A recurring theme in our examination of IELTS testing for nurses has been how the Writing module is often the primary cause of insufficient overall scores.

As we’ve discussed recently, there is a growing consensus that a General Training module for Writing, rather than Academic, would be more appropriate. But the idea of reducing the overall average to 7 with no element below 6.5 has also been proposed.

So we’ve been examining what the difference between a 6.5 and 7 in the Writing module actually looks like.

How the tests work

The writing test is split into two tasks.

Task 1 provides a graph, diagram, table or chart, and asks candidates to describe and compare its features, or analyse certain aspects. Meanwhile, Task 2 questions require candidates to present and justify opinions on specific topics – essentially, it’s an essay-writing test.

It’s also worth noting that the difference between an Academic or General Training IELTS test only applies to the Reading and Writing modules; the Speaking and Listening modules are always the same.

Small grammatical mistakes that make a big difference to the NHS

The tasks we initially analysed were Task 2 examples written by the same Italian nurse.

What is immediately apparent when comparing examples of a 6.5 and a 7 is that the difference is negligible. Both examples are easy to understand, and both are impressively articulate.

The one noticeable difference is that the example that scored 7 is more grammatically sound. However, those grammatical differences are technicalities – small details that make it no easier to understand but slightly more sophisticated. Task 2 carries more marking weight than Task 1 – so those small details make a big difference.

In fact, to be really specific, the only difference is that verb tenses are more often confused in the 6.5 example. Disappear is written when disappearing was required; decrease rather than decreased. The spelling is good, the punctuation is logical, and structurally it’s a perfectly well-balanced essay. But the damage is done: this Italian nurse is not coming to support the NHS because she’s confused her verb tenses. That’s the almost bizarre reality here.

In other widely available examples we’ve viewed, the vast majority of scores of 6.5 feature specific grammatical problems. Unsophisticated paragraphing is a regular offender, as is structural naivety. In other words, candidates might communicate perfectly clearly, but they score a 6.5 because they aren’t especially good at organising an essay.

If my plans to the work in the UK were scuppered for that reason, I think I’d feel pretty disgruntled.

Australian cinema attendances and the process of brick manufacturing

In the first examples referenced above, the questions asked the candidate to explore the morality of violence on TV and the issue of animal extinction respectively.

In response, both answers are fairly repetitive. It’s clear that the Italian candidate is struggling to think of different arguments to expand the essay sufficiently. Which begs the question: why is she answering questions about subjects she doesn’t necessarily have knowledge about? That problem would disappear if nursing- related subjects were used exclusively.

Looking at further examples, the problem only gets worse. In an IELTS score guide that’s publically available, Task 1 examples are mind-bogglingly irrelevant – and difficult as a result. One example asks candidates to analyse a line graph that illustrates how cinema attendances across Australia have changed between 1990 and 2010. Another presents a complex diagram showing how bricks are manufactured, and asks candidates to report and compare its main features.

As a result, you can’t help but wonder whether those who struggle to answer fluently are struggling with language, or simply struggling to understand the question.

Academic criteria for academic tasks

A brief look at the IELTS Task 2 band descriptions illustrates the problems that we’ve been exploring at HCL.

The criteria clearly focus on a candidate’s ability to construct an essay. A score of 7 ‘logically organises information’ and ‘uses a range of cohesive devices’ as well as ‘a variety of complex structures’. Evidently, an IELTS Academic writing task is looking for the foundations of an academic writer – something which, to our knowledge, the NMC is not looking for in international nurses.

Equally, the criteria are displayed for a score of 6 or 7, but not a 6.5. This is notable given that, at HCL alone, we have seen a huge number of candidates score a 6.5 for writing. Therefore, how a score of 6.5 is calculated is not clear.

The Academic Writing task does not make for good reading

A brief foray into task examples supports the growing consensus that the Academic Writing module is not suitable for the testing of international nurses.

With abstract questions and academically focused criteria, relevant knowledge is not being tested and nurses with appropriate communications skills are being overlooked.

But most damningly, all the examples we’ve examined suggest that nurses are having their dreams of working in the UK shattered simply because of small grammatical errors. These are the kind of errors that the British public make daily, and are preventing international nurses from cutting NHS vacancy rates. And arguably, they’re the kind of errors that simply wouldn’t have any impact on a nurse’s ability to do their job.

Switching to General Training might be the answer. Lowering the overall average to 7 would have a big impact. Even using a different, more vocationally-relevant test for nurses might produce better, fairer results. But whatever the answer, change is needed.

Click here to read our original report.

2 Responses to “IELTS report follow-up: Want to nurse in the UK? Better brush up on your essay-writing grammar”

  1. Paula Washington

    I am from an English speaking country, therefore English is my first Language. I first took the IELTS last September and got the following scores: Listening 6.0, Writing 6.5, Speaking 7.5 and Reading 7 with overall Band of 7.0. On Saturday I repeated the exams and I am very afraid. I am praying that I got the required . Since this is all this is standing between me commencing my English Career. I am and have been a Registered Nurse for over 12 years. This is so sad because I know that I have a valuable contribution to make.

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