OET Speaking Marking Criteria in Plain English

OET Speaking is marked against nine criteria. Four are about your English: Intelligibility, Fluency, Appropriateness of language, and Resources of grammar and expression, each scored out of 6. Five are about clinical communication, each scored out of 3. This page explains what each criterion listens for, what lowers it and how to practise it.

The nine criteria and their scores

How assessors mark

Your two role-plays are recorded. The interlocutor who plays the patient does not mark you. OET assessors listen to the recording later and decide which level description your performance matches most closely for each criterion. OET says assessors do not count how many mistakes you make.

The clinical communication criteria carry real weight. Fluent, accurate English is not enough if you give advice before finding out what worries the patient, or never check that they understood.

The four language criteria (each out of 6)

Intelligibility

OET describes this as the impact of your pronunciation, intonation and accent on how clearly the listener can hear and understand you. Everyone has an accent. What matters is whether the patient has to work to understand you.

• What lowers it: unclear word endings, stress on the wrong syllable of medical words, and a flat or rushed delivery.
• Drill: record yourself explaining one condition for two minutes. Play it back and note every word a patient might mishear.

Fluency

OET describes this as the impact of the speed and smoothness of your speech on the listener's understanding. Fluency does not mean speaking fast. An even pace with natural pauses is easier to follow.

• What lowers it: long silences while you search for words, frequent restarts, and speaking so fast that the patient can't keep up.
• Drill: explain a common treatment in plain English for one minute without stopping. If you lose a word, describe it in other words and keep going.

Appropriateness of language

OET describes this as the impact of your language, tone and professionalism on the listener's understanding and comfort. With patients, that usually means everyday words, a polite and warm tone, and careful wording around difficult news.

• What lowers it: medical terms the patient won't know, a tone that sounds abrupt or too casual, and blunt wording about serious topics.
• Drill: list ten terms you use at work, such as "hypertension" or "analgesia", and write a plain-English version of each.

Resources of grammar and expression

OET describes this as the impact of your grammatical accuracy and vocabulary choices on the listener's understanding. A wider range helps you say what you mean precisely, but accuracy comes first.

• What lowers it: errors that change meaning, such as the wrong tense for whether a medicine has been stopped, and repeating the same few phrases.
• Drill: practise three ways to give advice: "You could…", "It would help to…", "I'd recommend…". Use each one in your next role-play.

The five clinical communication criteria (each out of 3)

Relationship-building

OET describes this as your choice of opening to the conversation and how you show empathy and respect. It starts with your first sentence.

• Sounds like: "Good morning, I'm Sam, one of the nurses. Can I check your name, please?" and "I can see this has been a worrying week for you."
• What lowers it: skipping the introduction, ignoring a worry the patient mentions, and empathy phrases that don't match what they have said.

Understanding and incorporating the patient's perspective

OET describes this as how fully you involve the patient in the conversation. Find out what the patient thinks, feels and expects, then use it in what you say next.

• Sounds like: "What have you heard about insulin so far?" and later, "You mentioned you're worried about needles, so let me show you how small they are."
• What lowers it: asking about concerns and then moving on without using the answer.

Providing structure

OET describes this as how you organise the information you give and introduce new topics. The patient should always know where the conversation is going.

• Sounds like: "First I'd like to hear how things have been, and then we can talk about the options."
• What lowers it: jumping between topics without warning, and covering the tasks on the card in a random order.

Information-gathering

OET describes this as the type of questions you ask and how you listen to the answers. Start broad, then narrow down, and let the patient finish.

• Sounds like: "Can you tell me more about the pain?" followed by "Does it spread anywhere?" and a short summary of what you heard.
• What lowers it: a list of closed questions, two questions at once, and interrupting the patient.

Information-giving

OET describes this as how you give information and check that it has been understood. Give small amounts at a time and check before moving on.

• Sounds like: "There are two things to remember with this medicine. The first is…" then "Could you tell me how you'll take it, so I know I've explained it clearly?"
• What lowers it: long explanations with no pauses, and checking understanding with "OK?" instead of asking the patient to explain it back.

Before and after

Check your own role-play

Record every practice role-play and listen back once with this checklist. It takes about as long as the role-play itself.

For how the test works, a five-stage role-play structure and a worked example, read our OET Speaking guide.

Written by OET Practice team. Last reviewed: 27 October 2026. Read our editorial policy .