OET - Achieve 350+ in Speaking, Listening, Reading & Writing

Answer the OET Reading test available on the PDF document.

A sample OET letter. You can find both the notes and the sample letter on the PDF document.

A sample OET letter. You can find both the notes and the sample letter on the PDF document.

A sample OET letter. You can find both the notes and the sample letter on the PDF document.

Sample letter

OET NURSING WRITING: HOW TO STRUCTURE A REFERRAL LETTER

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Welcome. If you are preparing for the OET Nursing exam, you are in exactly the right place.

Today we are going to break down one of the most important and most tested letter types in the OET Writing subtest — the referral letter. By the end of this video, you will know exactly how to structure it, what language to use in each section, and what mistakes to avoid so you can walk into your exam with confidence.

Make sure you watch until the end, because I am going to walk you through a full example based on a real-style OET case note, so you can see how everything fits together in practice.

Let us get started.

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SECTION 1: WHAT IS THE OET WRITING TASK?

First, a quick overview of the OET Writing subtest so we are all on the same page.

You will be given a set of case notes about a patient. These notes are written in a typical nursing shorthand — abbreviations, bullet points, incomplete sentences. Your job is to use those notes to write a professional letter.

The letter is always addressed to a specific person, such as a doctor, a specialist, a community nurse, or a social worker. The most common letter types are:

— Referral letters, where you are sending a patient to another healthcare professional for further assessment or treatment.

— Discharge letters, where you are summarising a patient's hospital stay and what they need after they leave.

— Transfer letters, where you are handing over care to another facility.

Today we are focusing on the referral letter, which is the type you are most likely to see in your exam.

You have 45 minutes for the Writing subtest. In that time, you need to read the case notes carefully, plan your letter, write it, and check it. The expected length is around 180 to 200 words. Not 300 words. Not 120 words. Around 180 to 200. Quality over quantity.

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SECTION 2: THE PURPOSE OF A REFERRAL LETTER

Before we talk about structure, you need to understand the purpose of a referral letter, because understanding purpose is what separates a good letter from a great one.

When you write a referral letter, you are not copying everything from the case notes. You are acting as the nurse who cared for this patient, communicating with another professional who is about to take over or contribute to that patient's care.

Think about what the recipient needs to know. They need to know:

— Who the patient is and why they are being referred.

— What has already happened — the diagnosis, the treatment, the tests.

— What you want the recipient to do — the specific action you are requesting.

— Any urgent concerns or red flags they need to act on quickly.

Your letter must be professional, clear, and purposeful. Every sentence should earn its place. If a piece of information from the case notes is not relevant to the referral, leave it out.

This is one of the biggest mistakes candidates make — they copy everything from the case notes into the letter, and the result is a disorganised, unfocused letter that loses marks for communication and task completion.

Select. Organise. Prioritise. That is the mindset.

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SECTION 3: THE STRUCTURE OF A REFERRAL LETTER

Now let us get into the structure. A well-structured OET referral letter has five key parts. I want you to remember these five parts and practise them every time you sit down to write.

PART 1 — THE OPENING

This is your first paragraph, and it should be short — two or three sentences at most.

You introduce the patient: their name, age, and the reason for the referral. You also name yourself and your role if it is not already clear from the sender's details.

A strong opening sounds like this:

"I am writing to refer Mrs Elena Suarez, a 68-year-old woman, for specialist assessment and management of her worsening knee pain. Mrs Suarez has been under the care of our orthopaedic ward for the past two weeks following a fall at home."

Notice what that opening does. It tells the recipient immediately: who the patient is, why you are writing, and the relevant context. No padding. No vague language. Straight to the point.

PART 2 — BACKGROUND AND MEDICAL HISTORY

This is where you provide the clinical context. You give the relevant history — the patient's diagnosis, any significant past medical history, current medications, and allergies if relevant to the referral.

The key word is relevant. You do not list every single medication in the case notes if they are not related to the reason for referral. You select what the recipient needs to know.

Useful language for this section includes:

"Mrs Suarez has a background of type 2 diabetes and hypertension, both of which are currently well controlled."

