How to select the relevant case notes for OET letter writing? The audience awareness is the key

What is audience awareness and why is it important to you?

One of the criteria of the new version of the OET writing assessment is the content, according to the OET center,

“The content criterion examines a number of aspects of the content:
All key information is included
Information is accurately represented
Audience awareness is key here. The writing needs to be appropriate to the reader (and their knowledge of the case) and what they
need to know to continue care.”

WRITING Assessment Criteria and Level Descriptors, Public version

So, in the test, your letter should include the information that is relevant to the person you are writing to (the audience). You should know what the audience knows about the patient and the case and what they should know to continue the care of the patient. This is called audience awareness.

How audience awareness can help you to understand which information is relevant and which is not?

Before you start writing the letter, you should understand who is your recipient and what is the reason for your letter to them (the purpose).

The main factors you should find from your question booklet are,

  1. Who are you?
  2. Who is your patient and what happened to them?
  3. To whom you are writing to?
  4. Why you are writing to them?

Who are you?

Knowing who you are will help you understand the setting (For example, medical ward, diabetic care unit, etc.) and the urgency of the situation, etc. You can usually find this information at the beginning of the case notes.

Image of OET writing question booklet
An OET writing booklet

Who is your patient?

Information about your patient, like their age, the current and past medical condition, gives insight into the purpose and the urgency of the situation.

The purpose of the letter?

To find the main purpose of the letter, imagine that you are forced to write this letter to the recipient. What is that reason? that is the purpose of the letter.

Every letter has a purpose. The focus of your letter should be the purpose. The information you choose to include from the case notes should be relevant to the purpose.


The information should be relevant to the reader (the audience) too.

Audience awarness

An infograph about the audience awarness

Who is your recipient?

It is very important to know the recipient of the letter. You can find this information in the task section of the letter and sometimes inside the case notes too.

Find out,

What do they know about the patient and the case?
What do they need to know to continue the care?

Your information should be appropriate to their knowledge of the case

The address of the recipient

Compare it with the address of the patient and the hospital (Are they the same? do they know your patient already? Should you include the social and the medical history, etc?)

The profession of the recipient

What is their level of knowledge about the case?

Most importantly, ask yourself, what does the reader need to know?

What is the main purpose of the letter?

The information I selected is appropriate to the reader and the case?

What other information do they need to know to continue the care of the patient (like future appointments and any special instructions)?

The writing process

Before starting writing, I usually suggest my students stop doing everything else and take a minute to think about the factors we considered above.

Imagine the situation you are writing this letter: The patient, their situation and the purpose; the recipient, their knowledge on the case, and the patient. The reason for writing the letter and the other information your recipient should know.

Before you write the letter you should be clear about all these factors because, if you do, your letter will have clarity and coherence.

Also, while transferring the information (Please do not copy the information from the case notes, write it in your own words) be sure to be accurate. The inaccuracies you may make, about the name of the patient, the gender, diagnosis, and the other terminologies, are bad for your score.

Write a lot of letters before the test and get them corrected by a trainer. I hope this post will be useful for you in your OET preparation.

How to Prepare for OET

What is the best way to prepare for the Occupational English Test (OET)?

As a health care professional, OET is your best chance to work and enjoy your life in countries like the UK or Australia. OET is an expensive test and taking it without enough preparation is may be risking your money. So, it is a good idea to build an effective study plan and stick to it to avoid wasting money and a lot of frustration.

Do a lot of preparation before taking the test

OET is a high stake English test and like any other test, it has its own characteristics. You need to be familiar with them.
You may be a good English user or you may have even got a good score in any other similar English test too. But it is advised to take a few practice tests get to know the test and check your skill level before going for a real test.

Start with a mock test. Try to use only authentic test materials for mock tests (You can find two of them on the official website of OET for free).

You can also buy official practice materials from Amazon*

(*This is an affiliate link, Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for us to earn fees by linking to and affiliated sites. )

Practice as much as you can and sit for the test only when you are confident enough to do it.

Understand the OET writing and speaking assessment criteria.

The public version of the writing and speaking assessment criteria are available on the official website. Read and understand each criterion. This will tell you what the examiners are looking for in your writing and speaking sub-tests. This may also clear a lot of confusion about the test.

Read the assessment criteria and remember them. Make a checklist out of it.

Check whether you are fulfilling all the criteria on your speaking and writing practices.

Listen a lot to improve your speaking skills.

In a language, speaking and listening skills are very much related. Your speaking skill depends on how much you listen.

