R000007

READING SUB-TEST – QUESTION PAPER: PARTS B & C

TIME: 45 MINUTES

INSTRUCTIONS TO CANDIDATES
DO NOT open this Question Paper until you are told to do so.
One mark will be granted for each correct answer.
Answer ALL questions. Marks are NOT deducted for incorrect answers.
At the end of the test, hand in this Question Paper.
DO NOT remove OET material from the test room.

HOW TO ANSWER THE QUESTIONS

Mark your answers on this Question Paper by filling in the circle using a 2B pencil. Example: A
B
C

www.occupationalenglishtest.org
© Cambridge Boxhill Language Assessment – ABN 51 988 559 414 (2019)
 Part B

In this part of the test, there are six short extracts relating to the work of health professionals. For questions 1-6,
choose the answer (A, B or C) which you think fits best according to the text.

1. The memo reminds staff about

A the importance of explaining to patients what happens if they decline help.

B a situation where there is a requirement to override the protocol.

C guidelines which are available to provide additional support.

Memo

To: All staff

Subject: Reminder about guidance for safeguarding adults in suspected cases of domestic abuse

If you suspect a patient is the victim of domestic abuse, explain to them that you’re concerned and give your

reasons. Point out that this is a routine procedure where we think patients may be experiencing domestic abuse.

Tell them that there are specialists on site who they can talk to in confidence if they wish. If this offer isn’t taken

up, document your concerns and pass the information onto the Independent Domestic Violence Advocate

(IDVA), who will keep the information confidential. Remember that IDVAs will not make direct contact with the

patient without their consent unless there is significant threat to life. However, where you think the patient’s

own life may be in imminent danger, disregard matters of confidentiality and contact the police.
2. What does the extract say about original copies of informed-consent

A They must always be kept in the patient's medical record.

B It is acceptable for them to be placed in the research records.

C Researchers should make them available to hospital staff on request.

Medical Research: Storage of informed-consent documents

Informed-consent documents must be readily accessible to all medical staff. Therefore, where research

is pertinent to clinical care by hospital physicians and nurses, researchers must place either the original

document, or a copy of it, in the patient’s medical record, as well as a copy in the research records.

Should commercial sponsors require the original informed-consent document to be filed within a

research binder, the hospital's Medical Records Department will accept a copy of the patient’s signed

informed consent in lieu of the original. In order to determine the manner of storage, it is important to

understand sponsor requirements prior to initiating a research study. As an original consent document

could go astray, and therefore not make its way to the medical record, a researcher may always choose

to store the original document in the research binder.

3. The guidelines state that clinical staff must

A obtain permission to order new devices.

B record all instances of devices going missing.

C assess whether devices are functioning properly.

Extract from guidelines - Medical devices and equipment

Procurement

Any member of staff wishing to procure an item that is defined as a ‘medical device or piece of

equipment used for patient care’ should seek advice from the Health and Safety Manager, who will then

ensure that the device is being purchased from an approved supplier.

Device deployment

When equipment is allocated to a department, clinical staff have primary responsibility for the way they

treat the equipment and the state in which it is left. These responsibilities also include performance

checks before use and routine maintenance, such as charging batteries. Any problems with any device/

equipment should be reported to the manager without delay and the device/equipment should not be

used until it is fully tested as safe. If a piece of equipment or device is removed from service, then an

incident form should be completed and sent to the Health and Safety Manager.
4. This notice about the management and reporting of accidents is aimed at

A all managers and staff of the hospital.

B external contractors working in the hospital.

C any hospital employee regardless of location.

Management and Reporting of Accidents and Incidents

Every member of staff has a responsibility to maintain safe systems of work, to take care of their own

safety and that of colleagues and all other persons who may be affected by their acts or omissions. Any

incident or near miss should be reported to the person in charge, supervisor or senior manager as soon

as possible. That person is the person with responsibility for the area concerned at the time that the

incident or near miss takes place. An incident report should be completed as soon as possible after the

event.

In the event of a member of staff suffering an incident or near miss whilst in the course of their duties on

the premises of another organisation, the reporting procedures for that organisation should be followed in

addition to our own.

5. The extract from the policy document stresses that in the event of a fire,

A the required number of staff will always be on duty.

B all staff are competent to move patients out of danger.

C patients must never leave the building unaccompanied.