"She was diagnosed with osteoarthritis of the left knee three years ago and has been managing her symptoms with physiotherapy and oral analgesics."

Keep this section factual and organised. Use past tense for things that have already happened and present tense for current conditions.

PART 3 — REASON FOR REFERRAL AND CURRENT PRESENTATION

This section is the heart of your letter. Here you explain what has changed or what the current problem is — why this patient needs to see the person you are writing to, right now.

Be specific. Do not write: "She is not doing well." Write:

"Over the past four days, Mrs Suarez has reported a significant increase in pain, rated 8 out of 10, which is no longer adequately managed with her current pain relief regimen. She has been unable to weight-bear and has become increasingly immobile."

This section should also include any relevant test results, observations, or clinical findings that support the referral. For example:

"An X-ray taken on admission revealed moderate-to-severe joint space narrowing with subchondral sclerosis, consistent with advanced osteoarthritis."

Give the recipient the evidence. They need to understand why this referral is necessary and urgent.

PART 4 — WHAT YOU ARE REQUESTING

This is where many candidates lose marks because they forget to include it or they are too vague about it.

You must clearly state what you want the recipient to do. This might be:

— A specialist assessment and treatment plan

— A home visit or follow-up appointment

— Wound care management

— Medication review

— Counselling or social support

Be direct and specific. For example:

"I would be grateful if you could review Mrs Suarez with a view to considering surgical options, including potential knee replacement, as conservative management no longer appears sufficient."

Or for a community referral:

"I would appreciate a home visit to assess Mrs Suarez's living situation and provide ongoing wound care following her discharge."

The recipient should finish reading your letter knowing exactly what action they need to take.

PART 5 — CLOSING

Keep this short and professional. You offer to provide further information if needed, and you use a polite closing phrase.

For example:

"Please do not hesitate to contact me should you require any further information. I look forward to your assessment."

Then sign off with: "Yours sincerely," followed by your name and designation.

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SECTION 4: A FULL EXAMPLE

Now let us put it all together. I am going to walk you through a sample letter based on a typical OET-style scenario.

SCENARIO:

Patient: Mr James Fowler, 74 years old

Admitted to your surgical ward following a perforated bowel — treated and recovering well

Concerns: lives alone, low mood noted, poor nutritional intake, needs support at home post-discharge

Task: Write a referral letter to a community nurse requesting home support and a nutrition assessment.

Here is how the letter looks:

Dear Community Nurse,

I am writing to refer Mr James Fowler, a 74-year-old man, for community nursing support and nutritional assessment following his recent discharge from St Andrew's Surgical Ward.

Mr Fowler was admitted on 18 May 2026 following emergency surgery for a perforated bowel. He underwent a successful sigmoid colectomy with primary anastomosis and has been recovering well, with his surgical wound healing appropriately. His relevant past medical history includes hypertension and mild cognitive impairment. He is currently prescribed amlodipine 5mg daily and paracetamol 1g as required for pain management.

Mr Fowler lives alone in a ground-floor flat and has limited social support. During his admission, nursing staff noted a significant decline in his nutritional intake, with Mr Fowler consuming less than 50% of his meals consistently over the past five days. He has also displayed signs of low mood and expressed anxiety about managing at home independently. A formal nutrition screening using the MUST tool yielded a score of 2, indicating high risk of malnutrition.

I would be grateful if you could arrange an initial home visit within 48 hours of discharge to assess Mr Fowler's nutritional status, provide wound care as needed, and evaluate his overall capacity for independent living. Referral to a dietitian and consideration of social services input may also be warranted.

Please do not hesitate to contact me should you require any additional information.

Yours sincerely,

[Your Name]

Registered Nurse, St Andrew's Surgical Ward

Let us look at what that letter does well. The opening is clear and identifies the patient and the purpose immediately. The background gives relevant clinical history without copying everything from the case notes. The current presentation focuses on the specific concerns — nutrition, mood, and social support. The request is specific — home visit within 48 hours, wound care, nutritional assessment, possible dietitian and social services input. And the closing is professional and brief.