What to listen to?

To improve your listening score in OET, listen to a lot of conversations.

Only doing practice tests alone may not increase your listening score. Listening to podcasts and interviews on health-related topics and watching programs in health care settings is a great way to improve your listening skills.

In the OET speaking test, you need to perform two role plays on patient consultations. Give special attention to the OET Part A of the listening sub-test (Consultation extracts). Listen carefully for the vocabulary, tone, and register of the speaker and the expressions they use.

Watching videos of patient consultations also is a good way to improve your clinical communication skills.

(On YouTube, search a health condition + patient consultation, for example, search: Patient consultation with asthma and you will get a lot of videos on consultations)


Reading sub-test needs practice. Read a lot of health-related writings. Like articles, case studies, etc. ABC Health is a great resource for this purpose. Learn to read fast. But also ensure that you understand the main points they are discussing.

In the beginning, this may seem tiring but with enough practice, your reading score and vocabulary will improve.

Write letters and get it corrected by an expert OET trainer

Writing test is the most difficult sub-test in the OET. For most candidates, it is a struggle to get a band B in the writing. The test statistics from OET’s official website also show, globally, the average performance in the writing sub-test is far lower than the other sub-tests.

The best way to overcome this is to practice writing a lot of letters. Writing at least one letter per day is a good practice. There are plenty of good practice materials available for writing. Both official and materials created by trainers.

But before you start writing, understand the assessment criteria for writing. Read some good quality (If possible, authentic) sample letters.

Follow an effective writing process to improve your quality of writing. (Check out the writing process by S.OET )

Then write and re-write letters to hone your writing skills.

One difficulty with the writing sub-test is that you cannot grade your writing yourself. You can (and you should) proofread your letter every time but even that is limited to your knowledge of grammar and spelling.

To solve this problem, after writing a letter, it is important to show it to an experienced OET trainer to get corrections and insights from them. After the correction, write the letter again as suggested by the trainer.

Practice in this way as many times as possible.

A complete guide to OET Letter layout

Having a proper layout of the letter in OET writing test is important. It is one of the criteria in the OET Writing Assessment.

Also, a good layout of the letter will help you write down important information logically and in a cohesive manner. It adds neatness to your writing and helps you plan your letter quickly and effectively on the OET test day.

  • A sample of an OET writing Question paper

S.OET’s A Complete Guide to OET Letter format

Be flexible in your approach to the letter rather than following a strict structure.

According to the task, case notes, and the level of emergency of the situation, sometimes, you may need to change the structure of your letter, therefore, these factors should be taken into consideration before planning the letter.

Blocked or indented format?

A formal letter (OET letters are always formal) is usually written in a blocked or indented format. You can choose either as you wish however, the block style is more encouraged

An image shows different types of letter format
Image from

Parts of a letter

  • 1. Recipient’s name and address
  • 2. Date
  • 3. Salutation
  • 4. Name and age of the patient


  • 5. Introduction
  • 6. Summary of the chief complaints
  • 7. Summary of the additional information
  • 8. Discharge/ transfer/treatment plan and medications
  • 9. Closing sentence

End of the body

  • 10. Sign off
  • 11. Your job title

1. Recipient’s name and address

Include the title and the name of the recipient if it is given. The formal titles that can be used in OET letter writing are,

Ms (Miss or Mrs if it is mentioned)

Example: Dr Bradshaw or Ms Bradshaw

Only omit the title if you are not sure about the person’s gender like in the case of unisex names. If the name is not given, including the job title of your recipient.

Community health nurse,
The Emergency registrar,

2. Date (Where to put the date and in what format?)

The date of writing the letter can be placed either at the beginning of the letter or after the recipient’s name and address.

You can either use the full format (2nd October 2018 or 2 October 2018) or just numbers with slashes (2/5/2018). It is also acceptable to use the full format at the beginning of the letter and the number slashed inside (the body) of the letter.

3. The Salutation (Greeting)

The formal salutations in letters always start with the word ‘Dear’ followed by the title and the Surname of the recipient.

Dear Ms Carter
Dear Alexis Carter (If you are confused with the gender of the recipient)
Dear Community Health Nurse (If there is no name given, use the job title)

4. Name and the age of the patient you are referring

A good practice is to write the full name and the age of the patient here. Preferably in one line separated by a comma.

