You’ve meticulously transferred the patient’s details from the case notes into a letter. It feels complete, yet a sense of uncertainty lingers. Is it good enough for a Grade A or B? Have you demonstrated clinical communication or simply translated a list of facts?
The OET isn’t assessing your ability to copy information; it’s evaluating your professional judgment as a clinician. To score highly, you must think like an assessor.
Let’s dissect the five most common mistakes that prevent skilled nurses from achieving their target scores and introduce the strategies to fix them for good.
The Top 5 Mistakes That Lower OET Writing Scores
Mistake 1: The ‘Data Dump’ - Including Irrelevant Information
The Problem: Many candidates, fearing they’ll miss something important, include almost every detail from the case notes. This “data dump” approach is a major red flag for examiners. It suggests a failure in clinical reasoning—the inability to differentiate between what is crucial for ongoing care and what is historical noise.
The Fix: Adopt the “Recipient-First” filter. Before writing, ask yourself three questions:
- Who am I writing to? (A cardiologist doesn’t need a detailed history of the patient’s eczema).
- Why am I writing? (For an urgent referral, focus only on the acute presentation and relevant history).
- What is essential for them to take the next step?
Mistake 2: The ‘Casual Note-Taker’ - Inappropriate Tone and Register
The Problem: The language of bedside notes (e.g., “pt c/o pain,” “feels down”) is not the language of a formal letter. Using overly informal language, abbreviations, or subjective phrasing undermines your professionalism.
The Fix: Always use formal, objective, and precise clinical language.
Instead of: “The pt is feeling blue and doesn’t want to eat.” Write: “The patient reports a persistent low mood and has a decreased appetite.”
Instead of: “He’s bad at taking his meds.” Write: “The patient has been intermittently non-adherent to his prescribed medication regimen.”
Mistake 3: The ‘Scattered Storyteller’ - Illogical Organization
The Problem: A letter that jumps between past history and the discharge plan without a clear structure forces the reader to become a detective. This directly penalizes you under the ‘Conciseness & Clarity’ criterion.
The Fix: Use a logical blueprint for your letter.
- Introduction: Patient’s full name, age, and the precise purpose of the letter.
- Body Paragraph 1 (Most Important): The presenting complaint, recent changes, and key findings.
- Body Paragraph 2 (Relevant History): A concise summary of history relevant to the current situation.
- Body Paragraph 3 (Management & Request): Treatment to date and the clear action required.
- Conclusion: A polite closing remark.
Mistake 4: The ‘Meaning Mangler’ - Critical Grammatical Errors
The Problem: Assessors heavily penalize grammatical errors that confuse or change the clinical meaning. The most common offenders are verb tenses, prepositions, and articles.
The Fix: Create a “Proofreading Hitlist.” In the last 5 minutes, stop writing and actively hunt for your specific, common errors.
- Verb Tenses: Does the patient has a history or have a history?
- Prepositions: Is the pain in the abdomen or on the abdomen?
- Articles (a/an/the): Use “the” for specifics (“pain in the left knee”) and “a/an” for non-specifics (“She presented with a fever”).
Mistake 5: The ‘Buried Lead’ - An Unclear Purpose
The Problem: The purpose of the letter is the single most important element. If the reader has to get to the third paragraph to understand why you are writing, you have already failed a key criterion.
The Fix: Your first paragraph should be a purpose-built “GPS” for the reader.
Use this formula:
I am writing to [Purpose Verb] [Patient’s Full Name], who requires your [Expertise/Action] regarding [Primary Condition].
Example: “I am writing to urgently refer Mr. John Smith, who requires your cardiological assessment for symptoms indicative of a myocardial infarction.”
Beyond the Fixes: Adopting a Professional Clinician’s Mindset
Recognizing these mistakes is the first step. True improvement comes from a shift in mindset.
- You are a Colleague, Not a Candidate: Write to ensure seamless and safe continuity of care.
- The Case Notes are a Source, Not a Script: Your job is to interpret, select, and synthesize.
- Clarity is Kindness: A clear, concise letter is a mark of a competent professional.
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