That letter is approximately 260 words — slightly over the target, but strong in content. In your exam, aim for around 200 words of high-quality, purposeful writing.

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SECTION 5: COMMON MISTAKES TO AVOID

Let me quickly run through the most common mistakes I see in OET referral letters, so you know exactly what to avoid.

MISTAKE ONE — Copying case notes directly.

The case notes use shorthand and abbreviations. Your letter must use full, professional sentences. "Pt SOB, O2 sats 91%" belongs in the case notes. In your letter, write: "The patient presented with shortness of breath, with oxygen saturations recorded at 91% on room air."

MISTAKE TWO — Including irrelevant information.

If the patient has a history of a broken arm from twenty years ago and it has nothing to do with the referral, leave it out. Every sentence must serve the purpose of the letter.

MISTAKE THREE — Being too vague about the request.

"I would like you to see this patient" is not enough. Say what you want done, why, and with what level of urgency.

MISTAKE FOUR — Neglecting professional tone.

Avoid informal language. No contractions like "can't" or "doesn't." No casual phrases. Write as a healthcare professional communicating with a colleague.

MISTAKE FIVE — Ignoring the word count.

Forty words is too short. Three hundred and fifty words is too long. Practise writing concisely and hitting that 180 to 200 word target.

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And that is your complete guide to structuring a referral letter for the OET Nursing Writing subtest.

To recap: you need five clear sections — the opening, the background, the reason for referral and current presentation, the specific request, and a professional closing. Select information carefully from the case notes, write in full professional sentences, and make sure your request is clear and specific.

Good luck with your preparation. You have got this.

Welcome to your OET Speaking and Writing preparation course!

OET SPEAKING: FULL ROLE-PLAY PRACTICE

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Welcome back. Today we are doing something a little different, and honestly one of the most requested videos on this channel — a full OET Speaking role-play from start to finish.

Here is exactly what we are doing today. First, I am going to show you the role-play card, just like you would see it in the real exam. Then we are going to watch a complete role-play between a nurse and a patient — a high-scoring performance. And then — this is the part that will really change how you prepare — I am going to go through the dialogue line by line and explain exactly why each part earns marks, and how this performance would score 350 or even 400 and above on the OET Speaking scale.

If you have ever wondered what the examiners are actually listening for, stay with me, because this video answers that question completely.

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SECTION 1: THE ROLE-PLAY CARD

Here is the scenario. Read this carefully, because this is exactly how the role-play card is presented in the OET exam.

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ROLE-PLAY CARD — CANDIDATE (NURSE)

Setting: Outpatient Diabetes Clinic, City General Hospital

Patient: Mr Daniel Harper, 52 years old, office worker

Situation:

Mr Harper attended a routine health check last week. His blood test results have come back and show elevated blood glucose levels consistent with a new diagnosis of Type 2 Diabetes. He has been asked to come in today to speak with the nurse before seeing the doctor.

Your role:

— Greet and establish rapport with Mr Harper.

— Explore his understanding of and reaction to the blood test results.

— Explain the diagnosis of Type 2 Diabetes in simple, clear language.

— Address his concerns about medication and lifestyle changes.

— Explain the importance of follow-up and next steps.

— Provide appropriate emotional support throughout.

Note: Mr Harper is anxious. He has been worried since he received the call to come back in. He believes the diagnosis means he will need insulin injections immediately. He is also concerned that his job as a long-haul truck driver may be affected.

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So that is the scenario. A 52-year-old man, newly diagnosed with Type 2 Diabetes, anxious, with specific fears about injections and his career. A lot going on. Let us see how a high-scoring nurse candidate handles this.

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SECTION 2: THE FULL ROLE-PLAY DIALOGUE

The nurse in this role-play is Sarah. The patient is Mr Daniel Harper.

NURSE (Sarah):

Good morning, Mr Harper. My name is Sarah, I am one of the nurses here at the diabetes clinic. Please come in and take a seat — make yourself comfortable.

PATIENT (Daniel):

Good morning. Thank you.

