with 2 tasks beats a rushed one with 4 tasks.
No. The interlocutor follows a standardised script and is trained to behave consistently. You are scored on YOUR performance, not on the interaction outcome.
Learn useful structures and phrases, but don't memorise entire dialogues. The role-play is interactive, and the interlocutor's responses are unpredictable. Prepare flexible language you can adapt.
Yes, within reason. If the patient says something you genuinely don't understand, it's appropriate to ask them to repeat or clarify. This demonstrates good communication skills.
Practise nursing role-plays with our AI tool and get feedback on your clinical communication and language skills.
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