The OET Content criterion: how to include the right case notes and report them accurately
Content is marked from 0 to 7 and, in practice, comes down to two things: did you include the information this reader needs to continue the patient's care, and did you report it accurately from the case notes? You lose Content by leaving out a key note (a changed medication, a risk, the follow-up you are requesting) or by changing a fact: a wrong date, dose, name or a symptom the notes never mention. Choose notes by the reader's next action, then check every number and name against the notes before you finish.
What the Content criterion is about
Content is one of the six OET Writing criteria and is marked out of 7. It is about the information in your letter, not how well the sentences are written. A useful way to self-check for Content is to ask three questions:
- Is the key information there? Everything this reader needs to understand the situation and continue the patient's care.
- Is it accurate? Do the facts in the letter match the case notes: names, dates, doses, results, the plan?
- Does it suit this reader? A community nurse, a GP and a social worker need different details from the same notes.
Content works alongside Conciseness & Clarity: one rewards what you include, the other penalises what you should have left out. Both start with the same skill, selecting relevant case notes. For how all six criteria fit together, see the OET Writing criteria explained.
Five ways letters lose Content
| Problem | Example | Fix |
|---|---|---|
| A key note is missing | The letter asks a district nurse to manage a wound but never says what dressing to use | Before writing, list what the reader needs to do the task, and tick each item off in your plan |
| A changed medication is missing | "Her medications are unchanged" when the notes show a new anticoagulant | Read the medication list line by line; new, stopped and changed drugs are almost always key |
| A fact is altered | Notes say "BP 158/94"; letter says "blood pressure was normal" | Report the value, or describe it accurately ("elevated at 158/94") |
| Something is invented | "He has been very anxious about going home", with no such note | Write only what the notes support |
| Wrong focus for the reader | A letter to a school nurse full of hospital investigations, missing the daily care plan | Choose notes by the reader's role and next action |
Accuracy: the part nurses underestimate
Most Content advice is about selection, but accuracy is just as important and easier to control. Under time pressure it is easy to:
- copy a date wrongly (12/04 becomes 21/04),
- swap a frequency (twice daily becomes three times daily),
- mix up left and right, or the two children in a family,
- turn "denies chest pain" into "has chest pain",
- report a plan as completed ("has been referred") when the notes say it is only planned ("referral to be made").
Each of these changes the meaning for the reader. For how to phrase drug names, doses and changes, see medications in an OET letter.
A 60-second accuracy check
Before you finish, compare your letter with the notes for these items only:
- Patient name, age or date of birth, and the reader's name and title.
- Every date and duration.
- Every drug, dose and frequency.
- Every measurement or result you quote.
- Left/right, and who is who (patient, carer, family member).
- Plans: what has happened versus what is still to happen.
Choosing content for the reader
The same case notes produce different letters for different readers. Here is how one patient's notes might be selected for two tasks.
| Case note | Letter to the district nurse (wound care at home) | Letter to the GP (medication review) |
|---|---|---|
| Venous leg ulcer, left calf, 3 × 4 cm | Key | Brief mention |
| Dressing plan: change every 3 days | Key | Usually leave out |
| New: amlodipine stopped (ankle swelling) | Mention if it affects swelling | Key |
| BP 150/90 on discharge | Usually leave out | Key |
| Lives alone, daughter visits weekly | Key (access, support) | Brief mention |
| Retired bus driver | Leave out | Leave out |
The reader's job decides what counts as "key". That is why reading the writing task first, and planning before you write, saves Content marks.
Worked example
These case notes are invented for this guide.
Patient: Mrs Leila Haddad, 68. Lives alone in a first-floor flat (lift available). Son lives nearby. Admitted 3 September: cellulitis, right lower leg. IV antibiotics 3 days, then oral. Discharge 8 September: oral flucloxacillin 500 mg four times daily for 5 more days. Leg elevated when sitting. Redness reduced; area marked with pen on admission. PMH: type 2 diabetes (metformin, unchanged); hysterectomy 1998. Social: enjoys gardening; independent with personal care. Writing task: As the ward nurse, write to the practice nurse, Ms Anna Rossi, asking her to review Mrs Haddad's leg and diabetes control.
Draft paragraph with Content problems:
Mrs Haddad was admitted on 8 September with cellulitis of the left leg and was given antibiotics. She is now on flucloxacillin. She had a hysterectomy in 1998 and enjoys gardening.
Problems: the admission date is wrong (8 September was discharge), the side is wrong (right, not left), the dose, frequency and remaining duration are missing, the diabetes the reader is asked to review is not mentioned, and two notes the reader does not need are included.
Revised:
Mrs Haddad was admitted on 3 September with cellulitis of the right lower leg and received intravenous antibiotics for three days. She was discharged on 8 September on oral flucloxacillin 500 mg four times daily, to be continued for a further five days. The redness has reduced and its original margin has been marked on her skin. She has type 2 diabetes, managed with metformin, which has not been changed.
Every fact now matches the notes, and everything the practice nurse needs for the review is there. Gardening might be worth one clause only if the task linked it to wound or infection risk; here it does not, so it stays out.
Content checklist
- I can name what the reader must do, and every note they need for that is in the letter.
- New, stopped and changed medications are included with dose and frequency where relevant.
- Risks (falls, infection, deterioration, safeguarding) that affect the reader's care are included.
- Social circumstances are included only when they affect care or discharge.
- Every date, dose, side and name matches the notes.
- Nothing is invented, and planned actions are not reported as done.
Practise and check your Content
Pick a case from the medEmu practice case notes and, before writing, list the notes you will include and why. Then check your letter: the medEmu report gives Content its own 0–7 mark and includes a case-notes coverage check showing which relevant notes you included, which you missed, and which you could have left out. Your first letter is graded free without an account, and you get 5 more when you sign up. Grades are estimates for practice, not official OET results, and medEmu is not affiliated with OET.
Sources
This guide is medEmu's writing advice, not official OET guidance; all patients and case notes are invented. The criterion name and its 0–7 range are as OET describes them; the three self-check questions are medEmu's paraphrase, not OET's wording. For OET's official Writing assessment criteria and its own guide to the Content criterion, see oet.com.