When examining official OET Writing case notes, you'll encounter three crucial instructions: "Expand the relevant notes into complete sentences. Avoid using note form; adhere to letter format."

The rationale behind these instructions stems from the nature of the case notes themselves. Often, they exhibit grammatical deficiencies, lacking articles like "the'' or "a," omitting verbs (especially auxiliary verbs and "to be"), and featuring delexicalised verbs such as "make" and "do." Additionally, they are typically structured as lists with excessive comma usage, as seen in examples like "Depressive symptoms (reclusive, antisocial, irritable, agitation)."

Directly transcribing these notes into your letter without expansion would lead to poor scores due to issues with grammatical accuracy and language appropriacy. Although it may not always be immediately apparent how to expand the case notes effectively, this article aims to provide valuable tips for approaching this aspect of the task.

Expanding the Case Notes Effectively

Incorporate Articles

A common mistake made by OET Writing candidates is the omission of articles in their letters. For instance, if the case notes mention "6wk history progressively ↑ pain R and L knee joints," a candidate might write, "Patient has six-week history of increasing pain in right and left knee joints," which conveys the information but lacks grammatical correctness due to the absence of articles.

The correct sentence would be: "The patient has a six-week history of progressively increasing pain in the right and left knee joints," where articles are used appropriately, ensuring grammatical accuracy. Remember to use "a/an" for countable and singular noun phrases presenting new information, and "the" for shared or previously mentioned information.

Avoid Lists

To avoid listing information in your letters, employ a variety of cohesive devices that connect ideas more effectively than commas. Additionally, expand the notes into complete sentences by adding relevant vocabulary.

For example, instead of listing "Depressive symptoms (reclusive, antisocial, irritable, agitation)," expand the notes as follows: "The patient has demonstrated depressive symptoms, including a tendency towards reclusive and antisocial behaviour. She has also shown signs of irritability and agitation."

Utilise linking words like "and," "also," and discourse markers such as "including" to create cohesive sentences. This approach enhances clarity for the reader and demonstrates your ability to expand notes appropriately.

Include Verbs

The case notes may omit verbs and tense references, requiring you to add them for a complete sentence. Consider the example: "↓ADL – stopped accessing local shops and friends within walking distance."

Expand this using the present perfect tense to indicate relevance to the current situation: "The patient has reduced her activities of daily living. She has stopped accessing local shops and visiting friends who live nearby."

Incorporating appropriate verbs and tenses ensures your sentences are grammatically correct and convey the intended meaning accurately.

Pay Attention to Word Order

When presenting information from notes, consider word order for formal writing. For instance, instead of "Medications: OA – Glucosamine 1500mg daily," rephrase it as:

"In reference to medication, the patient takes 1500mg of Glucosamine per day for osteoarthritis."

Adjusting the word order enhances readability and aligns with expectations in formal writing, ensuring your letters are cohesive and grammatically appropriate.

Practice

Using the tips from this article, read the following notes and expand them into full sentences.

1. Acne – facial + upper back, shoulders and neck

2. Acne – unchanged, cyst like, leaves scars, C/o vaginal candidiasis and sore tongue since 4/52

3. Oral contraceptive pill (Diane-35, 2mg – low dose)

4. Patient married; discontinued OCP January 2013

5. Patient requests referral to endocrinologist

Answers

1. The patient suffers from facial acne, as well as acne on the upper back, shoulders and neck.

2. She returned complaining of vaginal candidiasis and a sore tongue. Symptoms were of four-weeks’ duration. Upon examination, we observed a Cystic acne with residual scars.

3. She is using a low dose of the oral contraceptive pill Diane 35.

4. The patient is now married and stopped taking her OCP in January 2013.

5. The patient has requested a referral to an endocrinologist.