Roy Miller OET Listening Script

 Roy Miller OET Listening Script

OET Listening Subtest - Part A - Extract 1

Narrator: So Roy, I see from your notes you've been admitted because of shortness of breath. Can you tell me more about that please?

Roy: Yeah, uh well it started last week. I noticed that getting up the stairs was more of an effort and I found that I had to pause on the way to catch my breath. I did used to get a little out of breath but it's definitely gotten worse. I normally managed to go shopping with my wife and we walked to the shops and back. I'd generally have to have a little rest but now everything is just taking me longer. I feel weary, you know, and I've got this cough, it's like a barking thing that I just can't shift. It's worse at night when I'm lying down and I get a bit wheezy. I'm just really tired because it keeps me awake for most of the night. My wife has been sleeping in the spare room because it's keeping her awake. I've also sort of been bringing things up when coughing without being too graphic, it's it's quite thick, uh it's a sort of dirty green color I suppose, right. It wasn't like that at the beginning of last week, it was just clear. But over the last couple of days I've noticed it's changed color and I'm coughing up a lot more. My wife was starting to get worried so she made me an appointment with our doctor and then he sent me here.

Narrator: Okay, right. Do you have any other symptoms?

Roy: Yeah, I was really hot yesterday and I thought it was because the heating was on but my wife hadn't turned it on. Then the next minute I was shivering. I guess I'm feverish. It sounds like you've been really suffering. Have you got any other medical conditions?

Roy: Well, I was diagnosed with this lung condition last year. I forgotten the name of it, hold on, um co co, hang on, I'll get it, uh uh, uh CD, is that it? Yeah, well um, anyway, they told me that my lungs weren't working as well as they could be because I used to be a smoker. Right, but I quit about six years ago. To be honest, I think it was because I worked in the mines and it was really dusty. Either way, I've got it and it makes me a bit breathless but nothing like this, right? Uh, and I also get gout from time to time and I take something called alopurinol or something. Uh, I've also got arthritis in my knees but that's just because of my age, so I just put up with that.

Narrator: You mentioned taking alopurinol. Are you on any other medication?

Roy: Well, uh, the doctor gave me inhalers and I'm using those. I'm getting better at taking them because I found it a bit confusing at first. Um, I've started to take my blue inhaler a lot more over this last week because I've been so breathless. I take this stuff I mentioned before, a Statin for my cholesterol, and then the odd paracetamol when my arthritis starts to play up. I don't really like taking pills but if it keeps me going then it's worth it. Also, I'm allergic to penicillin. I get an awful rash all over my body and it's so itchy whenever they give it to me. Don't give me any of that.

Narrator: We won't, Roy. You mentioned you live with your wife. Are you both managing at home?

Roy: Oh yeah, um, we still get around the town to get our shopping and see the family. The stairs are starting to get a bit much now so we're thinking about moving into a bungalow but we haven't started looking yet. Okay, that's good.

Narrator: Have you got any ideas as to what might be going on?

Roy: Well, I think it might be a chest infection because it's just getting worse. I just want to start feeling better of course.

Narrator: Roy, it does sound like that might be the case, but we'll start doing some tests to make sure and begin treatment.

OET Listening Subtest - Part A - Extract 2

Dr. Khaw: Hi Mara, Samarina, I'm Dr. Khaw. I understand that you've been experiencing some issues with your left eye.

Mara: Yeah, that's right.

Dr. Khaw: Okay, are you able to tell me a bit about what's been happening?

Mara: Yeah, sure. So, last Friday was our office party and so I was out quite late and I'd had a couple of glasses of wine. Anyway, when I came home I must have been a bit reckless taking out my contact lenses. I didn't notice anything then, but when I woke up in the morning I had this pain in my left eye. It felt like there was something stuck in it. Also, I had a headache. I'm not sure if that's because I was straining my eyes. My eye was also watering loads and it was kind of like what happens when you chop up onions. Anyway, I thought I'd just sort of keep blinking and whatever was in my eye would work its way out. So, well, I did that for a bit but I was getting more and more worried. I went to ask my roommate if she could see anything in my eye and she said my eye was swollen and she thought we should go to the hospital and get it checked out. So, we went to the ED, and thankfully my roommate was able to get the day off work so she drove me there. Oh, the pain was also so terrible that I couldn't concentrate. I don't know what I would have done without her help.

Dr. Khaw: Okay, so what happened when you went to the hospital?

