OET 2.

0 WRITING LESSON: REVIEW

DURING THIS LESSON

 Learned what is required in the OET Writing exam and how the test is structured.
 Completed exercises to understand what is required to be successful in the test.
 Completed activities to improve your comprehension of the case notes you may
encounter.
 Considered the importance of choosing relevant case notes.
 Reviewed an effective method of structuring your letter.
 Set homework for next week/arranged future lessons.

REVIEW
The OET writing exam requires for you to write a
short (180-200 words) letter regarding a patient.
You are expected to explain the type of letter that
you are writing (referral, discharge, information,
transfer etc,.) and to clearly relay key information to
the professional or organisation you are writing to
depending on the case notes that are provided.

This lesson focused on how to structure your letter

and how to choose the most relevant case notes.
Deciding on a structure to your letter is the first
step towards achieving a grade B+ in the OET
writing exam.

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HOW THE EXAM IS GRADED

Candidates are assessed against the following criteria:

1. Overall Task Fulfilment

This means have you understood the task and its requirements. If the task asks for a
referral letter, have you written a discharge letter by mistake? Have you written
enough words, but not too many?

2. Appropriateness of Language
Is the language that you use formal or informal? Are you confident about using
medical terminology effectively?

3. Comprehension of Stimulus
Have you understood the patient’s medical needs? Are you able to clearly prioritise
the relevant information in your letter?

4. Linguistic Features
Does your letter have good grammar and does one point naturally flow to the next?

5. Presentation Features (spelling, punctuation and layout)

Should any marks be deducted for mistakes in spelling or punctuation? Is your letter
formatted professionally?

The Writing sub-test is scored by experienced assessors who receive ongoing training,
monitoring and feedback on their performance after each administration of the test.
Assessors give a score from A-E for each of the five criteria listed on the previous page, using
a detailed set of level descriptors to guide their decisions.
A score of A is the highest for each criterion. The five criteria are equally weighted in the
scoring and analysis process.
You will need to achieve a grade of at least B in each of these five criteria to achieve a grade
of B overall.

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ACTIVITY 1

Now read through the practice letter below.

Nursing Unit Manager

The Rehabilitation Centre
Smithville
Waterford

9 February 2014

Hello sir,

Re: Mrs. Bery Casey (DOB: 21 November, 1941)

Mrs casey (Widowed recently), who was been treated for a fractured her left neck of
femur, as she fainted and fell to the floor, is being discharged tomorrow. Therefore
she is being referred to you for following up care.

Mrs casey - lives alone - was found by her son who lives close to her home 2 hours
later and admitted to our hospital on 4 February, 2014.

Mrs casey had a left hemiarthroplasty and closed with staples and 2 exudrain tubes.
After the operation, she has completed the intravenous antibiotics, also the drain
tubes and alternate staples has removed. In addition, her pain has controlled by
medication and her blood pressure has remained by Ramipril 5 mg (previously used
10 mg). Furthermore, she is able to walk with a pick-up frame and an assistant
person, although she needs full assistance with her ADL.

It would be greatly appreciated if you could continue maintaining her medication

and monitoring her blood pressure. Also, please assess for her rehabilitation
therapy.

In addition, she will require to check her hemoglobin levels on 11/2/14 and remove
remaining staple on 13/2/14. Finally, a hospital transport has arranged for 11 o’clock
tomorrow morning.

If you need further question, please do not hesitate to contact me.

Kind regards
Mary Khan

Consider any improvements you would offer to this letter and now look at the examiner’s
notes below. Fill in the missing words from the options in the box at the top of the notes
as part of the examiner’s comments.

