How OET Speaking works
The Speaking sub-test takes about 20 minutes. After a short warm-up conversation (not assessed), you do two role-plays. For each one you get a role-play card and 3 minutes to prepare, then about 5 minutes of conversation. You play the nurse; the interlocutor plays the patient or a relative.
Most nursing regulators, including the UK's NMC and Ireland's NMBI, ask for Grade B (350) in Speaking. Always confirm the current requirement on your regulator's own website.
The 4 linguistic criteria
Each is scored out of 6.
| Criterion | What it means in practice |
|---|---|
| Intelligibility | Can the listener follow you easily? Clear pronunciation, word stress and rhythm matter more than a "neutral" accent. |
| Fluency | Even pace, without long hesitations or restarts. Speed is not the goal: steady and natural is. |
| Appropriateness of language | Words a patient understands ("high blood pressure", not "hypertension"), and a tone that fits: warm, respectful, not too casual. |
| Resources of grammar and expression | Range and accuracy: questions, conditionals, reported speech. Occasional slips are fine if meaning stays clear. |
Try a nurse role-play freeScored on the OET Speaking criteria in about 14 seconds · no card · 6 free role-plays, up to 3 a day
The 5 clinical communication criteria
Each is scored out of 3. These decide many results, because nurses with good English often skip them.
1. Relationship building
Open with a greeting, your name and role, confirm the patient, explain why you are there, and ask permission. Show empathy that names what the patient said, instead of repeating "I understand".
2. Understanding and incorporating the patient's perspective
Find out the patient's ideas, concerns and expectations before explaining, then use their answers in your explanation.
3. Providing structure
Signpost what comes next, so the conversation has a clear shape: "There are two things I'd like to go through: your medication, then your follow-up."
4. Information gathering
Start with open questions, then narrow down. Summarise to check you've understood. Avoid firing a list of yes/no questions.
5. Information giving
Give information in small chunks and check understanding after each one ("Does that make sense so far?"). Avoid jargon, and don't lecture.
What Grade B usually looks like
A Grade B performance is not flawless English. It is a conversation where the patient feels heard, knows what is happening, and understands the key information. Nurses who plateau at C+ usually have enough language but under-use the five clinical criteria.
Try a nurse role-play freeScored on the OET Speaking criteria in about 14 seconds · no card · 6 free role-plays, up to 3 a day
Frequently asked questions
How many criteria are there in OET Speaking?
Nine: four linguistic criteria (intelligibility, fluency, appropriateness of language, resources of grammar and expression), each scored out of 6, and five clinical communication criteria (relationship building, understanding the patient's perspective, providing structure, information gathering, information giving), each scored out of 3.
What score do nurses need in OET Speaking?
Most nursing regulators, including the NMC (UK) and NMBI (Ireland), ask for Grade B, which is a scale score of 350. Requirements change, so always check your regulator's website.
Is grammar the most important part of OET Speaking?
No. Grammar is one of nine criteria. Clinical communication, such as building rapport and checking understanding, carries a large share of the marks and is where many nurses lose Grade B.
Can I practise OET Speaking alone?
Yes. Record yourself doing a role-play and listen back, or use a tool that scores your recording against the criteria and tells you what to fix.