Extract from Hospital Fire Safety policy

The basic concept governing means of escape from premises is that the occupants, including patients,
assisted as appropriate, should be able to turn their backs on a fire, wherever it occurs; then travel
away from it directly through circulation spaces and stairways to a relative place of safety, firstly within
the premises and then, if necessary, to one outside the building to a final place of safety. As far as
reasonably practicable, a minimum of two members of staff will be present at all times (three if there
are over thirty patients). These members of staff will have received training in the methods of patient
evacuation appropriate to the level of dependency of the patients and will be familiar with the evacuation
strategy particular to their place of work.
6. The extract from the users' manual explains that the device may be damaged

A if the collection jar is allowed to overfill.

B if certain parts are not cleaned regularly.

C if it is not regularly maintained by qualified staff.

Mains-powered suction units

The AC 20 is a mains-operated suction unit for removing secretions, blood and body fluids. During all
suction procedures, always observe the fill level in the collection jar (including foam). Rinse suction
catheter, suction cannula and suction hose with clean water after each suction procedure.

CAUTION!

• Make sure that the collection jar is evacuated in time. Generally, it must be evacuated after each
finished suction procedure. When the jar is full, the overflow safety reacts and the unit stops
sucking. In the event of extensive foam formation, however, liquid may reach the filter which will
then lose its air permeability and need to be replaced.

• When secretion has penetrated the pump the unit has to be maintained by an authorized service
technician.
 Part C

In this part of the test, there are two texts about different aspects of healthcare. For questions 7-22, choose the
answer (A, B, C or D) which you think fits best according to the text.

Text 1: Psychology and allergy

As a clinical psychologist, I’m very familiar with the concept of ‘Them and Us’, the idea that in order for me to be
okay, to have what I need, I have to keep others – them – out. It’s not an uncommon belief in society. Interestingly,
this definition also almost perfectly defines allergy. When the body - Us - mistakenly identifies foreign food proteins
- Them - as dangerous, it launches an excessive, possibly cataclysmic, defence. Of course, that food will usually
become part of Us once eaten and digested, but in cases when the body sees it as a threat, it is most certainly
Them. Them and Us confusion also causes other immune system diseases such as autoimmune arthritis where the
body mistakes connective tissue for a threat and attacks it, resulting in terrible joint pain.

You may be wondering why a psychologist would be interested in allergies. There are actually a few good reasons,
but basically, in terms of allergies in general, during the middle part of the twentieth century, we often viewed the
condition as a psychosomatic illness, a physical manifestation of psychological problems. In the case of asthma,
the asthmogenic, or asthma-producing, home, often featuring a stereotype smothering, overbearing parent, was
often seen as the cause of childhood asthma, to the extent that so-called ‘parentectomies’ – the separation of the
child from its parents – were suggested as a possible cure.

Also at that time, the relationship between mental illness and food allergy symptoms was similarly complicated,
and controversial. Food allergists and their critics clashed frequently. On the one hand, many prominent food
allergists stressed that food allergy could trigger mental disturbances, ranging from depressive and psychotic
episodes to hyperactivity in children. The solution to many a person’s mental illness, they argued, was a thorough
elimination diet to determine the food that was at fault. Food allergy critics however – and there were many of them
– argued the very opposite: the symptoms of food allergy were nothing more than the physical manifestations of
psychological problems. So-called food allergy sufferers, they argued, would benefit more from the counsel of a
good psychiatrist, rather than an unscrupulous food allergist, who would merely encourage their delusions.

As in many instances of medical controversy, it now seems likely that neither the allergists nor their critics were
completely right, nor completely wrong. While food, and especially food chemicals, are most probably the cause
of mental disturbances in some sensitive individuals, and particularly children, the intensity of an allergic reaction
can certainly be exacerbated by heightened levels of stress. There is most certainly a psychological component not
only to allergy, but also to many other aspects of our immune system.
But after I gave a talk on allergy at another conference recently, it became clear that there was also another
psychological aspect to the subject. As I stepped down from the podium, a crowd of people quickly assembled
in front of me, asking all manner of, well, fairly personal questions about their, frankly surprising, range of food
allergies. Now, while I always provide the disclaimer that I am not a medical doctor, I quite enjoy hearing the stories
people have to tell, which are often very poignant. And sometimes I feel I can give a small amount of advice, if it
is only to suggest that a second opinion is sought. In this particular instance, I could tell that many of the people
asking me questions had not received a great deal of sympathy from their doctors and simply wanted someone to
talk to. It was as if I was the first person with the word doctor in front of their name who was willing to listen. and I
felt the beginnings of a real connection. But time is not always on the side of the listener. After about ten minutes,
I needed to move aside for the next speaker. On the stairs outside of the auditorium, however, the fascinating
conversations continued until I had to be hauled away from them because I’d promised to give a media interview.