NURSE:

Before we get started, I just want to say — I know being called back in after a blood test can feel a bit worrying, so I really appreciate you coming in today. How are you feeling?

PATIENT:

Honestly? Pretty anxious. I have been worrying since I got the call. I did not sleep well last night.

NURSE:

That is completely understandable, and I am glad you told me that. We are going to go through everything together today, and I want you to feel free to ask me anything at all as we go. There are no silly questions. Does that sound okay?

PATIENT:

Yes, thank you. I appreciate that.

NURSE:

Good. Now, before I explain anything, I would like to find out what you already know — or what you have been thinking — since you got the call. What has been going through your mind?

PATIENT:

Well, I looked it up online and I am worried it might be diabetes. And if it is — I think that means I will need insulin injections every day. And I really cannot have that, because I am a truck driver. Long distances. I do not know if I would even be able to keep my job.

NURSE:

I can hear that this has been a huge worry for you — both the idea of injections and what it might mean for your work. I want you to know that those concerns are really valid, and we are going to address both of them today. But first, let me just confirm what the results actually show, so we are working from the facts rather than what-ifs. Is that okay?

PATIENT:

Yes, please.

NURSE:

So your blood test did show elevated glucose levels, which is consistent with a diagnosis of Type 2 Diabetes. I know that might be difficult to hear, and it is okay to take a moment with that.

PATIENT:

Right. I thought so. So — I do need injections then?

NURSE:

That is actually a really common misconception, and I am glad you brought it up. Type 2 Diabetes is quite different from Type 1 in terms of how it is managed. With Type 2, the majority of people — especially when it is caught early like yours — start with lifestyle changes and, if needed, oral tablets. Insulin injections are not the automatic first step, and many people never need them at all.

PATIENT:

Oh. I did not know that. That is actually a relief.

NURSE:

I am glad that helps. Now, in terms of your driving — I can absolutely understand why that is on your mind. There are regulations around driving commercially with diabetes, and they do depend on how the condition is managed. The good news is that Type 2 Diabetes, when well-controlled, does not automatically mean the end of your career. We will make sure you have the right information and connect you with the appropriate people who can advise you on the licensing side of things specifically. You should not have to figure that out alone.

PATIENT:

Okay. That is reassuring. So what happens next? What do I actually have to do?

NURSE:

Great question. So today after speaking with me, you will see the doctor, who will go through your results in more detail and talk about a management plan. What that plan looks like depends on a few things — your overall health, other test results, and what is realistic for your lifestyle. But in general, the first steps for Type 2 Diabetes are around what we eat, physical activity, and monitoring blood glucose levels. These changes can make a really significant difference.

PATIENT:

I am not very good with diets, honestly.

NURSE:

You would not be the first person to say that, and that is not something you need to tackle alone either. We have a diabetes nurse specialist and a dietitian as part of the team here, and they are excellent at working with people to find an approach that is actually manageable — not a rigid plan that nobody sticks to. It is about small, sustainable changes rather than turning your life upside down.

PATIENT:

That actually sounds doable. I was imagining something much worse.

NURSE:

I completely understand. A lot of people come in expecting the worst and leave feeling like they have a path forward — and I hope today is the beginning of that for you. Is there anything else worrying you that we have not touched on yet?

PATIENT:

No, I think — you have actually answered the main things. I feel a lot better than when I walked in.

NURSE:

I am really pleased to hear that. Before you go in to see the doctor, let me give you a summary leaflet about Type 2 Diabetes — it covers everything we discussed today in writing, so you can refer back to it at home. And please, if anything comes up after you leave today, do not hesitate to call the clinic. We are here. Okay?

PATIENT:

Thank you so much, Sarah. I really appreciate it.

NURSE:

It is my pleasure, Mr Harper. Take good care.

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SECTION 3: SCORING ANALYSIS — WHY THIS SCORES 350 TO 400+

Now let us break this down. The OET Speaking sub-test is assessed on nine criteria, grouped into two categories: Linguistic Criteria and Clinical Communication Criteria. I am going to go through each one and show you exactly where in this dialogue you see the marks being earned.