Mara: So, we waited around at the ED for a bit and then I was seen by a GP. Uh, I told him about the pain and how I thought I had something stuck in my eye. So, he opened my eye and tried to see if there was anything in there that shouldn't be. It must have been quite difficult for him to see anything. So, he did a fluorescein stain test. Then he took me to a dark laboratory room to look into my eyes with one of those uh, microscope things. And when he still couldn't find anything, he seemed to think it could be an infection and that's when I started panicking.

Dr. Khaw: And after that, were you referred to an optometrist?

Mara: Oh yes, that's right. They sent me to this department after that, and the optometrist used some numbing eye drops on me. I was incredibly thankful to her for that. My eyes felt better very soon afterwards. And then she looked at my eye and because I wasn't squinting from the pain anymore, she could see that there was a corneal abrasion. Uh, she said that I must have scratched it when I took my contacts out the night before.

Dr. Khaw: I see. So, can you tell me how you've been treating your eye at home?

Mara: Yes, she told me not to wear my contact lenses until this followup and she prescribed me a couple of things. Uh, I'm using the antibiotic eye drops she gave me. I put those in in the mornings and evenings. And the other thing she gave me is, ugh, really horrible to use, it's a healing ointment but it feels gross in my eye so I just use it once a day. Unfortunately, they couldn't give me any of their pain relief to take home so I've just been taking Ibuprofen when it hurts.

Dr. Khaw: How's your eye feeling now?

Mara: Much better, thanks. It still hurts when there's bright light though, and I wasn't sure if that was normal. Uh, the optometrist said it would take uh, quite a while to heal so I guess I need to hang on a bit longer.

Dr. Khaw: Yes, at this point it will most likely still be recovering. Do you mind if I take a close look at your eye now? If you can just take your glasses off.

OET Listening Subtest - Part B (Questions 25-30)

Question 25

Doctor 1: Hello Dr. Salos, this is Dr. Brink from the emergency department. I'm calling you with regards to an admission to the hospital medicine service.

Doctor 2: Right, yes hello Dr. Brink, um I'm the admitting physician for Hospital Medicine. Um, can you tell me more about the patient and why he needs to be admitted from the emergency department?

Doctor 1: Sure, so the patient is a 68-year-old man with a past history of CHF, DM2 and a chief complaint of shortness of breath for three days. Um, chest x-ray shows a right lower lobe pneumonia. His vital signs are normal but his blood urea is 36.

Doctor 2: I see, it sounds like he meets CRB-65 criteria for an inpatient admission. Have you started him on any medications in the emergency department?

Doctor 1: Yes, we have given him supplemental oxygen and started him on breathing treatments. He will also be getting empirical antibiotic coverage. If there are any other orders you'd like me to place, let me know and I'll do so.

Question 26

Speech Pathologist: I just don't really understand why my husband can't speak properly anymore. Is it a result of brain damage?

Speech Pathologist: Problems of this type are a result of damage to the brain, yes, but it's important to note that these issues haven't affected your husband's intelligence. No, of course I know it's still him, it's just frustrating when we can't talk like we used to. Will he get better eventually?

Speech Pathologist: Your husband has already shown improvement and we're confident that this will continue with regular sessions and practice. Patients tend to show the greatest change within the first six months, which is why we've planned such an intensive schedule for him during this time. We're confident that we'll see great strides in your husband's condition over the coming months.

Question 27

Trainee Doctor: I'm still just a bit unsure about chest tubes, uh, I was hoping you might be able to give me a bit more information.

Senior Doctor: Okay, sure. So you know about the three chambers on the chest tube, right?

Trainee Doctor: Yep, there's the collection chamber, the water seal chamber, and the wet or dry suction regulator, right?

Senior Doctor: So as the air from the pleural space passes through the water seal chamber, you should see gentle fluctuation in the water every time the patient breathes. This is called tidaling. If you notice that tidaling is no longer present, the tubing may be kinked or obstructed, or the patient's lung may have re-expanded.

Trainee Doctor: Ah, okay. You should also make sure the chest drainage unit remains below the level of the patient's chest at all times.

Question 28

Pharmacist: Hello, can I help you?

Customer: Yeah, I get terrible backache and my friend said you could give me some Codine for it.

Pharmacist: Do you have a prescription from your doctor?

Customer: No, but I don't want the full strength stuff, I only need the weaker one. You know, they mix it with ibuprofen or paracetamol so it's not as strong.

