Essential Speaking Strategies Doctors

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Strategies for the Speaking Component of OET (Doctors) This document has been designed to help doctors prepare for the speaking subtest of the Occupational English Test (OET)

Outline

1. Roleplay format and structure 2. Assessment Criteria 3. Possible Roleplay Scenarios 4. Example task 5. Useful expressions 6. Dos & don’ts

This resource was developed by OET Online Website: http://www.oetonline.com.au Email: [email protected]

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Roleplay Format and Structure The speaking sub-test consists of two roleplay scenarios. The interviewer will take the part of the patient and the candidate takes his/her professional role as a doctor. The interview is usually about 20 minutes long and stuctured as follows: 1. Identification check (not assessed) 2. Brief chat regarding the candidate’s medical career (not assessed) 3. The first roleplay including 2/3 minute preparation time and 5-6 minute roleplay (assessed) 4. The second roleplay including 2/3 minute preparation time and 5-6 minute roleplay (assessed) During the preparation time you must read the roleplay card handed to you and you can make notes on the card or underline key words. You may ask questions to interviewer if there is anything you are unsure about, especially vocabulary. This is important because if you misunderstand the situation it could effect how you approach the task. The roleplay scenarios are based on real situations you are likely to encounter in you work as a doctor in Australia. There are a variety of possible settings for the roleplay as follows: • Suburban Medical Clinic • General Practice • Emergency Department of a Hospital • Hospital Ward • Hospital Outpatients You can use this information to guage the seriousness of the situation and how to begin the roleplay. For example if it is a general practice you may already know the patient so an introduction may not be necessary. You could begin with: How are you today, Steven. On the other hand if it were an emergency department of a hospital it might be more appropriate to say: Hello, I am Doctor X and I have been looking after your daughter/son/husband. However, regardless of the situation, don’t rely on the interviewer to start the roleplay. That is your job. You need to control the structure of the roleplay as you are the person in charge. A typical roleplay structure is as follows: • Brief introduction dependant on the task. • Ask questions to make an initial diagnosis . • Respond carefully to the patient’s responses. • Provide an explanation of the condition & respond to further questions and concerns of the patient. • Provide advice and reassurance as required. • Short simple concluding sentence. You only have 5-6 minutes to complete the roleplay so it is important to follow the task closely and not spend too long on any one section. If the roleplay lasts more than 6 minutes the interviewer may signal you to end the roleplay. This could be a problem if you have not finished key aspects of the task.

This resource was developed by OET Online Website: http://www.oetonline.com.au Email: [email protected]

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Your speaking will be judged using the following criteria:

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This resource was developed by OET Online Website: http://www.oetonline.com.au Email: [email protected]

Overall Communicative Effectiveness

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For this criterion, you need to demonstrate your capability to handle a typical conversation between a doctor and a patient. This means you must lead the conversation based on the roleplay scenario on your card. You must ask questions clearly to find out the patient’s condition and /or main concern. You must also respond appropriately to questions from the patient (interviewer). This refers to how clearly you speak and can be broken down into the following categories: Intelligibility • Pronunciation • Intonation • Syllable and word stress • Rhythm While you are not expected to speak like a native speaker, it is expected that what you say can be clearly understood. Therefore you need to ensure that you pronounce words clearly, particulary words specific to a medical consultation. For all people from non English speaking backgrounds there are some sounds, stress patterns or rhythm which are difficult. It is important that you identify which aspects of English are difficult for you and work hard to improve in those areas. Recording your own speech is a useful starting point. This is a challenging category. You need to practice roleplay scenarios regularly so that you have the confidence to respond Fluency to the scenario and patient with a reasonable degree of fluency. If your speech contains too many hesitations and pauses you will be marked down. On the other hand, if you rush your speech there is a risk that you won’t be understood. Nervousness is often a cause of fluency problems and the best way to overcome this is regular practice using a variety of roleplay scenarios. Appropriateness This criterion refers to your choice of vocabulary and manner of speech. The roleplay is a formal situation so you need to use formal expressions and avoid overly casual expressions. For example: Overuse of yeah can sound casual. Yes is more appropriate. Or Wanna Vs would like to It is also important to explain medical conditions, treatments and medications using non medical terminology so that patient without any medical knowledge could easily understand. For example: If you say: You are febrile the patient would probably not understand. It is much better to say:You have a fever. Another common error is incorrect use of pronouns. Him when the patient is a female or Her when the patient is a male. If you have difficulties with pronouns, write them down in large letters on your role-play card as a reminder!

