The writing that nurses do: Investigating changes to standards over time

•Writing tasks that healthcare professionals perform have been undergoing simplification.•Standard-setting exercises on OET resulted in a lower passing standard for the Writing test.•The standards for Reading, Listening and Speaking remained largely the same.•It is important to review the writing construct in the healthcare context going forward. Unlike general language tests, specific-purpose tests have a greater need for updating should there be changes to context-specific language use. With near continuous inflow of migrant healthcare workers and long-standing language testing practices, the healthcare domain represents a good context for investigating the relationship between changes in the English language assessment standards and changes in the workplace. Focusing on the Occupational English Test (OET), this paper explores evidence from within the healthcare profession, and from nursing in particular, which shows that in some English-speaking jurisdictions (UK, Ireland, Australia), existing English language proficiency requirements for writing had been set at higher levels than necessary for safe and effective practice. Against this background, standard setting studies involving the OET are presented to further clarify the reasons for the recent lowering of the English writing proficiency standards. The study suggests that these changes were brought about by a combination of the original standard being too high, and, more interestingly, differences in the amount and nature of writing required of nurses in the workplace as a result of technology. The paper concludes with a discussion of the outstanding research in relation to the appropriate writing construct given the technological advances in the healthcare workplace.