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Comments on scores
grouped tenses organised haemoglobin discharge plan complex capital letter

Overall Task Fulfilment

The candidate has shown the ability to manage the task and organise the information in a
logical way. For example, the background information is (1) _____ together in paragraph 3,
and the remaining actions relating to the discharge plan follow in paragraph 4 and 5.
However, significant grammar errors and inaccuracies have a negative effect on the target
reader in places. There are also further problems with (2) ____ such as ‘who was been
treated for a…’
Appropriateness of Language
The candidate has chosen lexis, register and tone which are generally appropriate for the
target reader and the communicative task (e.g. ‘needs full assistance with her ADL’, ‘It
would be greatly appreciated if you could continue monitoring her blood pressure’). A few
inaccuracies (e.g. ‘following up care’) do not impede communication. As a whole, the letter
is (3) _____ well, in that the reader can see an underlying sense of coherence to the way it is
arranged and ordered.
Comprehension of Stimulus
The candidate demonstrates an understanding of the task and input which is generally
accurate. Many of the main points (including the completion of the post-operative IV
therapy and the need for a (4) ________ check) are explained clearly and given an
appropriate degree of prominence. However, important elements of the (5) ________ (e.g.
the paracetamol and the anti-embolic stockings) have not been covered and the target
reader is not fully informed in those respects.
Control of Linguistic Features (Grammar and Cohesion)
The candidate has used a range of devices to connect information appropriate, including
relative clauses, concessive clauses, and time phrases (e.g. ‘Mrs Casey, who has been
treated...’, ‘...although she needs full assistance...’, ‘After the operation, ...’). However,
inaccurate use and/or avoidance of passive structures impedes meaning at a number of
points (e.g. ‘her blood pressure has remained by Ramipril 5mg’, ‘she will require to check
her haemoglobin levels...’). (6) ________ sentences are attempted, frequently without
success (e.g. ‘Mrs. Casey – lives alone – was found by her son who lives close to her home 2
hours later and admitted to our hospital...’).
Control of Presentation Features (Spelling, Punctuation and Layout)
The candidate has chosen an appropriate layout for the letter and spelling is accurate
throughout. Lack of control of punctuation in the second paragraph (inappropriate hyphens
and missing comma) make it necessary for the reader to re-read in order to retrieve the
information. The patient also regularly forgets to put a (7) ________ at the start of the
patient’s name.

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Now guess the scores (A-E) for this candidate and fill in the boxes below with your
estimated score for this assignment…

Scores
Overall Task… Appropriate Comprehension Linguistic… Presentation…
Language of Stimulus

ACTIVITY 2
Read through the paragraph below and fill in the missing words using the words provided
in the box. The text discusses tips to consider when writing your letters. Some of the
words in the answer box are not required.

layout and punctuation word count laid out missing mistakes problems
accepted same proof-read formatting grammar deducted

1. Take care of spelling– Spelling, along with _________ are the main aspects included
under presentation features (one of the criteria under which assessment is done).
When you are writing, take care of spelling, because any will be taken account of in
your presentation features scores.
2. Write within the writing limits- Your marks will not be _______ if your write over or
under the ________ (180-200 words). However, if you write more than 200 words,
you will not get time to ______ your letter. Always spare some time at the end to
proofread your letter for any _______ .
3. Use accepted layout: – A number of layouts and letter formats are ______ by health
professionals in different contexts. It is important that your letter is clearly ______
and is appropriate for the task. There is no set layout to follow in the OET writing
task.
4. Use accepted abbreviations: – Candidates are allowed to use accepted
abbreviations in the OET writing subtest. Before you use any short form or
abbreviation, ensure you use the ______ ones used in the text.

Answers are available at the back of this workbook.

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ACTIVITY 3
Throughout the OET writing exam you will be expected to interpret and understand the
patient’s medical history. This can often by challenging as often ‘short-hand’ or
‘abbreviations’ are used. Your job during the exam is to transfer these case notes into easy
to understand sentences. Let’s look at some examples of this.
Read through the case notes below and decide what the note means in the box on the
right using the full correct term.

Case Note What this means…

BP ↑
R/v req by attend.
doc
Trauma → internal
bleed
Bad nutri. Diet ↓
0 children
Ramipril 5mg/day
Crutches 2 mth.
PHX
+ prog overall
0 exercise post
physi.

Answers to this activity are available at the end of this workbook.

