Learning outcome: Explain why you are asking about a patient's difficulty, use the answers to distinguish problems and agree the appropriate next step. Practise a hearing-aid conversation with paired five-task cards, condition teaching, task coaching and an extended nurse model with listening pauses.
A sequence of questions can feel disconnected when the patient does not know its purpose. A short explanation helps: “I'd like to ask separately about the soreness and about the sounds you hear, because they may need different kinds of help.” The next task is to listen. A signpost has little value if you then ignore the answer and continue a fixed list.
This original Mrs Okafor scenario builds on the existing Course7 lesson. Her goal is to join family dinner conversation. She describes both a benefit and a difficulty: voices are clearer in quiet, but competing sounds remain uncomfortable. Physical soreness adds a separate issue. Your explanation and next action must respect all three facts.
1. Original paired cards: a new hearing aid at home
These are original illustrative Jobins Training cards for learning. They are not official OET material and do not predict a score. The partner reads the patient card; the nursing candidate reads only the nurse card.
Nurse card
Setting: Community clinic follow-up.
Situation: Mrs Okafor, 67, received a left hearing aid two weeks ago. At home, conversation at the dinner table still feels difficult, and she says the device is uncomfortable by late afternoon. She is thinking of leaving it in a drawer. The first attempt includes no sudden hearing change, discharge, fever or acute dizziness. Recurrent soreness still needs assessment; the card supplies no examination result. You have no details of the device, its settings, a recent ear examination or the audiology instructions. Your role is to explore her difficulties, support communication and arrange appropriate follow-up, not to adjust the device yourself.
Tasks:
- Ask what Mrs Okafor hoped the hearing aid would help her do and acknowledge her disappointment.
- Briefly explain why you need to ask about both the physical fit and the sound before asking focused questions.
- Explore when the discomfort occurs, what the sound is like in different settings and whether anything has changed since fitting.
- Discuss a practical way to record the difficulties and seek advice from audiology, without claiming that the device is faulty or that the problem will settle by a fixed date.
- Agree a next step, adapt your communication to her hearing needs and check her understanding.
Patient card
Setting: Community clinic follow-up.
Situation: You are Mrs Okafor, 67. Your left hearing aid was fitted two weeks ago. You expected to follow conversation at family dinners more easily. Voices in a quiet room are clearer, but plates and cutlery seem unusually loud at dinner. By late afternoon the part in your left ear feels sore. You have not contacted audiology because you think they will tell you to “get used to it.” You lip-read to help you follow speech. In the first attempt you report no sudden hearing change, discharge, fever or acute dizziness when asked. Do not invent a reassuring examination result.
Tasks:
- Explain that you are disappointed because family dinner was the reason you wanted the aid.
- Say that you can hear voices better in quiet places but find the dining-room noises uncomfortable.
- Describe soreness later in the day; ask whether you must keep wearing the device despite the pain.
- Ask whether it is broken and whether the nurse can simply turn it down.
- Say you are hesitant to contact audiology and ask what useful information you should give them.
Pause and decide: What would you say before asking about soreness and sound? Which of her answers might change your plan? Write a one-sentence purpose statement and two follow-up questions. Then practise the role-play before reading the model.
2. Understand hearing loss, hearing aids and discomfort
Hearing difficulty is more than a volume problem
Hearing loss can affect the passage of sound through the outer or middle ear, the inner ear or hearing nerve, or a combination. The University Hospitals Sussex hearing-aid booklet explains these broad types. Mrs Okafor's card gives no hearing test or confirmed type of loss. Her age does not establish the diagnosis, and having a left hearing aid does not prove that the other ear hears normally.
Following speech depends on more than noticing that a sound exists. Competing voices and background noise can make conversation difficult even when some sounds seem loud. Ask what she can follow, where it becomes harder and which activity matters to her. “Can you hear?” is too broad to distinguish hearing a plate clatter from understanding a family member's sentence.
What a hearing aid can help with
The NHS hearing-aid guidance explains that aids can improve access to sounds and speech, but do not restore perfect hearing. Devices are fitted and programmed for the person's needs. A useful explanation therefore recognises the clearer quiet-room voices while taking the dinner difficulty seriously. Partial benefit does not make the remaining problem unimportant.