What struck me was that there was something missing in the relationship these people had with their various
physicians. Dealing with disturbing, unexplained symptoms, many food allergy sufferers feel isolated. This is terribly
unfortunate, but it does help to explain why often completely unqualified food allergists have been so successful
in attracting patients, despite their often eccentric theories. For one thing, they listened to their patients. Not only
that, they also had to rely on their patients’ testimony and experiences to diagnose their allergies. The relationship
between food allergists and patient was more of a partnership, with each party playing an essential role. Some
psychiatrists might even learn something from this approach.
Text 1: Questions 7-14

7. What does Dr Goody find interesting about the idea of ‘Them and Us’?

A The parallels between people’s mental and physical processes.

B The probability that the concept is generally a mistaken one.

C The fact that it is so widespread in terms of health problems.

D The wide range of medical conditions it is relevant to.

8. Dr Goody says that the psychologist ‘s interest in allergies reflects the fact that they were

A linked to some early theories of gender stereotyping.

B widely regarded as examples of psychological illness.

C considered to be good guides to general mental health.

D thought to be curable by treatments based on psychology.

9. According to Dr Goody, critics of food allergists believed that they

A were guilty of exploiting their patients’ own misguided beliefs.

B had misunderstood the exact role of allergy in mental health-issues.

C were deliberately ignoring the benefits of psychiatric help for patients.

D had overlooked important psychological research evidence on the subject.

10. Dr Goody explains that we now know that the food allergists and their critics had both

A contributed to current understanding of the immune system.

B been unaware of the mental health risks from chemicals in food.

C made a number of incorrect assumptions when discussing allergy.

D correctly understood different aspects of the consequences of allergy.

11. What did Dr Goody learn from his recent experience at a conference?

A A lot of allergy sufferers feel that their GPs have too little time to help them.

B Allergy sufferers are often in need of someone to share their problems with.

C Only a limited number of allergy sufferers have ever received any treatment.

D Many allergy sufferers are unwilling to take their problems to a psychologist.

12. In the sixth paragraph, Dr Goody uses the expression ‘hauled away’ to emphasise

A his reluctance to speak to the media about his work.

B the extent to which he had enjoyed giving his talk that day.

C his desire to learn more about the problems faced by his audience.

D the involvement he felt with the people who had wanted to talk to him.

13. Dr Goody believes that unqualified food allergists attract patients because

A they offer a fresh perspective on their patient’s problems.

B they have a mutually beneficial relationship with their patients.

C they are happy to tell their patients what the patients want to hear.

D they have more time to spend with patients than mainstream practitioners.

14. In the final paragraph, the word that in the expression not only that refers to

A an approach to the care of allergy patients.

B a particular way of coping with allergy problems.

C one assumption regarding the origin of certain allergies.

D the relative importance of doctor and patient in allergy cases.

Text 2: Chronic pain

You sometimes hear it said that physicians in the USA have a rather negative attitude towards chronic pain. If
so, it’s an attitude that is already evident in medical school. The literature supports the notion that undergraduate
medical students are concerned about treating patients with chronic pain. A qualitative study found that many
viewed chronic pain as the condition it was most difficult to deal with. The failure to teach undergraduates
appropriate bio-psychosocial chronic-pain management skills is consistent with the finding that pre-clinical
relationship skills curricula aren’t well co-ordinated. Of this disconnect, Giordano and Boswell astutely noted, ‘So,
while mechanisms of pain and analgesia are taught during basic neuroscience courses, there is no direct link to
how the complexities of these systems are relevant to the illness of chronic pain and challenges of chronic-pain
management’.

Inadequate training of primary-care providers is certainly not a new phenomenon. Early in the history of the
discipline of pain medicine in 1976, John Bonica called for increased education about pain in all health-sciences
schools. There was a minimal response to this call. Then, in 2000, the American Academy of Pain Medicine
(AAPM) issued a position statement, calling upon medical schools to increase required curricular content in
chronic pain, palliative care, and end-of-life care, but this, too, had little influence on medical school curricula as far
as we can determine.

In their 2011 study, Mezei and Murinson found that a number of American medical schools didn’t report any
teaching of pain whatsoever, with many requiring five or fewer hours of such education. The authors concluded
‘that pain education for North American medical students is limited, variable, and often fragmentary’. In 2005,
the International Association for the Study of Pain published its Core Curriculum for Professional Education in
Pain. The report of the First National Pain Summit also called for better education about pain, as did the Core
Competencies for Pain Management report and the Institute of Medicine (IOM) report. Little happened to medical
education in response to these guidelines and reports. As reported by Briggs and colleagues, ‘… the amount
of hours of pain education in the undergraduate curricula is woefully inadequate given the burden of pain in the
general population’.

