Beyond the Script: From OET Rehearsal to Function

This working paper documents the development of a practitioner-led approach to healthcare communication rehearsal, progressing from audio models and scripted OET Speaking roleplays through annotated transcripts, bounded AI interaction and unseen human-mediated scenarios towards function-led clinical communication simulation. Rather than organising rehearsal around reproducing familiar cases or memorised expressions, the proposed approach begins with communicative functions—such as clarifying responsibility, exploring concerns, repairing misunderstandings and checking understanding—and creates varied situations in which these functions may become necessary. The paper introduces a proposed learning architecture for Beyond OET: Real Hospital English, connecting standalone clinical audio drama, selected dramatic pre-texts, optional AI rehearsal, facilitated voice-only process drama and reflective debriefing. A central concern is the distinction between successful rehearsal performance and the transfer of interactional behaviour across unfamiliar situations. The paper proposes an observation sequence—designed opportunity, actual cue, participant response, interlocutor uptake and consequence—and distinguishes rehearsal, contextual adaptation, cross-interlocutor simulated transfer and workplace transfer. Drawing on relevant literature and documented teaching experience, the paper presents a conceptual and practitioner-based design proposal rather than an evaluated intervention. It outlines a small collaborative feasibility pilot and identifies questions for subsequent research. This is a working paper for discussion. It has not been peer reviewed and makes no empirical claims about the effectiveness of the proposed approach.