This guide develops the English performance skills assessed by the ETOE™ exam for CoreCHI-Performance™ candidates. Begin with meaning fidelity and clear expression, then apply those foundations to the examination’s listening, repetition, reformulation and reading activities. Each concept includes an original, resolved example and a specific error to recognize. The compact examples illustrate particular skills; they are not official questions or full-length examination items.
Meaning fidelity and language choices
1. Information units can span several words
CCHI evaluates preservation of information units: a unit may be one word, several words or a phrase expressing one concept. Analyze what each expression contributes before reformulating it. A response can retain the main nouns yet lose important information carried by a qualifying phrase. Accuracy therefore requires checking conceptual content, rather than merely counting familiar words that survived.
Worked example: Original: “The office accepts calls only during the morning.” Restatement: “You can call the office in the morning, but not at other times.” This preserves both availability and its limitation.
Mistake to avoid: Saying “The office accepts morning calls” loses the restriction expressed by “only.”
Supporting source: ETOE™ Exam Score – CCHI
2. Completeness and relevance must work together
Meaning fidelity requires a relevant, complete response. CCHI identifies omissions, meaning-changing additions, irrelevant information and incoherent statements as errors. Separate information the speaker actually supplied from explanations you could supply yourself. For tasks requiring the complete message, retain every meaningful condition and relationship. For Listening Comprehension, retain all key points and the context needed to understand them.
Worked example: Original: “The appointment moved to Thursday because the office will be closed Wednesday.” Accurate restatement: “Wednesday’s closure means the appointment is now on Thursday.” The change and its reason both survive.
Mistake to avoid: Adding “because of staff illness” invents a reason that the original never gave.
Supporting source: ETOE™ Exam – CCHI; ETOE™ Exam Score – CCHI
3. Register changes depend on the task
Register is the level of formality appropriate to a purpose or setting. CCHI discourages unnecessary register changes. Reading Comprehension answers may maintain the passage’s relatively high register or use neutral language; low-register wording may reduce the lexical grade. Some Restate the Meaning items necessarily require a register change, and CCHI expressly permits that change. Simplification is therefore a contextual choice.
Worked example: For a reading passage stating “The office received the request,” a neutral answer is “The office received it.” “They got that thing” introduces vagueness and a less formal tone.
Mistake to avoid: Assuming every task rewards either maximum formality or automatic simplification.
Supporting source: ETOE™ Exam Score – CCHI
4. Preserve intended emotion without adding your reaction
Delivery contributes to the message’s tone. Interpreter training distinguishes conveying the speaker’s intended emotion from expressing your own reaction to the content. Healthcare interpreting standards likewise call for preserving register, style and tone. An emotionally charged message should retain its expressed stance without becoming a vehicle for the interpreter’s approval, disbelief or judgment.
Worked example: Original, spoken with restrained frustration: “I am upset that nobody explained the change.” Faithful restatement: “I feel upset because no one explained the change,” delivered with the same restrained frustration. The wording preserves the complaint without adding sarcasm or accusation.
Mistake to avoid: Turning a restrained complaint into an angry accusation because you personally sympathize with it.
Supporting source: Court Interpreter Skill Building Exercises; National Standards of Practice for Interpreters in Health Care
5. Recognize an idiom as a complete expression
An idiom has a meaning that differs from the literal meanings of its component words. The State Department’s idiom guide also explains that idioms reflect cultural practices and beliefs. Recognize the expression before choosing an alternative. In a meaning-restatement task, convey the intended concept; in an exact-repetition task, preserve the actual wording rather than replacing the idiom with its explanation.
Worked example: “The successful scheduling redesign was a feather in our team’s cap” means it was an exceptional achievement for the team. It does not describe an item of clothing.
Mistake to avoid: Explaining the achievement during Memory Capacity instead of repeating the original words.
Supporting source: In the Loop: A Reference Guide to American English Idioms — Introductory Pages; ETOE™ Exam – CCHI
Grammar and clear English delivery
6. Speech quality is about intelligibility
CCHI’s Quality of Speech scale concerns physical features of the response. False starts, hesitations, repeated repairs, pronunciation, intonation and pace become problems when they hinder understanding. Evaluate their effect on the listener, rather than treating speed or uninterrupted speech as an achievement by itself. An accurate message still needs sufficiently clear delivery for its relationships and details to be understood.
Worked example: “The office opens Thursday—sorry, Tuesday—Thursday morning” leaves the day uncertain. A clear response to a Thursday prompt states “The office opens Thursday morning” without competing alternatives.
Mistake to avoid: Speaking faster to conceal hesitation when the resulting pace makes the message harder to understand.
Supporting source: ETOE™ Exam Score – CCHI
7. Keep tense consistent within a time frame
Use consistent tense when actions belong to the same time frame. Change tense when the time frame changes. Purdue’s guidance makes both decisions explicit: consistency does not require forcing every verb into one tense. During reformulation, identify which events happened earlier, which states continue now and which actions remain future before selecting the corresponding verb forms.
Worked example: “Yesterday the receptionist checked the request and called the patient” keeps both completed events in the past. “The office is open now, but it closed early yesterday” correctly changes tense because the time changes.
Mistake to avoid: Saying “Yesterday she checks the request and called” creates an unjustified shift.
