OET Speaking: what happens in the role-play, and what the assessors listen for

Of the four OET subtests, Speaking is the one that feels least like an exam. There is no paper. You sit with an interlocutor, there is a short warm-up conversation, and then you do two role-plays, each based on a card that describes a situation from your own profession. The interlocutor plays the patient, a relative or a carer; you play yourself at work. Each role-play lasts about five minutes, with a few minutes beforehand to read the card and prepare. The whole subtest takes around twenty minutes.

The role-plays are recorded, and the recording is marked afterwards by trained assessors, not by the person sitting opposite you. That matters: the interlocutor's job is to play the role, not to judge you, and they will not give you any signal about how you are doing. This guide describes the format and the nine assessment criteria as OET publishes them. Confirm the current details, and listen to the sample role-plays, on occupationalenglishtest.org.

The role-play card

Your card tells you the setting, who the patient is, what has happened so far, and a short list of tasks: things you need to find out, explain, reassure the patient about, or agree with them. The interlocutor has a different card with the patient's side of the story, including concerns, questions and sometimes resistance that you do not know about in advance.

The tasks on your card are the backbone of the conversation. A role-play that covers every task, in a sensible order, while responding to what the patient actually says, is what the criteria reward. A role-play that delivers the tasks as a monologue while the patient's questions go unanswered is not.

The four linguistic criteria

These are the criteria you would expect in any speaking test, and they are scored on a scale from 0 to 6:

• Intelligibility: pronunciation, stress, rhythm and intonation, judged by how easily a listener follows you, not by accent. An accent is not a problem; an unclear word is.
• Fluency: whether speech flows at a natural rate, with pauses in the places a native speaker would pause, rather than hesitation inside every sentence.
• Appropriateness of Language: whether the words and tone fit a healthcare conversation with this person. Plain language for a patient, respectful and professional throughout.
• Resources of Grammar and Expression: the range and accuracy of the grammar and vocabulary you use, judged by whether you can say what the situation needs.

The five clinical communication criteria

These are what make OET different from a general English test. They are scored on a scale from 0 to 3, and they come from research into what patients experience as good communication from a clinician:

• Relationship building: a proper greeting, introducing yourself and your role, showing respect and empathy, and keeping the patient's dignity through difficult topics.
• Understanding and incorporating the patient's perspective: asking about and responding to the patient's own ideas, worries and expectations, rather than talking past them.
• Providing structure: signposting what will happen in the conversation, moving between topics clearly, and summarising.
• Information gathering: open questions first, then focused ones; not interrupting; checking that you have understood.
• Information giving: finding out what the patient already knows, explaining in chunks, checking understanding, and avoiding jargon.

The pattern across these five is that they reward listening. The assessor is checking whether you noticed what the patient said and did something with it.

The mistakes that cost the most

• Reciting the card. Working through the tasks in order regardless of what the patient says scores badly on perspective, structure and information gathering all at once.
• Jargon. Using clinical terms with a patient without explaining them, or using abbreviations, costs marks under Appropriateness and Information giving.
• Not checking understanding. Explaining something and moving straight on, with no "does that make sense so far?" or a question that lets the patient show what they took in.
• Missing the emotional cue. When the patient says they are frightened or frustrated, acknowledging it briefly before continuing is worth more than any amount of accurate information delivered over the top of it.
• Speaking in long, prepared blocks. Natural speech is shorter turns. If you find yourself delivering a paragraph, stop and ask the patient something.

How to practise

Reading about the criteria is a start, but speaking improves only by speaking, and ideally by speaking to someone who behaves like a patient: who interrupts, worries about the wrong thing, and has questions that are not on your card. Practising with a colleague who reads the patient card is good. Recording yourself and listening back against the nine criteria is better than it sounds, because fluency problems and missing check-backs are obvious from outside and invisible from inside.

Clodia's role-plays put you opposite a simulated patient who responds to what you say, by voice, with a card drawn from your own profession and timed like the real thing. Afterwards you get a mark against each of the nine criteria with your own words quoted, which makes it clear whether the next thing to work on is a linguistic criterion or a clinical communication one.

The criteria, sample role-play cards and sample recordings on occupationalenglishtest.org are the authority. Use them alongside anything you practise elsewhere.