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May 29, 2024

In the OET Speaking sub-test, there could be an element of tension, which could include difficult patient interactions. As an OET candidate, developing a response strategy is essential for your success in the OET Speaking exam and your future career. This blog provides a structured approach to managing challenging patient encounters, using content from our best OET materials. Whether you’re preparing for the OET exam online or looking for free OET preparation resources for nursing or other professions like medicine, physiotherapy, pharmacy etc., this guide will be invaluable.

Understanding and Addressing Patient Concerns

Scenario: Mr. Smith, a 65-year-old man with chronic obstructive pulmonary disease (COPD), is visibly upset during his visit for a repeated chest x-ray. He complains about the necessity of the repeated imaging and the cumulative radiation exposure.

Task: How will you address Mr. Smith’s concerns?

Write your response. Revisit this at the end of the lesson and reflect on how you could improve your approach to address Mr Smith’s concerns effectively.

Response Strategy: Introducing the C-A-R-E protocol, a guide to help you Connect, Acknowledge, Reassure, and Empower your patients. This protocol is very beneficial for anyone preparing for the OET exam, especially those focusing on OET speaking test tips and OET practice tests.

The C-A-R-E Protocol


Listen actively

Use verbal affirmations or continuers like hmm, uh-huh, go on to facilitate patient’s narrative
Use techniques like paraphrasing, clarifying statements, reflection & echoing statements if necessary to ensure clarity
Always remain non-judgmental & practice emotional self-regulation. Demonstrate tact and diplomacy.
Be respectful and courteous towards patients (use the patient’s name, don’t interrupt the patient, say please and thank you)
Use language and vocabulary that is patient appropriate
Acceptance of the patient includes recognising the intrinsic value and worth of each patient.

Let’s put this into practice

Scenario: A patient says,

“I’ve been taking the medication, but I still feel tired all the time.”

Choose a response that paraphrases the patient’s concern effectively.

A. So, you’re saying the medication isn’t working?
B. It sounds like even with the medication, your fatigue hasn’t improved. That must be frustrating for you.

Scenario: You are speaking to a patient who is reluctant to share information.

Choose which response is suitable.

a.I understand it might be difficult to talk about, but I’m here to help you. Can we please start with something that’s easier for you to discuss?

b.I really need you to talk to me so I can assist you better. If you will not share, I cannot help you.

Scenario: A patient has just admitted to not following their prescribed treatment regimen due to personal beliefs about alternative medicine.

Choose which response is suitable.

a. I understand you have your views, but it’s irresponsible to ignore medical advice. You’re risking your health by doing this.

b. I appreciate you sharing your beliefs with me. Let’s explore how we can integrate your preferences with the treatment plan, ensuring it aligns with your health goals too.


Identify the emotion and find out what’s causing it

Can you tell me more about how you feel?
What do you think might be contributing to these feelings?
It sounds like you are feeling (emotion). Is that right?
I hear that you are feeling (emotion).

Validate their feelings. Normalise their experience.

It’s understandable that you would feel this way.
Anyone in your situation would probably feel the same. OR Most people would feel that way (normalising their feelings)
It must be hard to deal with all of this.

Respond with empathy. Show appreciation for sharing

Never minimise the patient’s feelings or concerns.

Thank you for sharing that with me. This sounds really overwhelming.
I’m sorry this has happened, and I understand how it would make you feel that way.

Let us put this into practice.

Scenario: A patient mentions casually,

“Sometimes, I just feel like it’s all too much.”

Choose which response is suitable.

a. It sounds like you’re overwhelmed. It’s okay to feel that way. Sometimes, talking about it helps. Would you like to talk more about what’s bothering you?

b. Well, everyone feels stressed sometimes. Lots of people go through these feelings, so it’s normal.


Reassurance is relieving someone’s doubts or fears by providing comfort, confirmation, feedback. The purpose is to make the patient more secure and less anxious. The need for reassurance arises out of situations in which patients are apprehensive, doubtful, uncertain, worried, anxious, full of misgivings or lacking confidence.

TIP: AVOID FALSE REASSURANCE: Reflect for a moment on how you feel whenever someone tells you not to worry about something that is causing you concern.

No trite, trivial cliches or readymade comments when you reassure or empathise. Comforting responses are spontaneous, fluid and ever-changing in response to the context.

The desired outcome in providing reassurance is a restored sense of confidence and feelings of safety within the patient. To reassure literally means to assure again. In this sense, reassurance is restorative. By supporting their inherent power and ability, effective reassurance enables patients to face situations with equanimity.

Reassurance may not ‘make everything all right’ (sometimes this is not possible), but the patient who is reassured can face experiences with confidence, hope and courage.

Scenario: A patient in her first trimester is experiencing severe nausea and has been waiting to see a doctor for 3 hours.

Choose which response is suitable.

Response A:”I understand that the wait has been frustrating. You’ve been very patient and I will ensure the doctor sees you as soon as possible. Meanwhile, the medication you’ve received should help alleviate some of the symptoms and the IV fluids will keep you hydrated.”

Response B: “I get why you’re upset. Please know that nausea and vomiting are common in the first trimester. We’re trying our best here. As you can see, we are busier than usual today, and that’s why the doctor’s been delayed but should see you soon.”

Scenario: A patient is anxious about upcoming surgery.

Choose which response is suitable. Explain why.

a. It’s completely normal / perfectly reasonable to feel anxious about surgery. We have a skilled team, and we’re all here to ensure your surgery goes smoothly.

b. You really shouldn’t worry. Our team has done this many times before.


Having patients participate in their care is contingent on them having knowledge about that care. To encourage patients to participate in their care, master the skill of Sharing Information.
The skill of sharing information encompasses a range of actions
from providing explanations,
to giving instructions,
To present treatment solutions to imparting knowledge and so on

Explain options in a way that allows patients to make informed decisions about their treatment plans. Keep 3 pointers in mind:

Suggest, not instruct!

If you need to advise the patient, soften the advice by making it sound like a suggestion

Why don’t you consider walking or cycling to work instead of taking your car?

You could also try to take the stairs

Elicit reactions

Demonstrate a keen interest in patient’s viewpoint by eliciting reactions (e.g. How do you feel about this?)
Encourage expression of ideas
Can I check if this suits you?
What are your own thoughts about this?


Explain reason for Position (benefits, risks etc.). Use labelling to underscore significance of something.

It is crucial to…
I want to highlight…
Be flexible and adaptable to find mutually agreeable solutions

Let’s put this into practice.

Scenario: A patient is reluctant to follow a dietary recommendation, saying,
“I don’t see why I need to change my eating habits.”

Choose which response is suitable.

a. Changing eating habits can be challenging, but it could significantly improve your condition. Let’s explore what’s holding you back and find a comfortable way to start making changes.

b. You just need to change your eating habits if you want to get better.

Now that you’ve completed the lesson, take a moment to reflect on your initial response to Mr. Smith’s concerns. Consider how the C-A-R-E Protocol and the strategies discussed can be applied to improve your communication and reassurances with patients. How would you adjust your approach based on what you’ve learned?

Reach out to us to get the answer key for activities in this blog and more…


Effective communication with patients, especially in challenging situations, is a skill that can be developed with practice and the right strategies. By using the C-A-R-E protocol, you can ensure they handle difficult interactions with confidence and empathy, ultimately improving patient care.