Supporting source: Verb Tense Consistency - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
8. Perfect tenses locate an earlier event
Perfect forms relate an earlier action to a reference time. With a past reference, past perfect can identify an event that preceded it; present and future reference frames use their corresponding perfect forms. Preserve this ordering when it matters to the message. Merely repeating two actions in the same tense can obscure which had already occurred when the other happened.
Worked example: “When the patient arrived, the office had already sent the letter” places sending before arrival. “By tomorrow afternoon, the office will have sent the letter” places completion before a future reference point.
Mistake to avoid: Changing “had already sent” to “will send” reverses the relationship between the events.
Supporting source: Verb Tense Consistency - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
9. Progressive forms preserve action underway
Progressive forms express action underway relative to a particular time or another event. They can distinguish an activity in progress from a completed activity. When restating a message, preserve that distinction rather than replacing every progressive form with a shorter simple form. The surrounding verbs and time expressions establish the reference frame needed to interpret the ongoing action accurately.
Worked example: “The coordinator was reviewing the file when the phone rang” means the review was underway at that moment. “The coordinator had reviewed the file when the phone rang” instead places the review earlier.
Mistake to avoid: Treating “was reviewing” and “had reviewed” as interchangeable descriptions.
Supporting source: Verb Tense Consistency - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
10. Agreement follows the actual subject
A noun inside a phrase between the subject and verb does not determine agreement. Find the grammatical subject, then select the matching verb. Expressions such as “with,” “including” and “accompanied by” do not automatically make a singular subject plural. This distinction is especially useful when reformulating sentences containing several people, records or services.
Worked example: “The request, including the attached forms, is complete” uses “is” because “request” is the subject. “The forms attached to the request are complete” uses “are” because the subject is now “forms.”
Mistake to avoid: Choosing “are” in the first sentence because “forms” appears closest to the verb.
Supporting source: Subject/Verb Agreement - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
11. Compound subjects require different agreement choices
Subjects joined by “and” normally take a plural verb. Two singular alternatives joined by “or” or “nor” take a singular verb. When those alternatives mix singular and plural subjects, Purdue’s guidance makes the verb agree with the nearer subject. Identify the joining relationship before choosing the verb; a list of nouns does not always represent a plural combined subject.
Worked example: “The receptionist and coordinator are available.” “The receptionist or coordinator is available.” “The coordinator or the receptionists are available.” Each verb follows the subject construction used.
Mistake to avoid: Using one agreement rule for both combined subjects and alternative subjects.
Supporting source: Subject/Verb Agreement - Purdue OWL® - Purdue University
12. Each and everyone remain grammatically singular
Indefinite pronouns including “each,” “either,” “neither,” “everyone,” “someone” and “nobody” require singular verbs in the constructions described by Purdue. Their messages may concern several people or objects, but their grammatical form remains singular. Distinguish a sentence about individual members from one whose subject is the plural group itself.
Worked example: “Each of the appointment letters contains a contact number” uses “contains.” “The appointment letters contain contact numbers” uses “contain.” The subject changes from “each” to “letters,” so agreement changes too.
Mistake to avoid: Saying “Each of the letters contain” because several letters are involved.
Supporting source: Subject/Verb Agreement - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
13. There is and there are agree with what follows
In an existential construction beginning with “there is” or “there are,” “there” is not the grammatical subject. The subject follows the verb, and its number determines agreement. Locate that following noun phrase before producing the sentence. This prevents errors when introducing the existence of a service, several alternatives or an outstanding question.
Worked example: “There is one unanswered question about the referral.” “There are two unanswered questions about the referral.” The singular and plural nouns following the verb determine the correct forms.
Mistake to avoid: Using “there is” mechanically before every noun phrase, including plural subjects.
Supporting source: Subject/Verb Agreement - Purdue OWL® - Purdue University
14. Pronouns need clear referents
A pronoun should clearly identify a stated noun in the current or preceding sentence. When an implied reference would confuse the listener, explicitly name the intended noun. During reformulation, avoid creating new ambiguity about who acted or what changed. Naming a referent helps only when the original message establishes that referent; it does not authorize resolving genuine uncertainty by guessing.
Worked example: Original: “The coordinator spoke to the receptionist. The coordinator then contacted the patient.” Retaining “the coordinator” in the second sentence keeps the actor clear; substituting “she” may obscure the reference.
Mistake to avoid: Replacing several different people with the same pronoun and losing their distinct roles.
Supporting source: Sentence Clarity - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
15. Parallel structure clarifies a series
Use similar grammatical forms for linked items in a series. Parallel wording helps the listener recognize that the items have the same relationship to the surrounding sentence. Reformulation can improve that structure while preserving each action and condition. Do not mistake grammatical tidiness for permission to remove an item that was less conveniently phrased in the original.
Worked example: “The coordinator will review the form, confirm the date and contact the patient” presents three parallel actions. All three remain distinct responsibilities of the same person.
Mistake to avoid: Changing the series to “reviewing the form, the date and contacting” makes the relationships harder to follow.
Supporting source: Sentence Clarity - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
16. Connecting words preserve logical relationships
Connecting expressions signal relationships between ideas, including contrast, addition and consequence. Their function matters more than retaining one particular connector during paraphrase. Read or listen to the complete relationship before selecting an alternative: a familiar word is not a universal shortcut to the speaker’s intention. Replacing contrast with consequence can change the message even when the surrounding facts survive.
Worked example: “The office added appointments; however, waiting times remained unchanged” expresses contrast. “The office added appointments, but waiting times stayed the same” preserves it. “Therefore” would introduce a different relationship.