--- LINGUISTIC CRITERIA ---

CRITERION 1 — INTELLIGIBILITY

This is about whether the speaker can be clearly understood. In the role-play, the nurse uses complete, well-formed sentences throughout. She does not trail off, mumble, or use heavily accented speech that obscures meaning. In a real exam setting, a candidate aiming for 350+ should aim for consistently clear pronunciation and natural stress patterns.

The line — "With Type 2, the majority of people — especially when it is caught early like yours — start with lifestyle changes and, if needed, oral tablets" — is a good example. It is complex, it contains an embedded clause, and it is delivered at a measured pace that allows the patient to follow it. Intelligibility is not about having a perfect accent. It is about being understood. This nurse is understood clearly throughout.

CRITERION 2 — FLUENCY

Fluency in OET Speaking means communicating without excessive hesitation, self-correction, or unnatural pausing. Notice that Sarah never starts a sentence and abandons it. She does not fill silence with "um" or "uh" repeatedly. When she pauses, it is purposeful — as when she says: "I know that might be difficult to hear, and it is okay to take a moment with that." That pause is communicative, not a fluency failure.

Candidates who score in the 350 to 400 range demonstrate fluency that flows naturally. They do not rush, and they do not stumble.

CRITERION 3 — APPROPRIATENESS OF LANGUAGE

This criterion assesses whether the candidate uses language that is suitable for the context and the listener. Notice how Sarah consistently adapts her language to a patient who is not medically trained.

She does not say: "Hyperglycaemia was detected consistent with a diagnosis of diabetes mellitus type 2."

She says: "Your blood test did show elevated glucose levels, which is consistent with a diagnosis of Type 2 Diabetes."

That is the same clinical information, delivered in patient-appropriate language. She also uses empathetic, warm phrasing throughout: "There are no silly questions." "It is okay to take a moment with that." "You would not be the first person to say that." This appropriateness is consistent from first line to last, which is what high scorers do.

CRITERION 4 — RESOURCES OF GRAMMAR AND EXPRESSION

This criterion looks at range and accuracy. Does the candidate use a variety of grammatical structures, or do they repeat the same simple patterns?

Look at the variety in this dialogue:

— Conditional: "If it is caught early... many people never need them at all."

— Passive: "There are regulations around driving commercially with diabetes."

— Hedging: "What that plan looks like depends on a few things."

— Empathetic concession: "I can hear that this has been a huge worry for you."

A candidate who uses only simple present tense and short sentences will plateau around 300 to 330. The grammatical range demonstrated here is consistent with a 350 to 400+ performance.

--- CLINICAL COMMUNICATION CRITERIA ---

CRITERION 5 — RELATIONSHIP BUILDING

This is one of the most important criteria for nurses, and it is assessed from the very first line.

Sarah's opening: "I know being called back in after a blood test can feel a bit worrying, so I really appreciate you coming in today. How are you feeling?" — this immediately signals warmth, acknowledgment of the patient's emotional state, and an invitation to share. That is relationship building in action, in the very first minute.

Later: "There are no silly questions" normalises the patient's uncertainty and makes him feel safe. And: "I am glad you told me that" reinforces that the patient's honesty is welcome. These are not throwaway phrases — in OET, they are evidence of a candidate who understands therapeutic communication.

A score of 350+ requires relationship building to be active and sustained throughout, not just at the start and end of the role-play. Sarah does this. Even in the closing — "Please, if anything comes up after you leave today, do not hesitate to call the clinic. We are here." — she is still reinforcing the relationship.

CRITERION 6 — UNDERSTANDING AND INCORPORATING THE PATIENT'S PERSPECTIVE

This criterion asks: does the candidate identify and respond to the patient's individual concerns? Or do they deliver a generic information script regardless of what the patient says?

The moment Mr Harper reveals his two specific concerns — insulin injections and his truck driving licence — Sarah does not skip over them to deliver her prepared information. She says: "I can hear that this has been a huge worry for you — both the idea of injections and what it might mean for your work. I want you to know that those concerns are really valid, and we are going to address both of them today."