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ACTIVITY 4
Now read through this essay below and suggest any improvements. Make any changes
that you believe would help improve the grade of this assignment.
Ms elizabeth Clarke
Community nurse ,community health centre
10 lupus street
Seaview 2006
Re: martha sculthorpe,75 years old
Dear Elisabeth,
I’m writing you to request a discharge plan for a patient which 10 days ago, more
exactly on 14/5/2015 presented at hospital with infected arterial leg
ulcer.consequently , after assessed her medical situation as nursing management, he
needs to apply compression bandage after dressing ,moreover ,during
hospitalisation with regard to her medication she has prescribed cephalexin for 10
days.
In terms of her medical history she suffered from peripheral artery disease which
started 10 years ago,furthermore the hypertension is another medical
affection ,started 12 years ago and she takes verapamil 40 mg every daily.
Additionally,she is widowed ,she lives alone and she lacks someone to care for her
because her daughter fiona visits her twice a week ,she can assist a few days a
week.therefore the patient accepted assistance from home care, but has refused
meals on wheels.
Apart from this was discussed with the patient about how important is to reduce
the cigarettes .after the treatment which received along hospitalisation ,she has the
discharge today on 24/5/2015.as assess the patient is afebrile, she need a walking
stick for mobilising the pain, moreover she needs personal care as showering
assistance.
Despite all medical affections the wound of the patient should be much much better
in 7 days after reapplication of compression bandage and she was announced that is
schedule for review at dressing clinic in 2 weeks. In addition she needs to be
encourage for continue reducing the cigarettes.
Should you have any further inquiries, please do not hesitate to contact me. i have
attached all the necesarry details along with this letter.
Your sincerely,
Charge nurse

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Some suggested improvements:

 Capital letter on names ‘Elizabeth Clarke’ and ‘Martha Sculthorpe’. Further capitals
required throughout such as on address and at start of paragraphs and sentences.
 Improvements on grammar: “I’m writing to you to request a…”
 Errors with articles “…with infected an arterial leg ulcer.”
 Spelling errors such as “necesarry”.
 Weak sentence structure and choice of words: “…and she takes verapamil 40 mg
every day/daily.”
 Informal language such as “…much much better...”
 Some mistakes with plurals such as ‘…she needs a walking stick.”
 Letter is also above word count. No marks are deducted for this but information is
not focused and does not flow coherently.

What grade would you guess that this student achieved?

Answer: D

A sample answer to this task is available at the end of this workbook.

ACTIVITY 5

We also discussed the correct format of the letter. It is important that your letter flows
naturally from one point to the other in a logical manner.

Write which paragraph the information should be placed into (1st paragraph, 2nd, 3rd etc)
next to the ideas below. You may need to refer back to this week’s lesson for the correct
structure.

1. The reason you are writing = Paragraph …….

2. Any secondary medical symptoms of problems. = Paragraph …….

3. The patient’s main medical problem. = Paragraph …….

4. Actions the recipient needs to take. = Paragraph …….

5. The type of letter you are writing (discharge, referral etc.) = Paragraph …….

Now read through the writing exam sample answer below. Take the following actions:

 Re-order the paragraphs so that they follow the correct structure.

 Put the main medical issues in bold.
 Underline any further actions required.
 Put any further information in italics.

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 Ms Georgine Ponsford
Resident Community Nurse
Community Retirement Home
103 Light Street,
Newtown

(Today’s date)

Dear Ms Ponsford,

Re: Mr Lionel Ramamurthy, aged 63 years

You’ll be glad to know that Mr Ramamurthy has made good progress overall and is no
longer feverish with his inflammatory markers having normalised. He does, however,
still have a dry cough. In addition, his mobility has improved; he can now walk short
distances without his walking frame as well as use the shower and toilet independently.

I am writing regarding Mr Ramamurthy who will be discharged tomorrow (11/2) from

Newtown Public Hospital back into your care following a bout of pneumonia. He was
admitted with acute SOB, wheezing, painful coughing, fever, sleeplessness and general
aches, and was hospitalised for seven days.

Mr Ramamurthy will also need to be kept warm and encouraged to drink plenty of
fluids during his recovery period. His diet will also need to be monitored as he did gain
some weight during his stay. If you have any questions, please do not hesitate to
contact me.

Please make sure Mr Ramamurthy sits up as much as possible to ensure postural

drainage. In addition, he will need to continue his deep breathing and coughing
exercises (he may also need paracetamol for his chest and abdominal pain).