Mistake to avoid: Dropping or changing a connector without checking how the two propositions relate.
Supporting source: Sentence Clarity - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
17. Clause placement should keep the main proposition clear
An inserted phrase or subordinate clause can interrupt the main clause enough to confuse the listener. When a task permits reformulation, move that material to a clearer position while retaining its content. Identify the main subject and action first. Keep any reason, timing condition or qualification attached to the proposition it actually modifies.
Worked example: “The coordinator, because the appointment date had changed, contacted the patient” can become “Because the appointment date had changed, the coordinator contacted the patient.” The reason remains connected to the call.
Mistake to avoid: Moving a qualifying clause so that it appears to explain a different action.
Supporting source: Sentence Clarity - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
18. Audit both meaning and independent expression
A paraphrase needs two checks: essential information must survive, and that information must be expressed in a new form. Purdue recommends comparing the rendition with the original for both. A fluent response may still omit a condition; a complete response may still copy the source instead of restating it. Apply this distinction when evaluating a meaning-restatement response.
Worked example: Original: “The office will respond after receiving the signed form.” “Once the signed form arrives, the office will reply” changes expression and preserves the condition. “The office will reply soon” fails the content check.
Mistake to avoid: Approving a response solely because it sounds different from the original.
Supporting source: Paraphrasing - Purdue OWL® - Purdue University; ETOE™ Exam – CCHI
Listening comprehension and useful notes
19. Separate the topic from the point being made
A topic names the broad subject; a main idea states the key concept about that subject. Supporting details explain matters such as why, when, where or how much. Listening Comprehension requires key points with necessary context, presented as a cohesive speech. Merely naming the topic is insufficient, and a list of isolated details may fail to communicate the speaker’s point.
Worked example: A speaker explains that evening appointments were added because daytime attendance was difficult. “Appointments” is the topic. “Evening appointments address difficulty attending during the day” states the point and its supporting reason.
Mistake to avoid: Restating “The speaker discussed appointments” and omitting the actual development being explained.
Supporting source: 307 Read Main Idea | Cuesta College; ETOE™ Exam – CCHI
20. Anticipation is a hypothesis to revise
Anticipatory listening can help identify where a message is heading, but an early interpretation remains provisional. The interpreter-training exercises compare an initial judgment of the speaker’s point with a final judgment after the speech. Let later information confirm or overturn your first impression. Accuracy requires reporting the completed message rather than the message you expected to hear.
Worked example: A speech starts, “We considered closing the evening office,” but ends, “Instead, we changed its staffing.” The resolved point concerns a staffing change, not an announced closure.
Mistake to avoid: Retaining “The evening office is closing” because the opening sentence suggested that possibility.
Supporting source: Court Interpreter Skill Building Exercises; ETOE™ Exam Score – CCHI
21. Notice differences across English accents
The ETOE™ blueprint includes discerning dialects in its audio activities. A bounded listening method described in British Council instruction uses recordings from speakers with varied accents and draws attention to potential sound differences. Apply that method to understanding the words actually spoken. Exposure to several accents does not establish a complete dialect vocabulary or justify assumptions about a speaker’s meaning.
Worked example: Two speakers record the same sentence, “The appointment is on Friday.” Comparing the recordings reveals different pronunciations while the resolved content remains the same appointment day.
Mistake to avoid: Treating an unfamiliar pronunciation as evidence that a familiar word must have a different meaning.
Supporting source: CCHI ETOE exam specifications2023; TeachingEnglish: How Can the ELT Sector Become Fairer for All Teachers? — Activity Booklet
22. Audio-only listening includes vocal signals
When a speaker cannot be seen, their manner of speaking is still audible. Interpreter-training guidance directs attention to pitch, tone, volume and sounds such as sighs and hesitations. These features can help you recognize the expressed delivery of a message. They do not establish an unstated diagnosis, motive or factual claim, so distinguish audible behavior from your interpretation of it.
Worked example: A speaker says, with hesitation, “I have not received the letter.” The stated fact is nonreceipt. The hesitation is audible, but it does not prove that the speaker lost the letter.
Mistake to avoid: Converting a sigh or pause into an invented explanation for what happened.
Supporting source: Court Interpreter Skill Building Exercises; ETOE™ Exam Score – CCHI
23. Notes support listening, analysis and reconstruction
Adding notes does not replace the three underlying processes of listening, analyzing and reproducing a message. The European Commission handout treats notation as a personal aid rather than a rigid system. The useful question is whether a mark helps reconstruct the understood message. Elaborate symbols provide little benefit if producing them consumes attention needed to follow the speaker.
Worked example: For “The office changed hours because attendance fell,” personal notes such as “hours changed ← attendance down” preserve the understood relationship. The spoken reconstruction restores the full statement rather than reading the symbols aloud.
Mistake to avoid: Concentrating on attractive notation while losing the next part of the speech.
Supporting source: Introduction to Note-taking
24. Understand ideas before noting them
The note-taking handout generally advises writing after understanding, while giving names and figures immediate capture priority. This is selective notation, not continuous transcription. For meaning-focused activities, record ideas and vulnerable details that will help reconstruct the message. Exact-repetition activities still require recovering the original wording, so meaning-based notes cannot replace the words you must retain.
Worked example: For “Ms. Patel will contact the office on Thursday,” immediately capturing “Patel” and “Thursday” protects easily lost details. The remaining notes represent the understood action: contacting the office.