The card does not identify the device, its controls or the instructions already given. Do not invent a model, select a programme, change a setting or prescribe a daily wearing schedule. A trained professional can review the actual aid, its fit and the patient's experience. The nurse in this scenario can gather useful information and help arrange that review.
Unfamiliar sound and physical pain need different responses
New users may notice sounds that were previously less audible, and follow-up can help address difficult listening situations. That does not justify telling someone to endure soreness. The UCSF hearing-aid adjustment guidance, updated in September2026, distinguishes unfamiliar sound from pain and advises stopping painful wear and contacting the clinician.
In this case, ask exactly where the soreness occurs, when it begins and whether it continues after the aid is removed. Recurrent discomfort needs a review; do not wait for a promised “settling-in date.” The cause may involve fit, skin or another ear problem. Without an assessment, none of these possibilities is a diagnosis.
Likewise, saying dishes are loud does not establish that the volume setting is wrong. Clarify whether the sound is merely unfamiliar, distressing or painful, and whether it happens elsewhere. Report the description accurately. Do not reduce the patient's account to “doesn't like the aid,” which loses information useful to audiology.
Ear symptoms can change the urgency
The NHS hearing-test guidance advises urgent GP or NHS111 assessment for sudden hearing loss, hearing that worsens over days or weeks, or hearing loss with symptoms such as earache or discharge. These are reasons to seek clinical assessment, rather than assume that the aid needs a routine adjustment.
The NHS earache guidance also identifies ear pain with discharge, swelling, fever, feeling generally unwell or hearing change as reasons for urgent help. Ask about relevant symptoms, but do not make the patient complete every routine question before arranging care. In this clinic, follow the appropriate urgent pathway. If the person becomes severely unwell, escalate according to the clinical situation.
The repeat attempt introduces discharge that was absent from the first card. That new answer removes the basis for continuing only with an adaptation discussion. You do not need to diagnose an infection, prescribe drops or claim an eardrum finding to explain why an urgent review is needed.
Make the conversation accessible now
RNID's clinical communication guidance, updated in September2026, recommends getting the patient's attention, facing them, speaking clearly, reducing background noise and checking understanding. Ask Mrs Okafor what helps her. Lip-reading is one support she uses, not a reason to assume that she can follow every word.
Keep your face visible while speaking and avoid giving instructions while looking down at notes. Offer written information if she finds it helpful. A nod may mean she is being polite or has heard only part of the message. A specific understanding check is more informative than repeating the same sentence more loudly.
Turn observations into a useful review request
A brief record can separate the location and timing of soreness from the listening situation: quiet conversation, clattering dishes, several speakers or another setting. Include what improved as well as what remains difficult. Two clear examples are more useful than a long diary that delays getting help.
Ask about the actual audiology contact route and whether telephone communication is accessible. Do not promise that email, text or a particular appointment is available until checked. If she wants a relative involved, seek her permission and continue addressing her directly. The next step should make it easier for her to obtain the right help, rather than hand her another inaccessible instruction.
3. Coaching for the five nurse tasks
Task 1: identify the goal behind the disappointment
Begin by checking how she can best follow the conversation. Then ask what she hoped the aid would make easier. The dinner-table goal gives the assessment a practical focus. Reflect the gap between that hope and the current experience without announcing that the treatment has failed.
Use her language to guide the next question. If she wants to hear one grandchild across the table, the listening situation differs from everyone speaking at once. Avoid introducing a family member or activity that she has not mentioned simply to make your answer sound personal.
Task 2: explain why there are two groups of questions
Give one short purpose statement before the focused questions: physical soreness and listening difficulty may need different reviews. Ask permission to begin with the soreness, since it needs attention. The purpose statement is a guide, not a prediction that you will discover a particular fault.
Do not explain the purpose again before every question. That makes the interview slow and can obscure the patient's answers. Revisit the reason only if she is uncertain, objects or introduces a new issue that changes what you need to ask.
