The OET Speaking sub-test evaluates your English proficiency using predefined standards known as the OET Speaking Assessment Criteria. While the Listening and Reading sections have set answers, in the Writing and Speaking sub-tests, variations in individual responses are expected. Hence, the OET uses a set of criteria to assess and score your answers based on factors like choice of words, grammar, organization of information, etc. This ensures a fair and standard assessment of your proficiency in English.

In this lesson, we’ll examine the assessment criteria for OET Speaking, deciphering them to assist you in effectively applying them for a higher score.

The OET Speaking sub-test is assessed based on two sets of criteria

Scores for linguistic criteria range from 0 to 6, while clinical communication criteria are scored from 0 to 3. 

To attain a score of 350 (OET Grade B) in Speaking, it’s essential to excel in both sets of criteria.

About the Linguistic Criteria

Linguistic Criteria in the Speaking Sub-test outlines how assessors will evaluate your language proficiency. The criteria are designed to cover the fundamental linguistic skills that you will require to communicate effectively in a healthcare workplace.

OET assessors will evaluate your ability to engage in conversation and communicate relevant information to patients or their relatives. Achieving high scores in these four criteria will demonstrate your competency as a healthcare professional. 

These criteria are equally weighted and evaluated by OET assessors on a scale of six.

01. Intelligibility

The focus of this criterion is how well you can communicate and be understood. This means being able to speak in a way that is easy to understand. It includes things like how you say words, how you use the pitch of your voice, and how you stress certain words to make your meaning clear.

Assessors will look at whether you:

• Say words clearly, especially the endings of words, the vowels, and the stress on words.
• Speak loud enough and not too fast so that people can hear you clearly.
• Use the tone of your voice to make your meaning clear.
• Speak in a way that sounds natural.

It’s okay to have an accent when speaking English, but it shouldn’t make it difficult for the listener to understand you. In many cases, your accent won’t affect communication.

02. Fluency

This criterion is about how someone speaks. Speaking assessors look at whether you talk:

• not too fast or too slow so people can understand you easily
• with pauses or hesitations that make sense for the situation, not because you are struggling to find words or structures (shown by sudden stops and starts, using too many filler words, or repeating words or phrases too much).

03. Appropriateness of Language

This refers to how well you can use language that is appropriate for the situation and the person you are speaking with. 

For example, can you explain medical information in a way that someone without medical knowledge can understand? 

It also includes using the right tone of voice for the situation and being able to change your tone when needed.

04. Resources of Grammar and Expression

This standard pertains to your ability to use language effectively and accurately. 

Examiners evaluate whether:

• • Your vocabulary and grammar are sufficient to convey ideas clearly and without confusion, and whether language limitations hinder communication.
• • You can restate ideas in a different way when necessary.
• • You can speak using longer sentences with the help of connecting words in an appropriate manner.
• • You can use common phrases and sayings correctly.

About the Clinical Communication Criteria

The Clinical Communication Criteria sets the OET Speaking Sub-test apart as the best English test for healthcare professionals. These five criteria will test your communication skills. Good communication is about more than just your delivery of the English language. It’s also about how you start a conversation, interact with patients (or their relatives), and check if someone needs additional help. It reflects the real-world demands of healthcare communication.

In the Clinical Communication Criteria, your speaking will be assessed on 5 sets of indicators, 

• 1. Indicators of Relationship Building
• 2. Indicators of Understanding & Incorporating the Patient’s Perspective
• 3. Indicators of Providing Structure
• 4. Indicators of Information Gathering
• 5. Indicators of Information Giving

For each criterion, you will be scored as

• 3 – Adept use
• 2 – Competent use
• 1 – Partially effective use
• 0 – Ineffective use

Note: the Clinical Communication Criteria solely assesses language proficiency and communication skills, not the evaluation of your medical knowledge.

01. Indicators of Relationship Building

• Initiating the interaction appropriately (greeting, introductions, nature of interview)

How well you have initiated the interview is assessed here. Properly initiating an interview is important for building a positive relationship with the patient and creating a comfortable setting. The initiation process includes greeting the patient, introducing yourself, confirming the patient’s name, and explaining your role in their care. Then, the purpose of the interview should be described and, if needed, discussed.