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This relates to how accurately you speak. To achieve a B score you will need to demonstrate good grammatical control in your speech. Common errors occur in the following areas: • Asking questions: What seems to be the problem?/How long have you been….? Practice in this area is essential. • Verb tense: You will need to demonstrate flexibility and accuracy in all verb tenses. Be especially careful with present perfect Vs simple past and passive forms • use of articles: Do you have headache Vs Do you have a headache • Countable/uncountable nouns: Let me give some advices Vs Let me give you some advice • Verb subject agreement: Your condition have worsened Vs Your condition has worsened

This resource was developed by OET Online Website: http://www.oetonline.com.au Email: [email protected]

Resources of grammar and expression

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Possible Roleplay Scenarios

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Measles/ Mumps/Chicken Pox Arthritis Conjunctivitis Angina

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Migraine Gastro-enteritis High blood pressure Acne

Main task requirements Doctor Patient Take a careful history of current conditions • Respond to doctor’s questions Explain the condition in detail • Express concern about seriousness of hepatitis Reasons not to return to work • Desire to returnto work Explanation • Unaware of immunisation Benefits of immunisation • Worried about side effects Reassurance • Be difficult to reassure Explain diagnosis • Explain concerns • Request referral to specialist Reaasure condition is not serious and referral not required • Be difficult to persuade Recommend treatment Question as to cause of injury • Find out the seriousness of the injury Explain treatment procedure • When will it get better? Refuse painkiller…rest is the best treatment • Request pain killer so you can play in a sporting event

Other possible tasks include: • Child’s Diet & Nutrition • Eczema • Suicide attempt • Anaphylatic shock in small child

Sprained wrist in teenager

Dermatitis in baby

Immunisation for child

Hepatitis A in Businessman

Condition

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There are a wide range of possible roleplay tasks. They are always original so you never know what your tasks will be. However you can prepare by be familiar with common scenarios. Below are examples of what you can expect and the roles of the doctor and patient. It is common for there to be some conflict between what the patient wants to hear and what the doctor has to say. Therefore the doctor will need to explain clearly the condition, reassure the patient where required and at times persuade the patient to follow a certain course of action which they may not want to do. You will be assessed on how well you are able to meet these requirements.

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Example Task Setting:

Suburban General Practice

Doctor A young father visits you with his 6 weeks old baby daughter. His wife wants to begin the recommended immunization program immediately because she has to return to work in 6 months and feels it will be necessary protection for her daughter. She also thinks that the child care agency will not accept her daughter without evidence of vaccination. The father is worried about the possibility of serious complications due to immunization. Task

• Explain why vaccination is recommended • Reassure the father that side effects (if any) will be minimal • Explain the potential risks if the child is not vaccinated

Setting:

Suburban General Practice

Patient You have decided to visit your doctor with your 6 weeks old daughter. You know that your wife wants the baby to start on the recommended immunization program immediately. She is due to return to work in 6 months and will need to place the baby in a childcare agency. She says the baby needs protection and that the child care agency probably won’t accept a child who has not had the recommended vaccinations. You are concerned as your brother has an autistic boy aged seven. Your brother and his wife believe it was a reaction to the vaccinations that brought on the autism. Task • Express your concerns regarding vaccination • Explain what happened to your brother’s child • Be difficult to reassure that the risks are minimal • Enquire about possible alternatives

The task above is typical of what you can expect in the speaking sub-test. It requires the doctor to do the following : • Ask relevant questions to help you assess the situation and make a diagnosis • Provide a medical explanation regarding immunization • Reassure the patient that risks are minimal • Persuade the patient to have the child immunised

This resource was developed by OET Online Website: http://www.oetonline.com.au Email: [email protected]

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Useful Expressions The roleplay can be looked at as having three stages: • The introduction and initial diagnosis • The main body which includes an explanation of the condition, reassurance and recommended advice • The conclusion which may summarise the advice or the set up of a following appointment

Introductions It is very important to start the roleplay in confident manner. Also match the closing statement with the setting of the roleplay. Here are some standard ways to begin the conversation. At a suburban medical clinic or general practice • Good morning Madam, I’m Doctor Green. What brings you here today? • Good morning Sir. I’m Doctor Green. How can I help you today? • Good morning John, please sit down. I’m Dr Green. How are you today? • Hello Steven, you’re here regarding your blood test results aren’t you. In a hospital ward • Hello Maria, how are you feeling today? • Hello John, you are looking better today. How do you feel? Asking questions about the patient’s problem (heartburn example) • When did you first have the problem? • What do you understand by 'heartburn'? • When have you been getting it? • Have you ever noticed any particular kind of other discomfort or pain, perhaps associated with the heartburn? • When you say 'after meals' - is that long after? • You're not regularly over-eating, are you? More detailed questions • Do any particular foods seem to bring on your heartburn? • Now, have you noticed that any particular foods that trigger the heartburn especially fast?