Task 3: explore comfort and sound without diagnosing
Ask one question at a time about where and when the soreness occurs, its severity and associated symptoms. Clarify any new hearing change or discharge. Use the answers to decide whether urgent clinical assessment takes priority; do not treat all discomfort as an expected part of wearing the device.
When appropriate, move to sound with a clear transition. Ask what is different between quiet conversation and dinner. Summarise the comparison so she can correct it. A positive answer about quiet voices should not cancel out an answer about painful sound or soreness.
Task 4: make follow-up specific and manageable
Ask what makes her hesitant to contact audiology. She may expect dismissal, have lost the details or be unable to hear on the phone. Each answer changes the next action. Do not respond to all three with the same generic instruction to call.
Help prepare a short message that states the problem and the goal. Explain which concern needs clinical assessment and which can be reported to audiology for device review. Check the available route, explain what has been requested and avoid presenting an unconfirmed appointment as booked.
Task 5: check both the plan and access to it
Ask her to describe what will be reported about soreness and about sound, then what she will do next. If she has missed an important distinction, rephrase it and check again. An understanding check also tests whether your communication method is working.
Close with a clear response to change: new discharge or hearing deterioration needs prompt clinical attention, not a wait for ordinary adjustment advice. Invite one remaining question and make sure the written or spoken information is usable for her.
4. Extended nurse-viewpoint model with listening pauses
This expanded learning model shows only the nurse's spoken turns. The italic notes describe listening and decisions; they are not lines to recite. Practise selected parts and then create a concise conversation of your own. If the patient reports a concerning new symptom, stop the routine route and respond to that information.
“Hello, Mrs Okafor. I'm the nurse seeing you today. Before we start, what helps you follow a conversation most comfortably?” Wait for her preference and adapt the seating, noise level or communication method.
“Can you see my face clearly from here? Please tell me if you miss something; I can say it another way or write the important points down.” Check that this offer suits her, rather than assuming written information is always preferred.
“What were you most hoping the new hearing aid would help you do?” Listen for the activity that matters to her. Do not begin with a device checklist.
“You wanted to join the conversation at family dinners, but that still feels difficult. Tell me what happens there.” Let her describe the experience before deciding which explanation to give.
“So voices are clearer in a quiet room, while the sounds at dinner compete with the conversation. Have I understood that correctly?” Allow correction. Both the benefit and the difficulty belong in the summary.
“You also mentioned soreness. I'd like to ask separately about how the aid feels and how things sound, because those difficulties may need different kinds of help. May we start with the soreness?” Pause for agreement.
“Where exactly does it feel sore?” Let her indicate the location. Do not announce an examination finding or assume the mould is responsible.
“When does it begin, and what happens after you take the aid out?” Listen for the pattern, then clarify severity and persistence if needed.
“Have you noticed any fluid from the ear, a new change in hearing, swelling, fever or dizziness?” Ask and clarify at a manageable pace. A concerning answer changes the priority to clinical assessment.
“You should not have to keep wearing it through pain. We need to have the soreness assessed and the fit checked, rather than assume it is something to put up with.” Agree prompt review through the available clinical and audiology routes.
“If it is painful now, take the aid out while we arrange advice. We can adjust how we communicate so you can still follow this conversation.” Check whether she needs help, and do not force a device that is difficult to remove.
“When it is comfortable enough to use, which sounds at dinner are most troublesome?” Move to this part only when the immediate clinical needs permit it. Ask about actual experience, not a fresh test that causes pain.
“Are those sounds unfamiliar and distracting, or do they actually hurt?” Wait for the distinction. Do not treat painful sound as something she must practise tolerating.
“What happens when one person speaks in a quiet room compared with several people at the table?” Use her comparison to refine the description for audiology.
“Hearing aids can make sounds easier to hear, but they do not make hearing perfect. Difficulty in a busy setting still deserves attention, especially when it is stopping you doing something important.” Pause and invite her reaction.
“Some sounds can feel unfamiliar with a new aid. That does not explain away soreness, and it does not tell us whether the settings or fit need changing. The actual device and your ear need the appropriate checks.” Keep a possible explanation separate from a diagnosis.
