OET Nursing practice test and referral letter guide: format, criteria and tips

A free OET Nursing practice test, with the shared Listening and Reading papers, a nursing letter and two nursing role-plays, is at /exam/oet/nursing. In OET Nursing, only Writing and Speaking are nursing-specific: the Writing task is one letter of about 180 to 200 words, written in 40 minutes after 5 minutes of reading case notes, usually a referral, transfer or discharge letter, and Speaking is two role-plays in which you are the nurse. Listening and Reading are the same papers taken by all twelve professions. This guide explains the format, how the letter is marked, and how to practise it.

OET Nursing at a glance

Each sub-test gets a score from 0 to 500, in steps of 10, and its own grade from A to E. There is no overall score. OET equates grade B with 350, and a worked example on its site equates C+ with 300. There is no single pass mark: each regulator, employer or university sets the grades it needs, often a B in each sub-test. Check your nursing council's own page.

You can take OET on paper or on a computer at a venue, or at home (OET@Home). Our OET 2026 guide has the booking steps and the next paper dates.

The nursing letter: what OET asks for

From OET's Writing pages and its sub-test description:

• Task types: usually a referral; sometimes a transfer, a discharge, or a letter to advise or inform a patient, carer or group. The task names the reader, and the case notes are about a nursing patient.
• Length: 180 to 200 words in the body. There is no automatic penalty outside that range, but OET says a letter that is much longer usually includes irrelevant material, and a much shorter one has usually missed information.
• Reading time: 5 minutes to read the case notes and plan; then 40 minutes to write. You can look at the notes and the task throughout.
• Layout: OET accepts the different formats used by health professionals; there is no single required layout, but the letter must be clearly laid out and suit the task. Use the reader's title and address exactly as the task gives them.
• Capitals: you may write in all capitals if you prefer, but be consistent.

How the letter is marked

Two OET assessors mark every letter against six criteria:

OET says candidates who get a grade B have 2 out of 3 for Purpose and 5 out of 7 for the other five criteria. Spelling mistakes count under Language.

A plan for a nursing referral letter

OET says the task requires you to select and organise relevant information and present it clearly for the intended reader. Use the 5 minutes of reading time for that.

1. Read the task first. Who is the reader, and what must they do (continue wound care, review medication, arrange home support)?
2. Read the notes and mark each line as needed, maybe, or not needed for that reader. Stable history that does not affect the next step of care usually goes.
3. Group what is left into three or four paragraphs.

A shape that works for most nursing referral and discharge letters:

• Opening paragraph (Purpose): who the patient is, why you are writing, and the request. For example: "I am writing to refer Mrs Ana Silva, aged 78, who is being discharged today after a hip replacement, for daily wound care and support with mobility at home."
• Paragraph 2: the relevant background and what happened in hospital, in time order, briefly.
• Paragraph 3: current condition and care: wound, medicines, mobility, diet, the patient's own concerns.
• Paragraph 4: what you ask the reader to do, with any warning signs to watch for, and a polite close.

Write in full sentences, not note form. Change case-note abbreviations into words the reader will understand, and avoid copying long lists of observations; summarise them ("observations have been stable").

Speaking for nurses

In each role-play you are the nurse; the interlocutor plays a patient, relative or carer. Two assessors mark the recording, not the interlocutor:

• Linguistic criteria, each out of 6: intelligibility, fluency, appropriateness of language, resources of grammar and expression.
• Clinical communication criteria, each out of 3: relationship building, understanding and incorporating the patient's perspective, providing structure, information gathering and information giving.

OET describes a grade B as mostly 5 out of 6 on the linguistic criteria and 2 out of 3 on the clinical ones. You do not lose marks for not covering every point on the card; what matters is a natural conversation that listens to the patient.

How to practise

• Listening and Reading: practise them as shared papers. OET says a grade B on Listening or Reading typically takes at least 30 of 42 marks. In Part A of both, answers must use the words from the recording or text, spelled correctly.
• Writing: write one timed letter a week at first, then two. After each, score yourself on the six criteria above, and count how much of your letter the reader would not miss if you deleted it.
• Speaking: record yourself doing role-plays from nursing situations you know: discharge advice, a worried relative, a patient refusing treatment. Listen for whether you asked about the patient's concerns before giving information.
• Full test: sit one complete practice test early to find your weakest sub-test, and another two to three weeks before your date.

Our article on how to use mock tests explains how to space them out.

Free OET Nursing practice test

The OET Nursing practice test has the shared Listening and Reading papers, a nursing letter and two nursing role-plays, and gives an estimated score for each sub-test. For test dates and booking, read OET 2026: test dates, format, how to book and free practice tests; doctors will find the Medicine test on the OET page.