Step 2 “Elimination”

Now, let’s Eliminate all the information that are irrelevant. Take Case Notes 1 and mark all the irrelevant information. 

1. Anything that the recipient already knows. 
2. Anything that the recipient can guess.
3. Anything that will not help the recipients for providing services requested.

Eliminating irrelevant information from OET case notes is a core scoring skill. Examiners assess your ability to select, filter, and prioritise clinically relevant data for the given task. The process should be systematic, not intuitive.

1. Start With the Writing Task (Non-Negotiable Step)

Before reading the case notes in detail, identify:

• Recipient (e.g., GP, physiotherapist, nurse).
• Purpose (referral, transfer, discharge, update).

Anything that does not support the purpose is a candidate for elimination.

Rule: If the information does not help the recipient act, decide, or continue care, exclude it.

2. Apply the “Recipient Relevance” Filter

Ask for each note:

• “Does this recipient need this information now?”

GP referral: 

• Relevant: Diagnosis, investigations, medication changes.
• Irrelevant: Ward routine, meal preferences, bed number.

Physiotherapist referral

• Relevant: Mobility status, pain, weight-bearing status.
• Irrelevant: Blood test values, family history (unless related).

Nurse Referral (Home care)

• Irrelevant: Values, diagnosis.
• Relevant: Further plan for the nurse.

3. Remove Administrative and Background Noise

The following are almost always irrelevant unless specifically required:

• Hospital name.
• Ward/bed numbers.
• Dates of admission (unless recent or critical).
• Staff names.
• Repeated vital signs without change.
• Normal findings with no impact on care.

4. Exclude Stable, Long-Term Conditions (Unless Linked)

Chronic conditions should be included only if they affect the current issue.

Include:

• Diabetes → wound healing, infection.
• Hypertension → stroke, cardiac event

Exclude:

• Long-controlled asthma when referring for a fracture.
• Childhood illnesses with no current relevance

5. Prioritise Changes, Not History Dumps

OET rewards clinical judgment, not completeness.

Keep:

• New symptoms.
• Deterioration or improvement
• Medication changes.
• Abnormal findings

Remove:

• Repeated “no change” entries.
• Old investigations already resolved.
• Redundant symptom descriptions.

6. Eliminate Social Details Unless They Affect Care

Include social information only if it impacts treatment or discharge.

Relevant:

• Lives alone → discharge planning.
• Smoker → respiratory condition.
• Poor compliance → medication issues.

Irrelevant:

• Number of grandchildren.
• Hobbies.
• Employer name.

7. Use the “One-Line Test”

If a point cannot be summarised in one concise phrase, it is likely unnecessary.

Example:

• Incorrect: “Patient was seen walking slowly along the corridor with support of nurse at 10 am”.
• Correct: “Requires assistance for ambulation”

8. Avoid Copying the Notes Verbatim

Direct copying signals poor selection skills.

Instead:

• Combine similar points.
• Use clinical terms.
• Generalise where safe

9. Common OET Traps to Avoid

• Including normal test results (unless they help the recipient).
• Writing full medication history instead of recent changes.
• Reporting patient complaints unrelated to the task.
• Overloading the introduction with background

10. Final Self-Check (30-Second Test)

Before submitting, ask:

1. Does every sentence serve the task?
2. Would the recipient thank me for this information?
3. Can anything be safely deleted without affecting understanding? If yes → delete.

NB: OET is not testing memory. It is testing clinical prioritisation and professional judgment.