“You asked whether it is broken. I can't establish that from this conversation. We can describe what you notice so the right person can check it.” Answer directly before offering the next step.
“I don't have the instructions for your controls, so I won't guess at a setting. What were you shown at the fitting, and do you have any written instructions?” Identify what is already available; do not blame her if she cannot remember.
“You said you are worried they may tell you to get used to it. Has something happened that makes you expect that?” Listen to the concern about asking for help, not only the device problem.
“A clear description of the soreness and the dinner difficulty is useful information for them. Would you like us to write those two points down together?” Obtain agreement and use the patient's own descriptions.
“We can include where the soreness is, when it starts, what is clearer in quiet and which sounds make dinner difficult. You do not need to complete a long diary before asking for help.” Check that the proposed note is manageable.
“How would you find it easiest to contact the service? Is the telephone workable for you, or do we need to check another available route?” Do not promise a communication channel that has not been confirmed.
“I will help check the contact route and raise the concerns we have discussed. I cannot confirm an appointment time yet. Would you like anyone involved, or would you prefer to handle this directly?” Respect her preference and consent.
“To check that I explained the difference clearly, what will we report about the physical soreness, and what will we report about the sound?” Listen to both parts. Rephrase any missing point without making it a test of the patient.
“New discharge or a sudden change in hearing needs urgent clinical advice, rather than waiting for an ordinary hearing-aid adjustment. If that happens, seek an urgent GP appointment or contact NHS111.” Check she understands how to obtain help in the practice setting and afterward.
“What would you like us to go over again before we finish? Let's make sure the next step and the contact information are clear in a form you can use.” Allow a final question and confirm only arrangements actually made.
5. Speaking tips: make the question purpose useful
It explains the purpose before collecting details
The signpost tells Mrs Okafor why there are two kinds of questions and asks permission to begin. It also prepares her for a later summary to audiology. Without that link, “Where does it rub?” followed by “Can you hear at dinner?” may feel like unrelated checks.
It uses the answers rather than moving through a fixed list
The model builds on the quiet-room improvement and the dinner-table difficulty. It asks about multiple speakers because that is connected to her actual goal. If she had instead said that the aid whistles constantly in every setting, the next question and referral description would change. A role card's tasks are aims, not a script whose order cannot move.
It avoids false reassurance
There is no basis for saying “It is not broken,” “The soreness is normal,” or “Your ear will adjust by next week.” Audiology may need to check fit or settings. The nurse can acknowledge that unfamiliar sounds may take time to get used to while still taking discomfort seriously. That distinction protects trust.
It adapts the conversation itself
Facing a patient who lip-reads, using a quiet space and checking hearing preferences are part of the communication task. A beautifully worded explanation delivered while looking at the computer screen would miss the patient's access need.
6. Useful sentences for purposeful questions
Purpose statements: “I'd like to understand where the discomfort is, then how the sounds change between places, so I can describe both clearly when we ask audiology to review it.” / “A few questions about when it happens will help us separate a fit problem from a listening difficulty.” The second sentence names possibilities, not a diagnosis.
Exploring comfort: “Where does it feel sore?” / “Does it start as soon as you put the aid in or later in the day?” / “What happens after you take it out?” These questions are short enough for a patient to answer; use one at a time.
Exploring sound: “What can you hear more clearly in a quiet room?” / “What gets in the way at dinner?” / “Is it harder when several people talk together?” This wording makes a comparison rather than asking whether the aid simply “works.”
Responding to reluctance: “You are concerned they may dismiss it. Would it help if we wrote down the two specific difficulties before you contact them?” This addresses the barrier to follow-up and offers a practical action.
Closing: “What would you like them to check first?” / “Can you tell me the two things we are going to report?” / “What should happen next if the soreness continues?” Choose the check that fits the conversation and the pathway you have established.
7. Common mistakes and repairs
Weak: “It's normal. Wear it all day until you adapt.” Better: “Some new sounds can take getting used to, but soreness needs reviewing. Let's describe when it starts and ask audiology to check the fit.” The revision does not dismiss pain.
