What these two criteria are about
These are the other two linguistic criteria, each scored 0 to 6. A B grade usually means around 5 out of 6 on each (approximate).
| Criterion | In our words | What the listener hears |
|---|---|---|
| Appropriateness of language | Choosing words, tone and level of formality that suit this person in this situation. | Plain words for medical ideas, polite requests, a warm but professional tone. |
| Resources of grammar and expression | How wide and accurate your grammar and vocabulary are. | A mix of sentence types, accurate tenses and modal verbs, and the ability to say the same idea in different ways. |
The two often work together. A wider grammar range gives you more polite and more natural ways to say things.
Register: talk like a clinician, not a textbook
Your interlocutor plays a patient, relative or carer, not a colleague. Medical terms are not wrong, but if you use them without explaining, the listener has to work hard and the patient may not understand. Use the everyday word, or use the medical term and explain it straight away.
| Too technical for a patient | Patient-friendly |
|---|---|
| Your hypertension needs treatment. | Your blood pressure is higher than it should be, so we'd like to treat it. |
| You're NBM from midnight. | Please don't eat or drink anything after midnight. |
| We'll do an FBC and LFTs. | We'll take some blood to check your blood count and how your liver is working. |
| Mobilise as tolerated. | Try to walk around a little more each day, as much as feels comfortable. |
| The lesion is benign. | The lump is not cancer. |
| You're at risk of a DVT. | There's a risk of a blood clot in your leg. |
Politeness: softeners, modals, indirect requests
Direct commands ("Stop smoking." "Take your tablets.") can sound harsh in English, even when the advice is correct. Native speakers soften advice and requests in a few common ways.
- Modal verbs: "You might find it helps to...", "It would be a good idea to...", "You could try..."
- Indirect requests: "Would you mind if I had a look?", "Could I ask you a few questions?"
- Softeners: "perhaps", "a little", "just" (in requests), "I wonder if..."
- Suggestions with a reason: "I'd recommend walking every day, because it helps your heart recover."
Nurse. A patient newly diagnosed with high blood pressure smokes 20 cigarettes a day.
You must stop smoking now. It's bad for your heart.
I wonder if you've ever thought about cutting down or stopping? It would make a real difference to your blood pressure, and there's a lot of support we could offer.
Why: The better version is still clear about the advice, but it invites the patient in. The weak version sounds like an order and may cause resistance.
Range of grammar you can use in any role-play
You do not need complex grammar for its own sake. But a role-play with only simple present sentences sounds limited. These structures come up naturally in clinical conversations:
| Structure | Clinical use | Example |
|---|---|---|
| First conditional | Safety-netting, consequences | If the redness spreads, please call the ward. |
| Second conditional | Gentle suggestions, hypotheticals | If you were able to walk a bit each day, it would help your circulation. |
| Modals of possibility | Explaining uncertain causes | It could be a muscle strain, but it might also be your gallbladder. |
| Present perfect | History and recent change | Have you noticed any change since you started the tablets? |
| Passive | Explaining procedures | A small camera is passed down into your stomach. |
| Indirect questions | Polite information gathering | Could you tell me when the pain started? |
| Relative clauses | Explaining terms | It's a medicine that stops your blood clotting too easily. |
Doctor. Asking about a patient's back pain.
You have pain? Where pain? Pain is bad?
Can you tell me about the pain? Where exactly do you feel it? And how is it affecting your sleep?
Why: The better version uses an indirect request, a wh-question and a present continuous question. The weak version uses broken grammar and sounds abrupt.
Paraphrasing when you don't know the word
Everyone forgets words under pressure. The skill is to keep going by describing the idea. This protects your fluency and shows range, because you are using different words to express the same meaning.
- Describe the function: "the tube that goes into your vein" (cannula).
- Describe the effect: "a medicine that reduces swelling".
- Use "a kind of" or "a type of": "a kind of scan that uses sound waves".
- Use the simpler word: "breathing problem" if you can't find "respiratory".
Phrase bank: appropriate, polite and varied
Would you mind if I asked a few more questions?
Polite indirect request before gathering more information.It might be worth thinking about cutting down a little.
Soft advice about a lifestyle change.If you were able to come in next week, we could check it again.
Second conditional for a gentle suggestion.If the pain gets worse, please let us know straight away.
First conditional for safety-netting.It could be a reaction to the new tablets, but we'll need to check.
Modal of possibility for an uncertain cause.That's the medical name for high blood pressure.
Explaining a technical word you just used.It's a kind of scan that uses sound waves to look inside.
Paraphrasing when the exact term isn't needed or is forgotten.I'd recommend keeping the leg raised, because it helps the swelling go down.
Advice with a reason.Could you tell me a bit more about your diet?
Indirect question for a sensitive topic.I wonder whether a different time of day would suit you better.
Very soft suggestion when the patient is resistant.
How it plays out across 5 minutes
- In prep: circle any medical term on the card and write a plain version beside it.
- Information gathering: use indirect questions and vary your question forms.
- Advice tasks: soften with modals and give a reason. Use a conditional at least once.
- Safety information: be clear and direct.
- If a word goes missing: paraphrase and keep moving.
Check yourself
4 quick questions. Tap an answer to see why.
1 Which sentence is most appropriate for a patient?
2 Which advice best balances politeness and clarity?
3 Which sentence uses a modal of possibility appropriately?
4 You forget the word "nebuliser" while explaining treatment to a parent. What is the best move?