Preparing for the OET Speaking sub-test requires a blend of clinical knowledge and sophisticated communication skills. In this guide, we explore a high-stakes scenario involving OET nursing speaking colostomy care, providing a comprehensive Grade B model answer and a detailed breakdown of the assessment criteria to help you succeed in your healthcare career.

The OET Speaking sub-test consists of two role-plays. For each, you receive a candidate card and have 3 minutes to prepare, followed by approximately 5 minutes of role-play. The interlocutor plays the patient or carer, while you act as the nursing professional. These sessions are recorded and double-marked by trained OET assessors in Australia. It is important to note that from 31 July 2025, Speaking tests will be conducted via OET’s dedicated Speaking Platform rather than Zoom, ensuring a more streamlined experience for candidates globally.

Role-Play Card

Setting: Surgical Ward
Profession: Nursing
Patient: Mrs. Johnson is a 60-year-old female who recently underwent surgery for a colostomy formation due to severe diverticulitis. She is due for discharge in two days but is feeling very anxious and overwhelmed about managing the stoma and the appliance at home. She is worried about leakages and how her social life will be affected.
Task:
1. Explore the patient’s concerns regarding the colostomy.
2. Provide clear, step-by-step education on how to change the colostomy bag.
3. Address her anxieties regarding lifestyle and social activities.
4. Reassure her about the support available after discharge.

Sample Role-Play Dialogue

Candidate: Good morning, Mrs. Johnson. My name is [Your Name], and I’m one of the registered nurses looking after you today on the surgical ward. How are you feeling this morning?

Interlocutor (Mrs. Johnson): To be honest, I’m feeling quite overwhelmed. The doctors say I can go home in two days, but I just don’t feel ready. This colostomy… it’s all so much to take in. I’m terrified I won’t be able to look after it properly.

Candidate: I can completely understand why you feel that way, Mrs. Johnson. It’s a significant change to your body and your routine, and it’s perfectly normal to feel a bit anxious at this stage. To help me support you better, could you tell me what specifically is worrying you the most about going home?

Interlocutor (Mrs. Johnson): I’m mainly worried about the bag leaking. What if I’m out for lunch with my friends and it just… fails? I don’t think I’d ever be able to leave the house again. And I don’t even know how to change the thing without making a mess.

Candidate: Those are very valid concerns. Many patients feel exactly the same way initially. Regarding the leaks, modern appliances are designed to be very secure and discreet, so once we get your technique right, the risk is actually very low. Would it be helpful if we went through the process of changing the bag step-by-step now? We can take it as slowly as you need.

Interlocutor (Mrs. Johnson): Yes, I suppose we have to start somewhere. I’ve watched the stoma nurse do it once, but I was too groggy from the surgery to really pay attention.

Candidate: That’s no problem at all. First, it’s important to gather all your supplies—your new bag, some warm water, and soft wipes. You don’t need any special soaps. Then, you’ll gently peel off the old bag from top to bottom while supporting the skin. Once it’s off, you clean the area around the stoma with just the water and pat it dry. Does that sound manageable so far?

Interlocutor (Mrs. Johnson): It sounds simple when you say it, but I’m worried about the skin. It looks so red and sore.

Candidate: That’s a great observation. The skin around the stoma—we call it the peristomal skin—needs to stay healthy. If it gets irritated, the bag won’t stick as well. That’s why we make sure the hole you cut in the adhesive part of the bag is the perfect size for your stoma. We will provide you with a template to make this easier. After the skin is dry, you just press the new bag firmly into place. How do you feel about trying this with me later today?

Interlocutor (Mrs. Johnson): I’ll try. But what about my clothes? I feel like everyone will see the bulge. I used to love going to the theater and out to dinner, but now I feel like I’ll have to wear baggy tracksuits forever.

Candidate: I hear your concern about your appearance and social life. It’s important to me that you regain your confidence. Most people find that they can wear their normal clothes with just a few small adjustments. There are even specialized high-waisted undergarments that keep everything flat and secure. You’ll be surprised at how invisible it can be. Does that offer some reassurance?

Interlocutor (Mrs. Johnson): A little, yes. I just worry I’ll be all alone with this once I leave the hospital.

Candidate: You definitely won’t be alone. Before you leave, we’ll make sure you have the contact details for the community stoma nurse. They can visit you at home to check how you’re getting on. We will also give you a discharge pack with plenty of supplies and a booklet that summarizes everything we’ve discussed today. If you have concerns about other aspects of recovery, like post-operative pain management, we can discuss those too. Would you like me to arrange for a representative from a stoma support group to give you a call?

Interlocutor (Mrs. Johnson): That actually sounds like a wonderful idea. It would be nice to talk to someone who has actually lived through this.

Candidate: I’m glad you think so. I’ll set that up for you. To make sure I’ve explained things clearly, could you tell me what you’ll do first when you’re preparing to change your bag at home?

