Majority of OET candidates believe information gathering means asking questions. However, this notion is only partially correct. Always try to compare your interaction with patients as an interaction of 2 people who visually don’t know each other. Would any normal human being be comfortable to discuss their personal life, habit confidential issues or sensitive topic with someone whom they meet for the first time? Certainly not!
Therefore, the information gathering should be done in a way which helps you as a healthcare professional to build that initial sense of trust. Firstly, be an alternative listener use phrases such as ‘UM’, ‘I see’ to convey the message that you are listening to their narrative interestingly. This, in turn, will motivate the patient to open up.
- Questioning itself is a skill. Do not compare the questioning of OET Test with your actual consultation. In a real consultation, you may ask multiple questions to rule out other disease conditions, but in OET, you have always been provided with a diagnosis. So, limit your questions to the particular disease condition.
For example, in real scenarios, if a patient presents with chest pain you may ask a number of questions to confirm if they are related to lungs, ribs, muscles, or heart. However, in the case of OET the role play card would mention that they have angina. So you limit your questions to the symptoms related to angina and the impact of this pain on the patient’s daily routine. It is important to note that if certain information is given, that does not mean you can’t ask questions related to those symptoms. You should plan a set of 8 -10 questions which would help you to get an overall idea about the patient’s condition.
- Questions should be framed as per the clinical communication skill framework. Always start with an open-ended question and then encourage patients to describe further details by slowly moving towards a targeted or closed question. Often, the patient may have underlying grief or guilty or they may have been an introvert person. In that case, you should be tactful in eliciting the information.
“Okay, I see that you are suffering from cough for 3 days, but as this is your first visit, I would like to ask more questions to get a detailed picture. May I?
“I can see that your child has got a cut on his hand. Can you tell me how did it happen?”
“I can see that you are very upset, can you tell me what exactly are you worried about?”
Generally, you should follow this sequence while questioning.
- Reason for presenting
What brings you here today?
When did you first notice the rash?
How long have you had this rash?
Apart from your hands do you have rashes on any other body parts?
Is the rash painful or itchy?
- Cause / aggravating factor
Do you know what may have caused this?
(This question will help you to understand patient’s perspective about the situation and sometimes can give you a very important clue about their disease condition)
What makes it worse?
What seems to bring on the rash?
- Associated symptoms
Apart from rash, do you have any fever or cough?
- Impact on ADL / Work / Sleep
This question is optional. Based on which type of task you have. You can include/exclude this question.
Does it affect your routine?
Does it wake you up at night?
- The treatment they may have received?
So what did you do for the rash?
Did you seek any treatment?
Have you taken anything to treat the rash?
- Occasionally the patients may give a vague history or may not clearly explain the situation. For this reason, you should ask a further question to clarify your doubts.
For example, if a patient tells you their job is very stressful, do not come to the conclusion that they have a lot of work.
Instead, ask “May I know why do you find it stressful?
As a result, you will get to know if the reason is that the patient’s boss is very demanding / the patient may have fatigue / colleagues may not be supporting / the shifts may have odd timing or the patient may not be enjoying the work they do.
It is equally important to respond to what the patient tells you in an appropriate way.
DO NOT SAY “OKAY” for everything.
“Oh I see that must be very difficult for you”
“I am sorry to hear that your father had cancer”
“So, you have been unable to sleep because of this pain? That must be very frustrating”
- Finally, once the patient has described all the relevant information, summarize it in your own words in order to confirm that you have clearly understood their complaints.
Throughout the role play, make sure you are not using ‘cliché’ such as ‘I understand your concern’. It is also important to form grammatically question. Practise forming different question types with present and past tense.
Acumen – English for Healthcare Professionals
Follow this blog post for more on OET Speaking Evaluation.