She names both concerns explicitly. She validates them. And she follows through on addressing both — the injection misconception is corrected with clinical accuracy and empathy, and the driving concern is addressed with honesty about the regulations and an offer of appropriate referral. This is exactly what high scorers do: they make the patient feel heard and then they act on what they heard.

CRITERION 7 — PROVIDING STRUCTURE

OET assessors look for a clear, logical progression through the conversation. The candidate should establish rapport before diving into clinical information. They should check understanding at key points. They should not jump randomly between topics.

In this role-play, the structure is clear:

Step 1 — Rapport and emotional check-in.

Step 2 — Elicit the patient's existing knowledge and concerns.

Step 3 — Confirm the diagnosis clearly but sensitively.

Step 4 — Correct misconceptions (insulin injections).

Step 5 — Address the career concern with accurate and supportive information.

Step 6 — Explain next steps and management overview.

Step 7 — Normalise the lifestyle change concern and introduce the multidisciplinary team.

Step 8 — Check for remaining concerns.

Step 9 — Close with resources and an invitation to call back.

That is nine logical, purposeful steps — and the candidate moves through them naturally, without it feeling like a checklist. A score of 400+ requires this kind of structural clarity combined with genuine responsiveness to the patient.

CRITERION 8 — INFORMATION GATHERING

This criterion is about how the candidate finds out what the patient knows, feels, and needs — before launching into information giving. Poor candidates skip this entirely and go straight to explaining. High scorers ask first.

Sarah's key information-gathering moment: "Before I explain anything, I would like to find out what you already know — or what you have been thinking — since you got the call. What has been going through your mind?"

This is an open question. It invites a full response. And it works — the patient reveals both of his key concerns because Sarah created the space for him to do so. If she had not asked this, she might have delivered a generic explanation of diabetes without ever addressing the insulin misconception or the driving licence concern. The information gathering is what makes the rest of the conversation targeted and effective.

CRITERION 9 — INFORMATION GIVING

This final criterion looks at whether the information the candidate gives is accurate, clear, appropriately pitched, and well-timed.

Notice that Sarah gives information in response to what the patient needs, not in one undifferentiated block. She corrects the insulin misconception when it comes up naturally. She explains next steps when the patient asks "What do I actually have to do?" She introduces the dietitian when the patient says he struggles with diets. The information giving is responsive, not scripted.

She also checks in as she goes: "Is that okay?" and "Does that sound okay?" — these are comprehension checks that show the candidate is monitoring whether the patient is keeping up and is comfortable. That is high-level clinical communication.

The closing summary — offering a written leaflet, recapping what was discussed, and giving the patient a way to reach out — demonstrates that information giving does not end with the spoken word. This attention to reinforcing key points is consistent with 400+ scoring behaviour.

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So that is the full role-play and the complete breakdown. Let me give you the summary.

This performance scores 350 to 400 and above because the nurse demonstrates all nine criteria at a high level — consistently, from the first line to the last. She builds genuine rapport, gathers information before giving it, addresses the patient's specific concerns, uses appropriate and varied language, and structures the conversation with clarity and purpose.

The difference between a 300 and a 400 is not just language. It is clinical communication — the ability to treat the patient as a whole person, not just a set of symptoms to explain.

Practise this role-play yourself. Replay the video, pause at key moments, and try to match both the language and the communication approach.

Good luck with your preparation. You can do this.

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Bonus Lecture

Thank you for taking this OET preparation course.

I hope the lessons, practice tasks, model answers, and explanations have helped you feel more confident about the OET exam.

If you have a question about the course content, please use the Udemy Q&A section, as this may also help other students who have similar questions.

For general enquiries or additional support with OET Writing, Speaking, Listening, or Reading preparation, you may also contact me at:

morrisoet@gmail.com

Please note that any additional writing correction, speaking practice, private feedback, or one-to-one support is optional and separate from this Udemy course.

I wish you all the best in your OET preparation.

Mauricio

OET Teacher