Interlocutor (Mrs. Johnson): Well, I’ll get my supplies ready—the bag, water, and wipes—and make sure I have a quiet space to do it.

Candidate: Exactly right. You’re already becoming an expert! We’ll practice together this afternoon. Is there anything else on your mind for now?

Interlocutor (Mrs. Johnson): No, that’s all for now. Thank you, nurse.

Candidate: You’re very welcome, Mrs. Johnson. I’ll see you in a little while.

Why This Scores Grade B

This performance demonstrates the high level of communication required by the Nursing and Midwifery Council (NMC) and the OET assessment board. Below is a breakdown of how the candidate met the nine assessment criteria.

Linguistic Criteria

1. Intelligibility: The candidate uses clear pronunciation and varied intonation to emphasize key points, such as when providing reassurance. Words like “peristomal” and “appliance” are articulated clearly so the patient can understand technical terms.

2. Fluency: The speech is smooth with very few hesitations. The candidate uses natural fillers and maintains a steady pace, which helps the patient feel calm. For example, “I can completely understand why you feel that way” is delivered without stuttering.

3. Appropriateness: The tone is professional yet warm. The candidate avoids overly medical jargon where possible and uses a register suited to a 60-year-old patient. A good example is using the phrase “invisible” instead of “non-apparent to the naked eye.”

4. Resources of Grammar and Expression: The candidate uses a range of complex structures, such as conditional sentences: “If it gets irritated, the bag won’t stick as well.” This demonstrates a high level of linguistic flexibility.

Clinical Communication Criteria

1. Relationship Building: The candidate starts by acknowledging the patient’s feelings immediately: “It’s perfectly normal to feel a bit anxious at this stage.” This builds rapport and trust from the outset.

2. Understanding and Incorporating the Patient’s Perspective: Instead of just giving facts, the candidate asks, “What specifically is worrying you the most?” This allows the nurse to tailor the education to the patient’s fear of leaks and social embarrassment.

3. Providing Structure: The candidate uses signposting to guide the conversation. Phrases like “First, it’s important to…” and “Regarding the leaks…” help the patient follow the logical flow of information.

4. Information Gathering: The nurse uses a mix of open and closed questions to uncover the patient’s hidden concerns about her social life and clothing, rather than just focusing on the physical procedure of stoma care.

5. Information Giving: The candidate uses the “chunk and check” method. After explaining a part of the procedure, they ask, “Does that sound manageable so far?” to ensure the patient isn’t overwhelmed.

Key Vocabulary for This Scenario

Common Mistakes to Avoid

• Ignoring the Emotional Cues: Candidates often focus so much on the “how-to” of colostomy care that they forget the patient is scared. If the patient says they are “terrified,” you must acknowledge that before moving to the technical steps.
• Overloading with Jargon: Avoid using terms like “stoma site maceration” or “flatus filter” without explaining them simply first.
• Monologuing: Don’t speak for two minutes straight. OET assessors look for interaction. Use the “chunk and check” technique mentioned earlier.
• Failing to Signpost: If you jump from talking about cleaning the skin to talking about social life without a transition, the patient (and the assessor) may get lost.
• Poor Time Management: If you spend 4 minutes on Relationship Building, you won’t have time for the education task. Aim to move to the main task by the 1.5-minute mark.
• Neglecting Lifestyle Advice: For a 60-year-old patient, social life is often a priority. If you only discuss the medical side, you haven’t fully met the patient’s needs.

Practice Tips

To master the OET nursing speaking colostomy care role-play, consider the following strategies:

1. Record and Review: Use your phone to record yourself performing this role-play. Listen back specifically for your use of “signposting” words (e.g., “Firstly,” “Moving on to,” “In addition to”).
2. Focus on Empathy Phrases: Create a “cheat sheet” of empathetic responses. Instead of just saying “I understand,” try “I can see why that would be a worry for you” or “It’s completely natural to feel overwhelmed by this.”
3. Practice with a Timer: The 3-minute preparation time goes fast. Practice reading a card and jotting down three key “patient concerns” and three “nursing actions” within that window.
4. Simulate the Platform: Since the test is moving to a new digital platform, practice speaking to a webcam rather than a person in the room to get used to the lack of physical presence.

If you found this scenario helpful, you might also want to practice other common surgical ward interactions, such as fall prevention with an elderly patient or educating a new mother about breastfeeding. Each scenario requires a unique balance of technical expertise and compassionate communication.

Success in the OET Speaking sub-test is about more than just English; it’s about demonstrating that you are a safe, competent, and caring professional. For more structured practice and expert feedback, explore our OET Speaking Role-play Practice course or check our OET Score Guide to see how your performance aligns with Grade B requirements.

Keep practicing, and remember that every role-play is an opportunity to show how you would care for a real patient in a real clinical setting. Good luck!