How to Acknowledge a Patient’s Concerns in OET Speaking Without Agreeing

There’s a moment that comes up in almost every OET Speaking role play: the patient says something you can’t just agree with. Common examples include: minimizing the severity of their condition, pushing back on a recommendation, asking for something you can’t provide, or they might even express a belief about their health that isn’t clinically accurate. What you do in that moment is one of the things OET assessors are specifically watching for. And for many candidates, it’s also one of the most difficult moments to handle in English under time pressure.

This post explains what’s happening in that moment, why it matters for your score, and exactly what to say.

What OET Is Actually Assessing Here

The OET Speaking sub-test uses clinical communication criteria alongside linguistic ones. One of those criteria is called “Understanding and Incorporating the Patient’s Perspective.” Assessors are looking for evidence that you can elicit and respond to the patient’s ideas, concerns, and expectations, not just deliver information to them.

The OET handbook describes this as “picking up the patient’s cues” and “relating explanations to elicited ideas.” In practice, it means you need to show the patient you’ve genuinely heard them before you respond clinically.

The problem is that many candidates, especially under exam pressure, skip straight to the clinical response. The patient expresses a concern, and the candidate immediately corrects it, explains it, or moves past it. This isn’t necessarily wrong medically, but it misses what the assessor is looking for: evidence that you can hold the patient’s perspective and your clinical responsibility at the same time.

The Motivational Interviewing Concept Behind This Skill

This is where motivational interviewing (MI) offers a useful framework. In MI, when a patient resists or pushes back, the approach is called “rolling with resistance.” The core idea is that arguing with resistance increases it while acknowledging it reduces it. Rolling with resistance doesn’t mean agreeing with the patient. It means reflecting their position back to them in a way that shows you’ve understood it before you offer any clinical information or correction. In MI terms, this is the difference between a simple reflection (mirroring the content of what the patient said) and a complex reflection (naming the underlying concern or emotion). [If you want to learn more about these terms or MI, check out our short course here.]

In the OET Speaking test, this distinction translates directly into score points. A candidate who immediately counters a patient’s concern is demonstrating the “righting reflex,” the instinct to correct and persuade. A candidate who first acknowledges the concern, then responds clinically, is demonstrating patient-centered communication. Those are two different bands on the OET assessment rubric. [Learn more about the righting reflex here.]

Three Scenarios and What to Say

Each of the following scenarios reflects the kind of “tension point” OET role plays are designed to include. The patient says something the candidate can’t accept without acknowledging, and the candidate’s response determines whether the interaction moves forward or stalls.

Scenario 1: The patient dismisses the severity of their condition

Patient: “I’ve had this pain for years. It’s nothing serious. I just came in because my wife made me.”

What not to say: “Actually, based on what I can see, this could be quite serious, and I’d like to run some tests.”

What to say instead: “It sounds like this has been part of your life for a long time, long enough that it’s started to feel normal. I can understand why it might not feel urgent to you. I’d like to find out a bit more about it, if that’s okay, because some of what you’ve described is worth looking at more carefully.”

The first response is clinically accurate but makes the practitioner into an adversary rather than an educator and advocate. The second acknowledges the patient’s experience, normalizes their perspective, and then introduces clinical concern without confrontation.

Scenario 2: The patient refuses a recommendation

Patient: “I’m not interested in changing my diet. I’ve eaten this way my whole life, and I’m not going to start now.”

What not to say: “I understand, but the evidence is really clear that diet plays a significant role in your condition.”

What to say instead: “I can understand that. You have a way of eating that’s been part of your life for a long time. It’s not a small thing to be asked to change. I’m not here to tell you what you have to do. What would it mean for you if things stayed the way they are?”

Notice that the MI-consistent response validates the patient’s autonomy explicitly (“I’m not here to tell you what you have to do”) and then uses an open question to invite the patient to consider the consequences themselves. This is far more clinically effective than presenting evidence, and it’s what higher-scoring OET candidates do.

Scenario 3: The patient demands something you can’t provide

Patient: “I want a referral to a specialist. I don’t think you can help me with this.”

What not to say: “A referral isn’t necessary at this stage. Let me explain what I think is happening.”

What to say instead: “It sounds like you’re not feeling confident that what you need is available here, and I want to take that seriously. Can you tell me more about what’s making you feel that way? I want to make sure I understand what you’re looking for before we talk about next steps.”

This response mirrors the graded OET sample role play in the test handbook, where a patient demands a neurological referral. The high-scoring candidate doesn’t immediately refuse or immediately agree. They acknowledge the concern, gather more information, and then present a clinical position. That progression is what boosts your score.

A Phrase Bank You Can Use During the Test

These phrases work across a wide range of OET Speaking scenarios. They acknowledge without agreeing, they’re appropriate for B2+ English speakers, and they sound natural rather than rehearsed.

To acknowledge the patient’s position:

“It sounds like…”

“I can hear that…”

“That makes sense, given…”

“I can see why it might feel that way.”

“It sounds like this has been on your mind for a while.”

To preserve autonomy while introducing a clinical view:

“I’m not here to push you in any direction.”

“Ultimately, this is your decision.”

“What I’d like to do is share what I’m seeing and then hear what you think.”

Why This Also Makes You a Better Clinician

The skills that earn higher scores on the test are the same skills that make patients more likely to engage with your recommendations, more likely to be honest about their challenges, and more likely to leave an appointment feeling heard. Acknowledging a patient’s concern without immediately agreeing or arguing is a clinical skill. For healthcare professionals working in English as an additional language, having the exact phrases ready can make the difference between a competent response and a confident one.

Want to practice this in a real OET Speaking scenario?

My one-on-one OET preparation sessions combine targeted language coaching with clinical communication skills, so you’re not just preparing for the test but building the English you need for real clinical practice. Book a free 15-minute consultation here.

Or try our free OET Clinical Scenario Coach, an AI-powered tool that gives you instant feedback on your role play responses here.

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