This resource was developed by OET Online Website: http://www.oetonline.com.au Email: [email protected]

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Main Body The main body needs to be well organised and structured in order to convey the information clearly. Informing the patient Based on my examination you are suffering from……. The blood test results indicate that child has……… The tests show that it is probably a condition known as…… Describing the condition In most roleplay scenarios you will need to explain a medical condition in some detail. This will take up to a third of the roleplay (1-2 minutes of essentially a monologue) so it essential that you do it in a clear and well organised manner as outlined below: The blood tests results indicate that you have Hepatitis A. Do you know anything about this condition? No? Okay I will explain it to you. It is a condition caused by…. The symptoms include……. The best treatment is to……. It is highly contagious so you need to…. Reassuring the patient • It’s nothing to get alarmed about. It’s just a routine check. • There really is nothing to worry about. It’s a standard procedure • Let me reassure you, if you follow my advice the risks of heart attack will be greatly reduced. Persuading the patient • If you return to work you run the risk of doing further damage to you health. • What is more important? The risk of permanent damage to your arm or a single game of cricket? • Let me reassure you, if you follow my advice the risks of heart attack will be greatly reduced. However if you do not follow my advice, and continue to smoke and drink heavily, then the risk of heart attack is much higher.

This resource was developed by OET Online Website: http://www.oetonline.com.au Email: [email protected]

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Concluding the Roleplay The important thing to remember is to make the closing sentence short and concise. Also match the closing statement with the setting of the roleplay.Here are some examples of how to do this: At a suburban medical clinic or general practice • Please make an appointment with reception to see me in a week. Goodbye. • Here is your precription. Take it to your chemist and they will give you the medication. All the best. • Thanks for coming to see me today. Goodbye. • Please come and see me again in a week. • I would like to see your child again in two months time. Take care now. In a hospital ward. • I’ll come back and check on your condition later today. • If there is any change in your condition please let me know. • If you need me again, just press the buzzer.

This resource was developed by OET Online Website: http://www.oetonline.com.au Email: [email protected]

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There are many ways to successfully approach the speaking task. Below are a list of simple points to remember to help you suceed on the day. Do Read the roleplay card carefully and ask the interviewer if you are unsure of any of the words or expressions in the task. Practise as many tasks as possible with a partner to ensure you are familiar with the speaking test. Remember it is very different to IELTS and requires different language skills, such as the ability to persuade, convince and reassure. Take charge of the roleplay. You are a medical professional and should act accordingly. Refer to your card during the exam so that you can work through the requirements one by one. Base you introductions and conclusions based on the settting of the roleplay and the information in the card. Use expressions such as: • based on my examination….. • My examination indicates that… to show that you have examined the patient. Act confidently and if you are unsure of the details of the condition, just make it up! Remember it is a test of English not your medical knowledge. Correct a grammatical or vocabulary mistake immediately if you are aware that you have made one. (Native speakers certainly do this!) Use a formal tone as it is quite a formal situation. Stay focussed on the task at hand. You only have 5-6 minutes to complete the task! This resource was developed by OET Online Website: http://www.oetonline.com.au Email: [email protected]

Don’t Plan what you are going to say in advance. React to the scenario on your roleplay card and plan your role accordingly. Ignore the task requirements and say what you think based on your medical knowledge. Remember it is a test of English language ability and not a place to demonstrate your medical knowledge. Wait for the interviewer to lead the roleplay. This is your job. Try to memorise the whole card. You can refer to it as required during the roleplay. Begin the task with: What brings you here today? or conclude with: Please come and see me again in a week’s time if the setting is a hospital ward. Pretend you are conducting the examination during the roleplays as it is hard to make it realistic. Just simply say: Okay, I will now have a look at your child. Pause. Based on my examination it appears that your child has chicken pox. Show how nervous you are as this can negatively affect your result. Lots of practice is the best way to overcome nerves Use a lot of medical jargon. You need to use layman’s language to describe the condition. Use a lot of casual expressions such as yeah/ wanna as they are not appropriate to the situation. Spend too much time on unrelated matters such as a detailed medical history as you do not have time for this. 10