Pharmacist: Ah, okay. Well, first of all, there's been some research done recently that suggests that low dose Codine doesn't offer much more pain relief than paracetamol or Ibuprofen alone. We're not actually authorized to provide Codine without a prescription anymore. So, I'd recommend picking up some alternative pain relief from the first aisle by the front door.

Question 29

Tutor: How do you feel you handled the patient's concerns?

Trainee Nurse: Well, I think I was okay. Mhm, maybe I wasn't as confident as I could have been.

Tutor: I'm still quite nervous about advising patients. I guess I just need more experience to gain confidence, uh, maybe, but I actually don't feel that was an issue for you. Do you think there's anything else you could have done for the patient during your examination?

Trainee Nurse: Well, you, you could perhaps have tried to be more reassuring rather than just stating the facts. Sometimes patients need to feel like their anxieties are being heard.

Trainee Nurse: Yeah, I actually think I did cover this with the patient though. Though he talked through his concerns

OET Listening Subtest - Part B (Question 30)

Doctor 1: We have 24 patients in total to see today across two bays and unfortunately, we only have four staff members.

Doctor 2: I think we should divide ourselves into two teams, would you agree?

Doctor 1: Absolutely. Also, I think we should see patients according to their National Early Warning Score (NEWS). That way we'll get through all those who have urgent requirements before lunch.

Doctor 2: Then we can be sure that the most pressing investigations are performed earliest and the sooner we get those organized the better.

Doctor 1: Forms will be coming to the ward at around half past one, so any blood forms should be given to them then.

OET Listening Subtest - Part C (Extract 1)

Introducer: Hello everyone, I'm here with Dr Matthew Leech, an expert on infectious disease, who's going to tell us about meningitis.

Dr. Leech: Thank you for being with us today, Dr. Leech. Can you tell me more about the disease?

Dr. Leech: Sure, well first off, not everyone who is exposed actually develops meningitis, but there are some common symptoms to look out for in those that are at risk. It can be quite difficult for patients to realize they have meningitis in the early stages as the symptoms can lead them to believe that they are developing the flu. They'll simply feel tired and achy for a few days.

Dr. Leech: Right. As this infection develops, patients may then notice a sudden onset of fever, headache and in particular, neck stiffness. Other possible symptoms include nausea or vomiting, confusion, sensitivity to light, no appetite or thirst, or even a skin rash.

Dr. Leech: If left untreated, bacterial meningitis is very dangerous, quickly progressing to seizures, shock and even death.

Introducer: Well, that sounds pretty serious. And you mentioned that certain people may be at risk. Now, which people are more likely to develop meningitis?

Dr. Leech: Well, there are many causes of meningitis, but one of the most severe is caused by the bacteria Neisseria meningitidis. The bacteria are spread by respiratory droplets and are often seen in college students. This is largely because of the sudden change in their lifestyle.

Dr. Leech: College students, particularly those who live on campus, are exposed to a hotbed of different infections they haven't previously encountered. All these kids from different parts of the US and the rest of the world get together, live in small dorms with each other, go to parties all that close contact really is a breeding ground for infection.

Introducer: Oh okay, well that makes sense. Now, can you tell us about a specific patient who had this type of meningitis?

Dr. Leech: Of course. I treated an 18-year-old man in his first year of college who was living in the dormitories. There was a flu going around and he started to feel the same symptoms. He was working hard to try to complete a couple of important essays before the deadline and he planned to delay going to the doctors until he had submitted them.

Dr. Leech: Soon after the initial symptoms, however, his roommate found him in severe pain and feverish and brought him to the emergency department where we diagnosed meningitis. We took a sample of spinal fluid but started him on antibiotics before we got the results back.

Introducer: So, you mentioned that you started antibiotics before you got the spinal fluid test results back. Can you tell me why?

Dr. Leech: Right, as I mentioned, there are many causes of meningitis like viruses, fungi, parasites and bacteria. However, it can take some time to determine the exact cause and waiting for the answer without treatment could make the patient worse. Instead, we use the patient presentation, age and our determination of the most likely cause to start antibiotics that would kill many of the causes. Once we get the results back on the cause, we can change the antibiotics to be more specific. By doing this, we don't delay treatment and are able to reduce the chance of complications.

Introducer: Ah, right, I see. So how is your patient doing now after being treated? Will he experience any long-term After Effects?

