The task
Assume that today's date is 23 October 2026. You received Ms Perera's letter on 19 October 2026.
You are Joanne Ashby, a senior radiographer in the Medical Imaging Department. Using the information in the case notes, write a letter to Ms Jing Perera, the mother of your patient Benedict Herath, replying to her concern about the X-rays her son has had. Explain why each X-ray was needed, what the radiation dose means and how the dose is kept low. Address the letter to Ms Jing Perera, Unit 3, 27 Banksia Avenue. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180–200 words.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Response letter.
Case notes
Patient details
- Patient: Benedict Herath, DOB 14/03/2020 (6 yrs)
- Mother: Ms Jing Perera, Unit 3, 27 Banksia Avenue
- Imaging requested by: ED doctors, then fracture clinic (orthopaedics)
Mother's letter (received 19/10/26)
- Worried 4 X-rays in 2/12 may be harmful; asks if cancer risk ↑
- Asks whether all X-rays were really necessary
- Asks whether son should avoid future X-rays (e.g. at dentist)
- Says pt's father 'thinks hospitals over-test'; parents separated, disagree about pt's care
- Also complains hospital car park fees too high
Social background
- Lives with mother and older sister (9 yrs)
- Year 1 student; plays junior soccer on weekends
- Mother works part-time as pharmacy assistant
Medical history
- Mild asthma — salbutamol PRN
- Nil other significant hx; allergies: nil known
- Routine dental X-rays 2025
Fracture and imaging
- 25/08/26 fell from trampoline → L distal forearm fracture (radius + ulna), displaced
- X-ray 1 (25/08, ED): confirmed fracture, showed bones out of position
- Fracture manipulated (straightened) under sedation in ED; above-elbow cast applied
- X-ray 2 (25/08, after manipulation): check bones in good position — satisfactory
- X-ray 3 (01/09, 1/52): check position maintained in cast — manipulated fractures can slip in first wks; satisfactory
- X-ray 4 (06/10, 6/52): confirm sufficient healing for cast removal — healed well; gentle everyday activities permitted, return to sport according to fracture-clinic advice
- Each exam: 2 views of forearm only; no images had to be repeated
- X-ray 3 taken by student radiographer under direct supervision
- Pt upset during X-ray 3; settled with sticker
Radiation dose
- Forearm X-ray = very low dose; each ≈ < 1 day of natural background radiation (from soil, air, food); all 4 together ≈ a few days' worth
- Forearm far from radiation-sensitive organs → risk to pt extremely small; benefit of each X-ray far outweighs risk
- Children more sensitive to radiation than adults → extra care always taken
Dose reduction
- Each X-ray requested by doctor only when result would guide treatment
- Child-specific low exposure settings; X-ray beam limited to forearm only; modern digital equipment
Plan
- Fracture clinic: no further X-rays planned unless new symptoms
- Future X-rays (incl. dental) should not be avoided if recommended by doctor/dentist — benefit > risk
- Final fracture clinic review 03/11/26
- Offer phone discussion — Medical Imaging reception, Mon–Fri 8 am–5 pm
Who is reading, and what do they need?
Ms Perera is a layperson, a pharmacy assistant, worried about harm and possible cancer risk. She asked three questions: were all X-rays needed, is the risk higher, and should future X-rays be avoided. She needs plain language, reassurance grounded only in the stated facts, and no technical detail.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| X-ray 1 confirmed the displaced fracture; X-ray 2 checked position after manipulation | Answers 'were they necessary' for the first two examinations, with reasons tied to treatment decisions. |
| X-ray 3 checked position held in cast; X-ray 4 confirmed healing before cast removal | Completes the reason for each remaining X-ray. Position can slip in the first weeks after manipulation. |
| Each forearm X-ray < 1 day of natural background radiation; all 4 a few days | Gives her an understandable comparison for the dose, which answers her central worry without invented figures. |
| Forearm far from radiation-sensitive organs; risk extremely small; benefit outweighs risk | Directly addresses her cancer-risk question using only what the notes state. |
| Children more sensitive to radiation; extra care always taken | Honest acknowledgement of her concern that also leads into the safeguards. |
| Child-specific low settings, beam limited to forearm, digital equipment, requested only when result guides treatment | Shows how the dose is kept low, which the task asks you to explain. |
| Two views per exam, forearm only; no images repeated | Reassures her that no extra exposure came from repeats. |
| No further X-rays planned unless new symptoms; do not avoid future X-rays if recommended | Answers her question on future X-rays, including dental, and the recommendation is clear in the notes. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Also complains hospital car park fees too high | Trap: part of her letter, but not about the X-rays and not for the radiographer to address here. |
| Father 'thinks hospitals over-test'; parents separated, disagree about care | A private family disagreement. Writing about it could take sides or breach sensitivity. |
| Patient upset at X-ray 3; settled with sticker | Not relevant to her questions and does not help the explanation. |
| X-ray 3 taken by student radiographer under direct supervision | She did not ask, and no image was repeated. It adds nothing to the dose explanation. |
| Asthma with salbutamol, junior soccer, sister, school year | Social and medical detail unrelated to the radiation concern. |
A paragraph plan for this case
Start by acknowledging her letter and concern, then explain each X-ray and why it was needed in order. Next cover the dose and how it is kept low, then the plan for future X-rays and the review date, ending with the phone offer and hours.
Where candidates slip on this task
- Do not promise there is no risk. Use the notes' statement that the risk is extremely small and the benefit outweighs it, and avoid adding percentages or other figures.
- Keep each X-ray's reason separate and tied to a treatment decision, with dates matching the notes (25/08 twice, 01/09 and 06/10), so she can see none was routine or repeated.
- Do not take sides in the parents' disagreement or respond to the car park complaint. Use neutral, warm language that answers her three questions.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
More Radiography letter tasks
- Information on a reaction to CT contrast response letter
- Complaint about an older patient's wait in the department response letter
- Complaint from a residential aged care facility response letter
Your profession's guide: OET Radiography. Layout and structure: OET letter format.
Questions about this task
Should I give a precise dose figure?
No. The notes give only comparisons to natural background radiation: each X-ray under one day's worth, all four a few days' worth. Using these keeps the letter accurate and understandable for a parent.
How should I handle her question about dental X-rays?
State that future X-rays, including dental, should not be avoided if a doctor or dentist recommends them, because the benefit outweighs the risk. Do not add statements about dental dose, which the notes do not give.
Sources
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