Mistake to avoid: Writing a long string of words before identifying who is doing what.
Supporting source: Introduction to Note-taking; ETOE™ Exam – CCHI
25. Reduce notation when reasoning becomes difficult
When a speaker’s reasoning becomes difficult to understand, the European Commission handout recommends taking fewer notes or temporarily none so attention can return to comprehension. A dense record of misunderstood words cannot reliably reconstruct an argument. Use notation to support understanding, and distinguish this response to difficult reasoning from abandoning important details merely because they require effort.
Worked example: A speaker explains two competing reasons for changing hours. You stop copying phrases, identify which reason supports each option, and then note “option A: access; option B: staffing.” The alternatives remain distinguishable.
Mistake to avoid: Continuing to transcribe mechanically after you have lost the relationship between the ideas.
Supporting source: Introduction to Note-taking
26. Layout can preserve the structure of reasoning
Analytical notes can separate ideas, group lists, reserve space for links and mark cause-and-effect relationships. Layout therefore carries information, rather than merely storing words. Use a consistent personal arrangement that makes the speaker’s structure recoverable. An arrow is useful only when you remember its intended relationship; it must not turn a sequence or association into a cause.
Worked example: “Attendance fell, so hours changed; the location stayed the same” can be noted as “attendance down → hours changed” followed separately by “location unchanged.” Reconstruction preserves consequence and the unchanged feature.
Mistake to avoid: Placing every detail in one undifferentiated list and losing which fact explains another.
Supporting source: Introduction to Note-taking; ETOE™ Exam Score – CCHI
Simultaneous shadowing
27. Shadowing combines repetition with ongoing listening
Shadowing requires repeating the speaker’s English while continuing to listen. CCHI specifies simultaneous repetition, with one playback and a response during the speech rather than afterward. Interpreter-training guidance likewise defines shadowing as verbatim repetition. The operation differs from delayed recall and from paraphrasing: you must keep processing incoming words while producing the words already heard.
Worked example: When a recording says “The office received the form and confirmed the date,” shadowing repeats those words as the recording continues. “They processed the paperwork” is a paraphrase and does not perform the task.
Mistake to avoid: Waiting until the entire recording ends before beginning your response.
Supporting source: ETOE™ Exam – CCHI; Court Interpreter Skill Building Exercises
28. Lag is a training variable, not a fixed exam rule
The Judicial Council skill-building document uses progressively increased lag behind a recording, including working a unit of meaning behind the speaker. That is a training suggestion rather than a CCHI timing requirement. Its purpose is to develop concurrent listening and speaking. Evaluate whether the retained segment remains accurate and whether you continue following the incoming speech.
Worked example: In an original recording, “The office has changed its hours” forms a meaningful segment. Repeating that segment while hearing the next develops overlap without inventing an exact required delay in seconds.
Mistake to avoid: Treating a suggested practice lag as an official ETOE™ scoring threshold.
Supporting source: Court Interpreter Skill Building Exercises; ETOE™ Exam – CCHI
29. A dual-task exercise must actually overlap its tasks
The training document adds writing while shadowing to exercise concurrent processing. It explicitly distinguishes simultaneous writing and speaking from writing only during pauses. When written text is added, copying supplied text avoids introducing a separate memorization demand. These are training operations, not additional tasks required in the examination’s Shadowing activity.
Worked example: While repeating an original recording, copy a short supplied sentence during the same spoken interval. If you wait for silence before writing, the result tests alternating attention rather than the intended simultaneous demand.
Mistake to avoid: Adding memorized written material and assuming every new error measures shadowing alone.
Supporting source: Court Interpreter Skill Building Exercises
30. Check names and numbers under simultaneous load
The shadowing exercises include noting heard names and numbers, then checking them against playback. This isolates accuracy for details that may be lost while attention is divided. The check compares your output with what was actually said; it does not replace the examination’s requirement to repeat the whole speech. Use the original recording to resolve uncertainty rather than accepting plausible-looking details.
Worked example: An original recording mentions “Ms. Chen, room twenty-four.” Your notes say “Chen, 42.” Playback resolves the error: the name survived, but the room number was reversed.
Mistake to avoid: Counting the detail as accurate because the incorrect number still sounds realistic.
Supporting source: Court Interpreter Skill Building Exercises; ETOE™ Exam – CCHI
31. Reduce added load when intelligible output collapses
The skill-building document recommends increasing an exercise’s challenge when it becomes comfortably manageable and returning to the previous exercise when overload makes keeping up or speaking difficult. This is a decision about training load, without a numerical mastery threshold. Distinguish an exercise that challenges concurrent processing from one that produces so little intelligible output that errors become difficult to diagnose.
Worked example: Shadowing remains clear alone, but adding writing produces only scattered words. Remove the added writing demand and restore intelligible simultaneous repetition before increasing that extra load again.
Mistake to avoid: Keeping every added task merely because a more complicated exercise appears more advanced.
Supporting source: Court Interpreter Skill Building Exercises; ETOE™ Exam Score – CCHI
32. Distinguish analytical reformulation from shadowing
The same training document includes a separate analysis exercise that rephrases a recording instead of repeating it. Reformulation requires understanding a meaningful segment and expressing it differently. That exercise develops a different operation from verbatim shadowing. Recognize which operation a response demonstrates before judging its quality; a good paraphrase can still fail a repetition task.