Most medical schools utilise a biomedical model and focus on knowledge-based learning, often ignoring students’
emotional development and reflective capacity, both of which are necessary to deal with pain patients effectively. A
recent study in which board members of the AAPM rank-ordered ideal objectives of medical student pain education
yielded not only examination and prescribing skills but also compassionate care/empathy and communication as
the top four of twenty-eight topics identified.
Recently, Carr and Bradshaw recommended changing the approach of the standard pain curriculum from an
emphasis on subcellular and cellular processes to a focus on interpersonal, social processes, thereby shifting
the paradigm from ‘bio-psychosocial’ to ‘socio-psychobiological’. Medical students and residents, they say, need
to be taught the differences between acute and chronic pain, and the potential for acute pain to progress toward
chronicity if the psychosocial sequelae of pain aren’t treated appropriately.

Altering a medical-school curriculum by internal political processes can be exceedingly difficult. The reality, of
course, is that the number of hours allotted to a curriculum is fixed; indeed many schools are trying to reduce
their classroom hours. To introduce something new into the curriculum, something old must be taken out. As most
medical schools are strongly departmentally organised, nobody wants to give up time from their specialty area to
allow this to happen. This is compounded by the fact that pain doesn’t have a clear departmental home, in contrast
to all organ systems. So what department is likely to fight for pain turf? The problem isn’t the lack of educational
materials but rather the lack of time in the curriculum to teach about the sciences basic to pain and its clinical
management.

It is widely recognised that optimal management for chronic-pain patients comes from a multi-disciplinary and
even multi-professional approach that makes use of medical, nursing, social work, psychology, physical, and
occupational-therapy skills. Inter-professional education will facilitate chronic-pain management, but this is a novel
educational format in most health-sciences educational programs. The response to the IOM report should include
a revolution in education regarding chronic pain in American schools of medicine. We’ve seen little evidence that
this is about to occur in spite of the NIH Pain Consortium Centers of Excellence for Pain Education programs in
twelve health-sciences schools. Chronic pain remains an orphan disease for undergraduate medical education; yet,
it is one of the most common reasons for seeing a healthcare provider. The time is long overdue for a change in
what we teach medical students and residents about pain, and, most importantly, how to deal compassionately with
chronic-pain patients
Text 2: Questions 15-22

15. What point is made about chronic pain in the first paragraph?

A Medical schools should include courses on its causes.

B Medical students should be better trained to recognise it.

C There should be a greater focus at medical school on how to treat it.

D Courses on managing it should no longer be optional for medical students.

16. What does the word ‘this’ refer to in the second paragraph?

A a response to John Bonica's call

B required curricular content

C medical school curricula

D a position statement

17. In the third paragraph, the writer refers to the guidelines and reports to

A qualify a previous statement

B reinforce an earlier argument

C question a contradictory claim

D acknowledge alternative points of view

18. What does the writer say about medical students in the fourth paragraph?

A Many dispute the need for further training in crucial subjects.

B Many are unaware of significant gaps in their medical knowledge.

C Many have ultimately proved to be unsuited to their chosen career.

D Many lack guidance in key areas relating to professional competence.

19. Carr and Bradshaw suggest that the pain curriculum should

A include a wider range of relevant topics.

B prioritise the study of patients with acute pain.

C reflect the most recent scientific research findings.

D cover the consequences of inadequate interventions.

20. In the sixth paragraph, what attitude does the writer express towards medical schools?

A irritation with the behaviour of their staff

B frustration at how old-fashioned they are

C understanding of the challenges they face

D approval of the way they deal with innovation

21. In the sixth paragraph, the expression ‘fight for pain turf’ tells us that there is

A little demand for the study of pain amongst students.

B a general refusal to recognise the value of the study of pain

C nobody willing to promote the study of pain at medical school

D resistance to attempts to include the study of pain in the curriculum

22. In the final paragraph, the writer expresses

A optimism about evolutions in chronic pain education

B impatience with the rate of improvement in chronic pain management

C confidence in the ability of healthcare workers to address chronic pain.

D concern about the impact of developments on patients with chronic pain

END OF READING TEST

THIS BOOKLET WILL BE COLLECTED
 N K
L A
B