• Demonstrating an attentive and respectful attitude

Signs of attentiveness and respectful attitude in your speaking during the interaction are noted. During the interview process, it is important to display attentiveness and respect towards the patient to establish trust, create a foundation for a collaborative relationship, and ensure that the patient understands your willingness to help. Instances of such behavior could include acknowledging the patient’s comfort, seeking consent and permission before proceeding, and showing sensitivity towards sensitive or uncomfortable topics.

• Adopting a non-judgemental approach

Your ability to provide a non-judgemental atmosphere during the role-plays is evaluated here. Accepting the patient’s perspective and views reassuringly and non-judgementally without initial rebuttal is a key component of relationship building. A judgemental response to patients’ ideas and concerns lessens their contributions. 

A non-judgemental response would include accepting the patient’s perspective and acknowledging the legitimacy of the patient to hold their own views and feelings.

• Showing empathy for feelings/predicament/emotional state

It is important to exhibit empathy when interacting with a patient as it is a crucial aspect of building a strong relationship (Interpersonal relationships). Empathy involves the ability to understand and appreciate another person’s situation or emotions in a sensitive manner and then communicate that understanding back to the patient in a supportive manner. 

Nonverbal and verbal behaviors can both be used to accomplish this. Even with audio alone, certain nonverbal cues such as silence and appropriate tone of voice can be used to respond to a patient’s expression of emotions. Verbal empathy makes this more explicit by specifically acknowledging and appreciating the patient’s emotions or situation.

02. Indicators of Understanding & Incorporating the Patient’s Perspective

• Eliciting and exploring the patient’s ideas/concerns/expectations

Gaining insight into a patient’s viewpoint is an essential aspect of patient-centered healthcare. Illness affects individuals in different ways, including their emotions, thoughts, worries, and impact on their daily lives. Patients may share this information either unprompted or in response to questions from healthcare professionals.

• Picking up the patient’s cues

Assessment of your ability to recognize verbal and non-verbal cues from patients is done here. Patients usually express their thoughts and emotions indirectly through hints or changes in non-verbal behavior, like changes in tone or hesitation. Being able to pick up on these cues is vital for exploring both the biomedical and the patient’s perspectives.

• Relating explanations to elicited ideas/concerns/expectations

This assesses whether you have addressed the worries and expectations that you have gained from the patient. One of the primary motives behind understanding the patient’s viewpoint is to incorporate it into explanations, especially in the latter stages of the interview. 

If the explanation fails to cater to the patient’s specific ideas, apprehensions, and expectations, then their recall, understanding, and satisfaction will be compromised as they will still be preoccupied with their unaddressed concerns.

03. Indicators of Providing Structure

• Sequencing the interview purposefully and logically

Your proficiency in organizing the interview in a systematic manner and in collecting or providing information to the patient in a logical order will be observed. You as a health professional are responsible for maintaining a consistent and coherent approach that is readily apparent to the patient throughout the interview. A structured approach to consultation assists both you (the professional) and the patient in efficient and accurate data collection and dissemination. However, this approach should be balanced with the need to prioritize the patient’s needs and preferences. 

Flexibility and logical sequencing must be thoughtfully integrated to ensure a successful outcome. A lack of sequencing is more apparent when the health professional wanders aimlessly or jumps between different areas of the interview, causing the patient to become uncertain about the purpose of specific lines of inquiry.

• Signposting changes in topic

The ability to guide patients through an interview is a valuable skill that involves making the structure of the conversation clear. It’s important for both the healthcare professional and the patient to understand the direction of the conversation and why it’s taking that direction. Signposting statements are a useful tool for introducing topics and drawing attention to upcoming information. Additionally, signposting can be used to transition from one section to another and provide reasoning for the upcoming section.

• Using organizing techniques in explanations

You can and should use various skills to organise their explanations in a way that helps patients to remember and understand the information. 

These skills may include 

• Categorization – the health professional informs the patient about the different types of information that they WILL BE providing.
• Labeling – this involves the health professional explicitly highlighting important points using emphatic phrases or adverb intensifiers (absolutely, completely, extremely, highly, really, so, too, totally, utterly…).
• Chunking – involves delivering the information in small sections with clear gaps (pause) between each section, before repeating and summarising the key points.

04. Indicators of Information Gathering

• Facilitating the patient’s narrative with active listening techniques, minimizing interruption

It’s important for health professionals to listen to the patient’s narrative. This enables you to efficiently discover the patient’s situation, hear the patient’s perspective, and show support and interest. Interruptions, while the patient is speaking, can have the opposite effect and often result in a predominantly biomedical history, thus omitting the patient’s perspective. 