Weak: “Is it working, yes or no?” Better: “You hear voices better in a quiet room. What changes at dinner when several sounds compete?” The revision uses information already given.
Weak: “I'll ask all these questions so I can fix it.” Better: “I'll ask about the fit and the sound separately so we can explain the problem accurately to the team who can check your aid.” The revision names a realistic purpose.
8. Repeat with a new answer and review the evidence
First attempt: two difficulties, one personal goal
Separate the cards and prepare a few short prompts: communication access, dinner goal, purpose of questions, soreness, sound and next action. Do not read the model during the attempt. The patient should reveal information naturally in response to questions rather than recite the five tasks immediately.
Record only with agreement. Afterward, ask the partner whether they understood why you asked about both comfort and sound. Then identify the exact words that showed you had used the quiet-room benefit and the dinner difficulty. If the same response could have followed any answer, revise that part.
Second attempt: new ear discharge
Replace the first-attempt absence of discharge with: “It's not only sore. Since this morning, there has been fluid coming from that ear.” Keep examination findings and diagnosis unknown. Record your next two or three turns before opening the suggestion. Do not invent an infection result to make the conversation easier.
Open the suggested response and reasoning after your attempt
Possible nurse language: “Thank you for telling me. Fluid from the ear changes what we need to do. When did you first notice it, and has your hearing or pain changed?” Assess the current problem and ask about relevant associated symptoms without delaying help.
“Because you have ear symptoms with discharge, we need an urgent clinical assessment. I will use the clinic's urgent route now. We should not treat this only as a hearing-aid adjustment.”
“I can't tell you the cause before your ear is assessed. Please don't push the aid back into a painful ear or put anything inside to clean it. We will check what care is needed.”
Why this works: The response explains the change in priority, links it to the new information and arranges clinical review. It does not diagnose infection, prescribe drops or claim that changing the volume will help. Outside the clinic, an urgent GP appointment or NHS111 is the appropriate route for this symptom pattern; a person who becomes severely unwell needs escalation according to their condition.
What to listen for: Did you stop the routine sound-adaptation discussion? Did you explain why? Did the patient hear a concrete next step? A sympathetic phrase followed by the same old questions does not demonstrate adaptation.
Third variation: the contact route is inaccessible
Return to the first-attempt symptoms. This time the patient says she is willing to seek a review, but cannot hear staff on the telephone. Explore which communication method works for her and check the options the service actually offers. Do not simply repeat “call audiology” more loudly or automatically hand control to a relative.
Review a short section before repeating the whole role-play
Write down your purpose statement, the patient's next answer and the question or action that followed. Ask whether the connection is clear. Shorten any long justification and remove questions that repeat information already given. Then try the same section with a different patient answer.
On a second replay, check your delivery: one question at a time, a real pause and a visible face when speaking. Ask the partner what they understood about the next action. If they missed it, change the wording or communication method and check again. Do not count a nod as proof.
Finally, list any claim that would require verification: a device fault, examination finding, setting, individual wearing schedule, recovery date or confirmed appointment. Remove unsupported claims from the next attempt. Your goal is a conversation that leads to an appropriate decision while the uncertainty remains honest.
Course connection: The saved Course7 curriculum includes phrase and vocabulary banks and mock-test work. Use this original hearing-aid exercise to practise a phrase for its purpose, then adapt it to a different clinical situation. The matching book, OET Speaking for Nurse Profession, supplies the hearing-aid theme in Roleplay36 and the assessment-purpose theme in Roleplay1. The complete selected cards, explanations, phrases and models were reviewed alongside the full saved curriculum. Mrs Okafor, the paired five-task cards and this expanded model are original teaching adaptations, not official OET material.
Continue learning: Return to OET Speaking for Nurses — Course 7. For guided practice, one-to-one tuition can be discussed around proposed dates and times, subject to tutor availability.
Your next step
OET Speaking for Nurses — Course 7
Explore the complete course outline and related practice topics.
Source: 15 OET SP 151225.epub, Jobins Training. Examples labelled original or illustrative were written for this article. Independent exam preparation; no affiliation with or endorsement by the examining body. Practice does not predict an official score.