Worked example: For “The office changed its hours,” “The office changed its hours” is repetition. “The office now operates at different times” is reformulation. Only the first matches the wording required for shadowing.
Mistake to avoid: Using successful meaning preservation as proof that a shadowing response completed its specified task.
Supporting source: Court Interpreter Skill Building Exercises; ETOE™ Exam – CCHI; ETOE™ Exam Score – CCHI
Exact recall for Memory Capacity
33. Equivalent meaning is insufficient for exact recall
Memory Capacity requires repeating every word after one hearing, without changing, omitting or adding words. CCHI identifies paraphrasing as a task-completion error in this activity. Evaluate the response at the wording level, even when its general meaning remains accurate. This separates a faithful summary from the exact reproduction that the particular task demands.
Worked example: Original: “The office received your letter yesterday and will contact you about the appointment.” Required repetition retains that sentence. “They got your letter yesterday and will call about your visit” changes several words.
Mistake to avoid: Accepting synonyms because they would be suitable in Restate the Meaning.
Supporting source: ETOE™ Exam – CCHI; ETOE™ Exam Score – CCHI
34. Organize related content without changing its sequence
Interpreter-training guidance connects recall with organizing heard information into meaningful patterns. Related details can be mentally associated instead of treated as disconnected items. In Memory Capacity, however, that internal organization must still support recovery of the original words and order. Categories help retain content; they do not authorize regrouping the spoken response into a more convenient summary.
Worked example: Original: “The morning appointments are Monday and Thursday, and the afternoon appointments are Tuesday and Friday.” Associate days with morning and afternoon, then reproduce the original sentence rather than listing all days chronologically.
Mistake to avoid: Replacing the original sequence with a category list that changes its wording.
Supporting source: Court Interpreter Skill Building Exercises; ETOE™ Exam – CCHI
35. Group number sequences without transforming them
The training document describes grouping numbers into small sets rather than retaining them as unrelated individual digits. This changes the mental organization of the sequence, not its required spoken form. Preserve order and the exact words used in a Memory Capacity prompt. A grouped identifier must not become a different number merely because its digits can be combined arithmetically.
Worked example: Original: “The reference number is six four nine two seven eight, and the appointment is Friday.” Internally group 649 and 278, but repeat the digit words in their original sequence.
Mistake to avoid: Saying “six hundred forty-nine” when the original used separate digit words.
Supporting source: Court Interpreter Skill Building Exercises; ETOE™ Exam – CCHI
36. Keyword notes must recover the complete wording
Keyword notes can cue recall, and the training document compares recall with and without them. For Memory Capacity, their value depends on helping recover the original wording. Notes containing only the gist may leave out articles, qualifiers or the speaker’s chosen verbs. Keep the distinction between a memory cue and a permissible final response clear.
Worked example: Original: “Please leave the completed form at the front desk before you return home.” Notes reading “form; front desk; before home” cue the message, but the correct output restores every original word.
Mistake to avoid: Speaking directly from abbreviated notes and treating the resulting compressed message as exact repetition.
Supporting source: Court Interpreter Skill Building Exercises; ETOE™ Exam – CCHI; ETOE™ Exam Score – CCHI
37. Compare recalled words with the actual original
A concrete recall diagnostic compares an attempted exact repetition with the original recording. The training document uses playback to determine how accurately the message was reproduced. Feeling familiar with a message is not the same as retaining its words. Classify the discrepancy specifically as an omission, addition or substitution so the nature of the recall error is clear.
Worked example: Original: “The coordinator will contact your sister after the office receives the completed request.” Recall changes “after” to “before.” Comparison identifies a substitution that also reverses the timing condition.
Mistake to avoid: Checking only whether the people and office were mentioned, while overlooking the changed relationship.
Supporting source: Court Interpreter Skill Building Exercises; ETOE™ Exam – CCHI; ETOE™ Exam Score – CCHI
Restating spoken meaning
38. A paraphrase retains more than a summary
Purdue distinguishes a paraphrase, which restates essential information in a new form, from a summary focused concisely on one main idea. ETOE™ Restate the Meaning requires preserving the meaning of the entire message. A brief response is acceptable only if its brevity does not remove a condition, reason or other meaningful detail that belongs to that message.
Worked example: Original: “The office extended its hours because some patients could not attend during the day.” Faithful paraphrase: “Because some patients were unable to come during daytime hours, the office lengthened its opening hours.” This preserves the completed change and its stated reason without asserting that patients actually benefited.
Mistake to avoid: Reducing a complete message to its broad theme.
Supporting source: Paraphrasing - Purdue OWL® - Purdue University; ETOE™ Exam – CCHI
39. Understand the whole message before changing its form
Reformulation begins with understanding, rather than replacing isolated words as they arrive. Purdue advises establishing the full meaning; interpreter-training guidance similarly requires analyzing the message before changing its wording. Identify the central proposition and how its clauses relate. Restate the Meaning permits up to two hearings, but any response must reflect the entire message rather than an incomplete early interpretation.
Worked example: Original: “Although the office received the request, the appointment has not been confirmed.” Understanding the contrast yields “The request arrived, but confirmation of the appointment is still pending.”
Mistake to avoid: Restating only “The office confirmed the appointment” after recognizing familiar appointment vocabulary.