Dr. Leech: Well, he is currently doing much better. He responded well to antibiotic treatment and regained his mental state within a few days. Unless the patient has a disease of his immune system, meningitis is unlikely to occur again. Because this patient had some delay for seeking treatment, he may still have some side effects, but it will take some time to see what long-term effect it will have on him. Bacterial meningitis requires urgent medical treatment and can cause serious complications such as hearing loss, memory difficulty, brain damage, gait problems or kidney failure.

Introducer: Well, let's hope he makes a full recovery. And aside from seeking immediate medical treatment, what advice can you give to our listeners today about bacterial meningitis?

Dr. Leech: So, first off, there is a vaccine that is effective at preventing this disease. So anyone in close contact with a large group of people, such as those living in a military base or on a college campus, should ask their doctor about it. Finally, if you have not had the shot and have spent a lot of time with someone who is later diagnosed with meningitis, wear a mask to prevent spreading the bacteria and go and see a doctor immediately. There are medications that can reduce your risk of developing meningitis, and getting treated immediately will reduce your risk

OET Listening Subtest - Part C (Extract 2)

Dr. Evina Horton: Hello everyone, my name is Dr. Evina Horton and in my presentation today I'd like to discuss an issue that I deal with daily: de-escalating agitated patients in an emergency setting.

Dr. Horton: To provide some perspective on the issue, most patients who enter the hospital do so via the emergency department (ED). Many won't have received medical treatment yet, and that can make them more likely to become agitated. This can be exacerbated by their medical condition, a psychiatric illness or other stress factors.

Dr. Horton: Given the chaotic and crowded nature of the ED, it's imperative that we identify agitated patients early and apply non-physical de-escalation techniques as soon as possible.

Dr. Horton: The provider who is going to initiate the de-escalation process should make sure that they create a considerable amount of space between themselves and the patient and ensure no one else is closer to the patient than they are. This not only gives the patient space but also keeps the provider safe in the event of attempted physical violence.

Dr. Horton: Ideally, both the patient and provider should also be able to leave the area without the other blocking their exit. Body language and tone of voice convey overall emotional state to a patient, so providers should remain outwardly calm throughout the encounter.

Dr. Horton: When speaking to the patient, you should start by introducing your name and role in the team. You should determine how the patient prefers to be addressed and err on the side of being respectful. Use short sentences and simple vocabulary to enhance understanding. Leave a suitable amount of time between statements to allow patients to process what is being said – sometimes repetition and enunciation may be necessary.

Dr. Horton: Eye contact should be intermittent so the patient does not think you're staring, and verbal responses should be calm without any hint of insults or challenges. Only one provider should interact with the patient as multiple speakers can confuse an agitated patient.

Dr. Horton: When the patient speaks, it's important to identify what their wants and feelings are, even if they may be impossible to address at this time. Try to consider things from the patient's perspective. Although they may be suffering under a particular delusion, such as paranoia, try to understand how the patient might feel or react if that delusion happened to be true.

Dr. Horton: While we don't want to endorse these delusions, it's important to find common ground. For instance, if the patient is agitated because they think they're being followed, the provider can agree with the general principle, saying something like "I understand that your suspicion of other people can make it hard to get the treatment you need here."

Dr. Horton: It is also okay for a provider to agree that while they may not be having the same experience as a patient with an obvious delusion, they can believe the patient is having that experience and reacting to it in that way.

Dr. Horton: Additionally, patients should be encouraged to make choices in order to give them a sense of control over the current situation and diffuse their overall aggressiveness. These choices should be realistic, however, and deliverable as unfulfilled promises may backfire and irreparably damage the therapeutic alliance. Some of these choices can include medications to help calm the patient. A good way to state this is: "It's important for you to stay calm so we can talk. Can we provide you with some medication to help you feel less anxious?"

Dr. Horton: Offering patients a choice between different medications or routes of delivery may also provide a feeling of control to the patient.

Dr. Horton: Lastly, when the crisis is over, a key technique is debriefing both the patient and staff on how the situation went. The patient, now calm, may be able to provide more insights on what they were thinking and how they were feeling at the time.

Dr. Horton: The provider can discuss coping skills or alternative options in order to prevent another aggressive incident in the future. It is also important to talk to staff as well to gain any third-party feedback on the provider-patient interaction, what would have been appropriate, what helped de-escalate the patient, and any other changes that could be made to ensure patient, staff, and bystander safety.

Dr. Horton: These techniques can be applicable to a wide variety of patients in numerous settings, not just restricted to the emergency department. Our hope is that providers will be able to de-escalate patients safely and effectively without having to resort to the use of physical or chemical restraints, which should be considered only when all other approaches have failed.