Re: Ms Monica Smith, aged 71 years

It is also acceptable to use the date of birth of the patient

Example: Re: Ms Monica Smith, DOB 10/05/1982

Body of the letter

Ideally, The first paragraph should state your purpose of writing the letter and the following paragraphs should elaborate on the information.
(Remember the words are only counted from here)

5. Introduction

The introduction of the letter should be short and must clearly state the purpose of the letter.
It should include the name of the patient, the chief complaint, and the purpose of writing the letter.

Letters can begin with phrases like,
Mr Daniel is being discharged today back to your care
Thank you for seeing Mr Daniel
I am writing to refer Mr Daniel

6. Summary of the chief complaint(s)

Give a detailed summary of the chief complaint in this section of the letter. (Sometimes according to the case notes and the nature of the task you may need to write more than one paragraphs for this.)

7. Secondary or additional information

In this section of the letter, you can add more relevant information about the patient that you think your recipient should know. (Also: Sometimes according to the case notes and the nature of the task, you may need to write more than one paragraphs for this)

8. Discharge/ Treatment/ Transfer plans and medications

According to the type of letter (referral or discharge, etc.), this paragraph(s) should mention the plans from the case notes.

9. Closing Sentence

This is an important part of a formal letter. Here you are telling your recipient that you are willing to answer any questions they may have. This sentence gives a nice correspondence tone to your letter.

A common phrase is,
‘If you have any questions, please don’t hesitate to ask me.’

10. Sign off

There are mainly two formal sign off styles,
‘Yours sincerely’ and ‘Yours faithfully.

For OET letters, however, S.OET suggests you use ‘Yours sincerely’ as your sign-off as all the official sample answers from OET are signed in that way.

11. Your job title

You don’t need to write your name in OET letter. Writing instead your job title is enough.

Yours sincerely,


Read S.OET’s OET Writing strategy to improve your score in OET Writing Sub-test.

OET Writing Strategy: How to Plan & Write Letter for Grade B or Above

OET Writing Sub-test has a simple task but unfortunately, it is the sub-test most OET candidates fail to secure a band B score. Mostly it is because they start writing without the proper planning that will affect the score in the Comprehension of Stimulus and Cohesion criteria. Having an effective writing strategy is therefore important in getting a good score in the Writing sub-test.

Practice writing with this strategy regularly and getting valuable feedback from an expert trainer also is important.

An info-graph describing the stages of OET writing

The OET Writing strategy by S.OET

1. Analyze the Task

In OET Writing sub-test, you will be given ‘the stimulus’ and ‘the task’. ‘Stimulus’ is a collection of information for the letter, ie the case notes, and ‘the task’ tells you what you need to do. Read the task carefully. It will give you important information to select and organize the relevant case notes for the letter. This include,

  • Who you are writing the letter to?
  • The profession and the position of the recipient?
  • Does the recipient know the patient already?
  • What is the purpose of writing this letter?

2. Analyze the stimulus

Choose the relevant information from the case notes for your letter. Missing relevant information in your letter may cost you dearly. Your band score may go down to a ‘C’. Read each case note and ask yourself whether your recipient should know this? Also, consider these factors,

  • What is the profession/ position of the recipient?
  • Does the recipient know the patient already?
  • What is the purpose of writing this letter?

3. Prioritize the information

Ordering the information according to the relevance and significance is important to write a well-organized letter. Prioritize the information that you want to convey to your recipient,

  • The current medical issue(s)
  • Secondary issues
  • Additional issues

4. Plan your paragraphs

Plan your paragraphs before you start writing the letter. This is usually the most common advice trainers give to their students but it is also the most ignored advice too. However, a well-organized letter reduces the need for re-writing and re-organizing during the test thus it actually saves time. Also, it makes your writing easy to follow and reduces the risk of missing relevant information. A simple organization of paragraphs could be,

The first paragraph– The purpose of the letter (Make sure you mentioned the purpose of writing the letter, also should include the name of the patient and the current issue)

The last paragraph– Tell the recipient what do you want them to do. The requests, recommendations, suggestions, and reminders, etc. (More about the organization of letters will be in another post. Please like and follow the page S.OET to stay tuned)

5. Execute the writing

Some important information to remember,

  • Do not miss any relevant information
  • Do not change the pronouns (He/She) (a very common mistake)
  • Be accurate in name, age, sex, diagnosis, etc.
  • Write in a proper letter format
  • Be consistent in the tone and register

6. Proof-Read

Finally, please do not forget to proofread after writing. It is not that difficult and you would not believe how many mistakes you can correct yourself in your writing by proofreading it.

Please like and follow the page S.OET for more tutorials.