Supporting source: Paraphrasing - Purdue OWL® - Purdue University; Court Interpreter Skill Building Exercises; ETOE™ Exam – CCHI
40. More or fewer words can express the same content
Interpreter-training exercises include expansion and condensation while retaining the same meaning. Word count alone therefore does not determine fidelity. A longer version must avoid adding claims, and a shorter version must avoid removing information. In Restate the Meaning, select wording that clearly expresses the complete message rather than pursuing length as a goal.
Worked example: “The office cannot respond until the form arrives” can become “A response must wait for the form to arrive.” Both preserve the dependency. “The office will respond later” is shorter but loses the stated condition.
Mistake to avoid: Assuming condensation permits deleting any detail that makes the sentence longer.
Supporting source: Court Interpreter Skill Building Exercises; ETOE™ Exam – CCHI; ETOE™ Exam Score – CCHI
41. Choose voice without inventing an actor
Active voice often makes the performer of an action clearer. Passive voice can remain appropriate when the performer is unknown, obvious, unimportant or intentionally backgrounded. A meaning-preserving reformulation must respect those conditions. Do not turn an agentless passive statement into an active statement naming a person unless the original message supplies that person.
Worked example: Original: “The appointment was canceled yesterday.” Faithful restatement: “The appointment was called off yesterday.” This preserves the completed cancellation and its timing without naming an actor. “The receptionist canceled the appointment yesterday” adds an actor whom the original did not identify.
Mistake to avoid: Improving apparent clarity by guessing who performed an action.
Supporting source: Sentence Clarity - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
42. Unpack noun strings into explicit relationships
Several nouns placed together can obscure how the concepts relate. Purdue recommends unpacking such strings, including changing a noun into a verb where useful. Before reformulating, determine which noun names the thing and which nouns describe its purpose or subject. The revised wording should make those relationships explicit without changing them.
Worked example: “Appointment reminder message delivery” can be expressed as “delivering messages that remind people about appointments.” The reformulation identifies the action, the delivered items and their purpose rather than leaving their relationship compressed.
Mistake to avoid: Rearranging the nouns into “delivery appointment reminders” without resolving what the phrase means.
Supporting source: Sentence Clarity - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
43. Turn action nouns into verbs when appropriate
A nominalization expresses an action through a noun, such as “confirmation” rather than “confirm.” Purdue recommends using verbs when appropriate to make actions clearer. This differs from unpacking a multi-noun phrase: the decision concerns how one action is grammatically represented. Preserve the actor, timing and status of that action when converting its form.
Worked example: “The coordinator completed the confirmation of the appointment” can become “The coordinator confirmed the appointment.” Both describe a completed action by the coordinator. “The coordinator will confirm it” changes the action to the future.
Mistake to avoid: Making a sentence more direct while accidentally changing whether the action has happened.
Supporting source: Sentence Clarity - Purdue OWL® - Purdue University; Verb Tense Consistency - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
44. Resolve multiple negatives without reversing the claim
Purdue notes that multiple negatives can be difficult to understand and recommends affirmative wording when suitable. Before simplifying, identify exactly what the original denies or permits. A clearer sentence must preserve its logical content and strength. Avoid treating every negative phrase as mechanically interchangeable with a stronger positive assertion.
Worked example: “It is not impossible to change the appointment” can become “It is possible to change the appointment.” It cannot become “The appointment will be changed,” which turns possibility into a definite future event.
Mistake to avoid: Removing negative wording while also removing uncertainty or a limitation.
Supporting source: Sentence Clarity - Purdue OWL® - Purdue University; ETOE™ Exam Score – CCHI
45. Read ahead to identify the sentence structure
Practice anticipatory reading by scanning the upcoming sentence for its main subject and verb before producing speech. Separate embedded clauses so intervening information does not obscure the main action. This analysis supports Equivalence of Meaning and Reading Comprehension. Retain embedded information when reformulating the entire passage; identifying the sentence’s core does not authorize deleting its details.
Worked example: Text: “The coordinator, who reviewed both requests, will send the appointment letters tomorrow.” Identify “coordinator—will send” as the main subject and verb. Reformulation: “The coordinator reviewed both requests and will send the appointment letters tomorrow.” Both actions and their timing survive.
Mistake to avoid: Treating “reviewed” as the main verb and overlooking the future action after the embedded clause.
Supporting source: CCHI ETOE exam specifications2023; ETOE™ Exam – CCHI; Court Interpreter Skill Building Exercises
Medical terminology and Equivalence of Meaning
46. Replace target terms inside a coherent passage
Equivalence of Meaning requires a coherent restatement of the entire passage, replacing all five underlined medical terms. Separate definitions do not complete the task.
Worked example: Targets: physician, monitor, oral, medications, dose. Original: “The physician will monitor the patient’s response to oral medications and discuss the dose at the next appointment, when the patient can ask questions about the plan and raise concerns.” Restatement: “The doctor will check the patient’s response to medicines taken by mouth and discuss how much medicine to take at the next appointment, when the patient can ask questions about the plan and raise concerns.”
Mistake to avoid: Giving five separate definitions instead of restating the passage.
Supporting source: ETOE™ Exam – CCHI; ETOE™ Exam Score – CCHI; Plain Language Words | Agency for Healthcare Research and Quality
47. Medical word-part analysis has limits
Some medical words can be analyzed into prefixes, roots and suffixes. MedlinePlus explains that roots often concern body parts, while prefixes and suffixes can add other information. Not every word has every component, and a component can appear in different positions. Use decomposition to understand supported parts, then consider the complete expression and passage rather than treating every word as a predictable formula.