Yours sincerely
Medical Professional

A corrected copy of this letter is available at the end of this workbook.

IN THE NEXT LESSON

We will start to look at grammar for the Writing exam, considering such areas as tenses,
sentence structure, articles and word choice.

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ANSWERS

ACTIVITY 1
1. Grouped
2. Tenses
3. Organised
4. Haemoglobin
5. Discharge plan
6. Complex
7. Capital letter
Scores: B, B, C, C, B

ACTIVITY 2
1. Layout and punctuation
2. Deducted
3. Word count
4. Proof-read
5. Accepted
6. Laid out
7. Same

ACTIVITY 3

Case Note What this means…

BP ↑ Blood pressure increased/has risen
R/v req by attend. Review required by attending doctor
doc
internal bleed→ Trauma caused an internal bleed
trauma
Bad nutri. Diet ↓ Bad nutrition. Dietary quality has decreased
0 children No children
Ramipril 5mg/day Ramipril 5mg per day
Crutches 2 mth. Crutches for 2 months
PHX Patient history
+ prog overall Positive progress overall
0 exercise post No exercise post/after physiotherapist
physi.

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ACTIVITY 4
Ms Elizabeth Clarke
Community Nurse
Community Health Centre
10 Lupus Street
Seaview 2006

24/05/2015

Re: Martha Sculthorpe, 75 years old

Dear Ms Clarke,
I am writing to you to request your support regarding Martha Sculthorpe’s discharge plan.
Mrs Sculthorpe was admitted to our hospital on 14/5/2015 due to an infected arterial leg
ulcer. She is being discharged today.
During her admission, Mrs Sculthorpe has been treated with cephalexin for 10 days and has
undergone daily dressing with a compression bandage. The patient will continue to need the
ulcer dressing following her discharge.
In terms of the patient’s medical history, she has suffered from peripheral artery disease for
10 years. Furthermore, she has experienced hypertension for the past 12 years, for which
she takes verapamil 40 mg every daily.
Mrs Sculthorpe is widowed and lives alone. The patient’s daughter, Fiona, visits her twice a
week but the patient does need more support than this. Therefore, she has accepted
assistance from care but does not want to access the meals on wheels service.
Going forward, Mrs Sculthorpe will need support with reducing her cigarette intake. Upon
discharge, Mrs Sculthorpe will need a walking stick to mobilise and will require personal
care, including assistance with showering. The patient’s ulcer wound needs to be reviewed
at the dressing clinic in two weeks time. However, it is anticipated that wound will be much
improved within the next 7 days, as long as the compression bandage is reapplied.
Should you have any further inquiries, please do not hesitate to contact me. I have attached
all the necessary details regarding this patient along with this letter.
Yours sincerely,
Charge Nurse

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ACTIVITY 5
1. 1st
2. 2nd
3. 1st
4. 5th
5. 1st

Ms Georgine Ponsford
Resident Community Nurse
Community Retirement Home
103 Light Street,
Newtown

(Today’s date)

Dear Ms Ponsford,

Re: Mr Lionel Ramamurthy, aged 63 years

I am writing regarding Mr Ramamurthy who will be discharged tomorrow (11/2) from

Newtown Public Hospital back into your care following a bout of pneumonia. He was
admitted with acute SOB, wheezing, painful coughing, fever, sleeplessness and general
aches, and was hospitalised for seven days.

You’ll be glad to know that Mr Ramamurthy has made good progress overall and is no
longer feverish with his inflammatory markers having normalised. He does, however, still has
a dry cough. In addition, his mobility has improved; he can now walk short distances without
his walking frame as well as use the shower and toilet independently.

Please make sure Mr Ramamurthy sits up as much as possible to ensure postural drainage.
In addition, he will need to continue his deep breathing and coughing exercises (he may also
need paracetamol for his chest and abdominal pain).

Mr Ramamurthy will also need to be kept warm and encouraged to drink plenty of fluids
during his recovery period. His diet will also need to be monitored as he did gain some
weight during his stay. If you have any questions, please do not hesitate to contact me.

Yours sincerely
Medical Professional

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