How to manage difficult conversations in OET Speaking

Use “I Statements” to open up the discussion (tends to

decrease defensiveness in the listener).
 “I’m worried about your getting to clinic late…”
 “I’m concerned about your interaction with…”
 “I have something important to discuss about…”
 “I wanted to meet with you to follow up on…”
 “I wanted to meet with you because the doctor is
concerned about….”
 “I can see that you seem angry/anxious……..”

Try to stay calm if the patient engages in disruptive or

inappropriate behavior. Use the “Six Second Rule” – when
you feel you are getting angry, wait for 6 seconds or until yoi
are calm before responding.
Use “Tell me more” to clarify.
 “When you say I don’t think it’s possible to make
changes to your lifestyle, can you tell me more?”
 “When you say you are angry because you were
treated unfairly/mistreated, could you please tell
me a little more?
 “I’m wondering what you think is getting in the way
of……….losing weight or making changes to your
diet?”

Rephrase the other person’s issue to ensure you have an

accurate understanding of the situation.
“So, what I hear you saying is…”
TIP: Avoid being judgmental towards the patient. It’s about
changing behavior using negotiating techniques.

Use empathy to validate and acknowledge their feelings

 “I can see you why you are upset/angry.”

 “I know this is hard for you to hear.”
 “I see your point.”
 “This isn’t easy to talk about, is it?”
 “If I were you, I would react in the same way”
 “It sounds frustrating.”
 “I appreciate that this is difficult for you.”

Use “Wish Statements”

 “I wish I could change that.”
  “I wish I had better news.” (in case of unpleasant or
bad news).

State your expectations.

 “It’s important that we resolve this.”
 “I’d like to see you try to…”
 “This is really important so let’s find some way as to
how we can fix this.”

State facts and consequences– to justify your advice and

explain the risks associated with non-compliance.
 “In going over your report,……”
 “I see that…”
 “It can exacerbate your health in the long run.”
 “It can have adverse effects on your health.”
 “The repercussions of not making changes at this
stage can be quite serious.”

Elicit patient’s perception or ideas

 “What are your ideas for how we can…?”
 “What do you think it will take for you to……?”
When you have achieved concordance, reiterate.
 “I am glad that we have a consensus (a general
agreement). So, this is what we’ve decided.”