Worked example: In “cardiologist” and “myocardial,” the cardi component points to the heart despite appearing in different positions. That observation identifies a shared component; it does not alone define either complete word.
Mistake to avoid: Assuming every medical word must contain a prefix, root and suffix.
Supporting source: MedlinePlus: Break It Up; MedlinePlus: Appendix A: Word Parts and What They Mean
48. Anatomical roots keep the organ distinct
MedlinePlus identifies cardi-/cardio- with the heart, nephr-/nephro- with the kidney and hepat-/hepatico-/hepato- with the liver. These distinctions help identify which anatomical subject a term concerns. Root recognition is only one part of understanding a complete term. Retain the organ distinction without inventing a diagnosis, procedure or additional meaning that the remaining components do not establish.
Worked example: A word-part exercise presents cardio-, nephro- and hepato-. The resolved matches are heart, kidney and liver, respectively. Substituting “liver” for nephro- would change the anatomical information before any further reformulation.
Mistake to avoid: Recognizing that a word is anatomical but choosing the wrong organ.
Supporting source: MedlinePlus: Appendix A: Word Parts and What They Mean; MedlinePlus: Break It Up
49. Keep amount and rate modifiers distinct
The word-part reference distinguishes hyper-, associated with above or excess, from hypo-, associated with under or deficiency. It separately distinguishes brady-, meaning slow, from tachy-, meaning fast. These are different kinds of modifiers. Identify the supported component contrast before selecting contextual wording, and avoid supplying a numerical threshold or complete clinical definition from the modifier alone.
Worked example: For a component-identification exercise, tachy- matches “fast” and brady- matches “slow”; hyper- matches excess and hypo- deficiency. “Fast” is not a general substitute for every term beginning with hyper-.
Mistake to avoid: Confusing excessive amount with fast rate merely because both suggest an increase.
Supporting source: MedlinePlus: Appendix A: Word Parts and What They Mean; MedlinePlus: Break It Up
50. Distinguish between, within and around
MedlinePlus defines inter- as between, intra- as within and peri- as around. These components encode different spatial relationships, which should survive an equivalent expression. Apply the relationship to the structure actually named by the complete term or passage. Recognizing a location component does not by itself identify the structure involved or what is happening there.
Worked example: A word-part exercise asks whether a relationship is between two structures, within a structure or around one. The resolved component matches are inter-, intra- and peri-, respectively.
Mistake to avoid: Treating “within” and “around” as interchangeable because both describe proximity to the same structure.
Supporting source: MedlinePlus: Appendix A: Word Parts and What They Mean; MedlinePlus: Break It Up
51. Removal, incision and opening are different actions
The reference distinguishes -ectomy as removal, -otomy as incision and -ostomy as opening. These procedure components should not collapse into an undifferentiated description of surgery. A candidate alternative needs to retain the supported action while using the complete term and passage to identify the object and other details. The suffix alone does not establish extent or clinical purpose.
Worked example: When comparing the components, “removal” matches -ectomy, “incision” matches -otomy and “opening” matches -ostomy. Replacing all three with “a procedure” loses the action distinction the components express.
Mistake to avoid: Inferring that a removal is complete rather than partial solely from recognizing the suffix.
Supporting source: MedlinePlus: Appendix A: Word Parts and What They Mean; MedlinePlus: Break It Up; ETOE™ Exam Score – CCHI
52. Condition components differ in specificity
MedlinePlus lists -itis as inflammation, -pathy/patho-/path- as disease and -osis as a condition that is usually abnormal. Preserve both the distinctions and the qualification “usually.” A component naming inflammation is more specific than a generic condition label. Avoid treating component recognition as evidence for a cause, severity or treatment that the passage does not state.
Worked example: In a component exercise, -itis matches inflammation, while -osis matches a condition, usually abnormal. “Disease caused by infection” is not an equivalent component definition for either entry.
Mistake to avoid: Adding an infectious cause merely because a component indicates inflammation.
Supporting source: MedlinePlus: Appendix A: Word Parts and What They Mean; MedlinePlus: Break It Up
53. Medication amount and route carry different information
AHRQ offers “amount” or “how much medicine to take” as alternatives for dose or dosage, and “by mouth” as an alternative for oral. One describes amount; the other describes route. Preserve both when both occur in a passage. These vocabulary alternatives explain existing information and do not authorize choosing a medication amount or giving new treatment instructions.
Worked example: “The physician will discuss the dose of the oral medication” becomes “The doctor will discuss how much of the medicine taken by mouth is to be used.” Amount and route remain separate.
Mistake to avoid: Replacing the dose with “by mouth,” thereby omitting the amount concept.
Supporting source: Plain Language Words | Agency for Healthcare Research and Quality; ETOE™ Exam Score – CCHI
54. Choose acute and chronic alternatives from context
AHRQ offers several everyday alternatives for acute and chronic, including sudden or short-lasting wording for acute and recurrent or long-lasting wording for chronic. Select an alternative that fits the passage’s actual meaning. The list does not make every offered phrase universally interchangeable. Preserve whether the text concerns onset, duration or recurrence instead of substituting a memorized phrase mechanically.
Worked example: In a passage expressly defining “chronic” as lasting a long time, use “long-lasting.” “Happening again and again” would instead emphasize recurrence, which that particular passage did not establish.
Mistake to avoid: Using “sudden” whenever acute appears, regardless of what the passage says about time.