Active listening techniques that can be observed include,

• Silence and pausing – this will give the patient a chance to speak.  
• Verbal encouragement – “um,” “uh-huh,” and “I see,”
• Echoing and repetition – “You said you are worried?”, “not feeling well”
• Paraphrasing and interpretation such as restating – “So you are worried that you will have another attack again?”

• Using initially open questions, appropriately moving to closed questions

It is crucial to know when to use open and closed questioning styles during an interview. An effective healthcare professional begins by using open questioning to understand the patient’s perspective on the problem. As the interview progresses, the questioning style becomes more focused, with specific yet still open-ended questions. Closed questions are used later to obtain additional details that the patient may have missed. 

Using open questioning techniques at the beginning of an interview is crucial, and rushing to closed questions too soon is a common mistake.

• Closed questions are designed to elicit a specific, often one-word response, such as “yes” or “no.”
• Open questioning techniques, on the other hand, ask questions without limiting the patient’s response. They guide the patient toward a specific topic but allow for more explanation in the answer. This approach encourages the patient to elaborate on their answers and feel more at ease.

• NOT using compound questions/leading questions

When multiple questions are asked together without any time for the patient to answer, it is called a compound question. This type of questioning can lead to confusion in the patient about the specific information required.

For instance, asking “Do you have any allergies to medications, and if so, which specific drugs cause adverse reactions?” is a compound question.

A leading question is one that assumes the answer, potentially influencing the respondent’s reply. These questions can inadvertently steer the conversation or bias the information gathered.  Here’s an example: “You didn’t finish the course of antibiotics I prescribed, did you?”

In this leading question, the assumption is that the patient didn’t finish the antibiotics. A more neutral and open-ended alternative would be: “Did you finish the course of antibiotics I prescribed?”

• Clarifying statements which are vague or need amplification

It is crucial for health professionals to possess the ability to gather precise information by asking follow-up questions when patients give vague or incomplete responses to open-ended questions. In order to fully understand the patient’s statement, health professionals may need to ask for additional details, clarity, or accuracy. Patients’ statements can often have multiple interpretations, so it is essential to clarify the intended meaning.

• Summarising information to encourage correction/invite further information

Summarizing is a crucial information-gathering skill that involves providing the patient with a clear, concise verbal summary of the information that has been gathered so far. 

This technique is used periodically throughout the interview to serve two primary purposes: to ensure accuracy and to encourage the patient to provide further responses.

5. Indicators of Information Giving

• Establishing initially what the patient already knows

Assessing the prior knowledge of the patient is a useful approach to providing them with information. This method helps in determining the appropriate level to present the information, the amount and type of information needed by the patient, and the extent to which their perception of the problem differs from yours.

• Pausing periodically when giving information, using the response to guide next steps

Chunking and checking, a commonly used approach, is an essential skill during the information-giving stage of an interview. During this stage, a medical professional delivers information in small pieces, pausing and verifying understanding before moving on. The professional is guided by the patient’s reactions to determine what information is needed next. This technique is a critical component of assessing the patient’s information requirements. By providing information in small chunks and allowing the patient to contribute, they will give clear signals about the amount and type of information they still need.

• Encouraging the patient to contribute reactions/feelings

It is important to give patients the opportunity to ask questions, seek clarification, or express doubts while providing them with information. Health professionals should be clear about this as some patients may be hesitant to speak up and ask their doctors questions. If patients aren’t invited to ask questions, they may leave their consultation without having their concerns addressed, leading to a reduced understanding and commitment to the proposed plans.

• Checking whether the patient has understood information

Ensuring the accuracy of information transfer involves checking if the patient has comprehended the given information. Patients often respond with a “yes” even if they are unsure because they don’t want to admit their lack of understanding. A more effective approach is to employ patient restatement where the patient is asked to repeat back to you what has been discussed to ensure mutual understanding. 

• Discovering what further information the patient needs

Asking the patient directly about any additional information that might be useful can help the health professional uncover areas that require attention and that may have been overlooked. It is challenging to anticipate the specific requirements of each patient, hence direct questioning is an effective method to avoid missing any crucial details.

OET Speaking sub-test assesses your language as well as your communication skills in the clinical settings. Your understanding of these assessment criteria will help you prepare for the test more effectively and perform well in the exam. Understanding and incorporating these criteria not only improves your chances in the OET test, but they are valuable tools in your interactions with the patients in your professional settings too.