Supporting source: Plain Language Words | Agency for Healthcare Research and Quality; ETOE™ Exam Score – CCHI
55. Similarity does not establish equivalence
The State Department guide distinguishes synonyms, antonyms and expressions included for comparison. Synonyms share meaning; antonyms express the opposite; comparison expressions may merely look similar or relate to the same subject. Apply that distinction when considering alternatives. A word associated with the same topic is not necessarily an equivalent replacement, and a shared component does not guarantee shared meaning.
Worked example: The guide identifies “in a fix” and “in a bind” as alternative forms of one idiom. A passage saying someone is in a bind can use “in a fix” without changing that expression’s meaning.
Mistake to avoid: Choosing an alternative because it looks related, without checking its actual meaning in context.
Supporting source: In the Loop: A Reference Guide to American English Idioms — Introductory Pages; ETOE™ Exam Score – CCHI
Reading comprehension and working-language speaking
56. Locate the main idea rather than assuming its position
An explicitly stated main idea may appear at the beginning, middle or end of a paragraph. Cuesta College explains that the topic sentence is often first, but its location is not guaranteed. Compare the statements and identify which expresses the central point supported by the others. Position can orient your reading; it cannot substitute for understanding the paragraph.
Worked example: A paragraph first lists longer waits and unanswered calls, then concludes, “These changes show why the office needs a clearer contact process.” That final statement expresses the central point; the earlier observations support it.
Mistake to avoid: Reporting the first detail as the main idea solely because it appears first.
Supporting source: 307 Read Main Idea | Cuesta College
57. Distinguish inference from an explicitly stated fact
An inference uses available clues to select a likely explanation for information not directly stated. Cuesta College emphasizes that other explanations can remain possible. When answering a passage-based question, distinguish what the text establishes from what it merely suggests. Preserve the strength of the evidence rather than converting a plausible conclusion into certainty or adding facts needed to support it.
Worked example: A passage says unanswered calls decreased after contact hours expanded. This suggests the expansion may have helped, but it does not by itself prove that expanded hours were the only cause.
Mistake to avoid: Presenting a suggested explanation as the passage’s explicit, exclusive causal claim.
Supporting source: Inferences and Conclusions | Cuesta College; ETOE™ Exam Score – CCHI
58. Use context to resolve a word, not merely the gist
General context, examples and contrasts can suggest an unfamiliar word’s meaning. Cuesta College distinguishes understanding a sentence broadly from identifying the particular word accurately. Check which specific meaning explains the surrounding details. A general impression that the passage is positive or negative may be insufficient for a question requiring the meaning of one expression.
Worked example: “The arrangement was reciprocal: each office provided the other with appointment information.” The explanation supports “mutual” or “involving both sides,” rather than merely “helpful.” The context identifies the relationship.
Mistake to avoid: Choosing an emotionally plausible word without matching the relationship described in the sentence.
Supporting source: Inferences and Conclusions | Cuesta College
59. Answer the passage’s questions without adding medical claims
Reading Comprehension requires oral answers to three questions based on the passage. CCHI treats incorrect medical information and inaccurate vocabulary as lexical-content errors. Locate the information relevant to each question and express it accurately at the passage’s register or a neutral register. Outside knowledge should not replace the account given by the text or supply an unstated diagnosis.
Worked example: Passage: “The patient requested a different appointment because transport was unavailable.” Asked why the change was requested, answer “Transport was unavailable.” Do not add that the patient’s health had worsened.
Mistake to avoid: Providing a medically plausible explanation that the passage never states.
Supporting source: ETOE™ Exam – CCHI; ETOE™ Exam Score – CCHI
60. Working-language speaking requires observable clarity
The unscored image-description activity uses the candidate’s language other than English; ASL candidates describe the image in English. Its objectives include fluency and clear articulation. Interpreter-training guidance uses recordings to assess voice, pitch, tone, hesitation and enunciation. These observations support spoken delivery without providing language-specific instruction or ASL signing techniques.
Worked example: An imagined image shows two people beside a reception desk. For an ASL candidate, a resolved English description is: “Two people are beside a reception desk.” It identifies the visible people and location without guessing their roles. Other candidates describe the image in their working language other than English.
Mistake to avoid: Assuming the activity being unscored changes its specified working-language requirement.
Supporting source: CCHI ETOE exam specifications2023; ETOE™ Exam – CCHI; Court Interpreter Skill Building Exercises
Sources
Source-supported explanations:
- CCHI ETOE exam specifications2023
- ETOE™ Exam – CCHI
- ETOE™ Exam Score – CCHI
- here
- Court Interpreter Skill Building Exercises
- Introduction to Note-taking
- National Standards of Practice for Interpreters in Health Care
- Paraphrasing - Purdue OWL® - Purdue University
- Sentence Clarity - Purdue OWL® - Purdue University
- Verb Tense Consistency - Purdue OWL® - Purdue University
- Subject/Verb Agreement - Purdue OWL® - Purdue University
- 307 Read Main Idea | Cuesta College
- Inferences and Conclusions | Cuesta College
- MedlinePlus: Break It Up
- MedlinePlus: Appendix A: Word Parts and What They Mean
- In the Loop: A Reference Guide to American English Idioms — Introductory Pages
- Plain Language Words | Agency for Healthcare Research and Quality
- TeachingEnglish: How Can the ELT Sector Become Fairer for All Teachers? — Activity Booklet