READING COMPREHENSION TECHNIQUES

INTRODUCTION

Comprehension strategies

Comprehension strategies are the cognitive and metacognitive strategies readers use to accomplish the goal of comprehension.

1. Cognitive strategies are mental processes involved in achieving something. For example, making a cake.

2. Metacognitive strategies are the mental processes that help us think about and check how we are going in completing the task. For example, ‘Is there something that I have left out?’

Cognitive and metacognitive strategies may overlap depending on the purpose/goal. For example, as the cognitive strategies involved in making a cake proceed (following the steps in order), the metacognitive strategies assess and monitor the progress (to check that a step has not been missed).

How does this relate to comprehension?

Cognitive strategies assist in understanding what is being read. For example, predicting

Metacognition is particularly relevant to comprehension. Metacognitive strategies allow individuals to monitor and assess their ongoing performance in understanding what is being read. For example, as a text is being read, the reader might think: I don’t understand this. I might need to re-read this part.

Teaching ideas

Teaching ideas are the activities and practices that teachers use with students to help them learn how to use comprehension strategies. For example, Picture This, Storyboard.

COMPREHENSION STRATEGIES

1. Making connections.- Learners make personal connections from the text with:

something in their own life (text to self)another text (text to text)something occurring in the world (text to world).

Example questions/statementsThis story reminds me of a holiday to my grandfather’s farm.This character has the same problem that I read/saw/heard in another text.I saw a program on television that presented things described in this text.

Does this remind me/you of something?Has something like this ever happened to me/you?

Example teaching ideaBook and me: Students create two columns with headings Book/Me. Prior to and during reading students add details about the connections between the book and their lives.

2. Predicting.- Learners use information from graphics, text and experiencesto anticipate what will be read/ viewed/heard and to actively adjust comprehension while reading/ viewing/listening.

Example questions/statementsWhat do I/you think will happen next?What words/images do I/you expect to see or hear in this text?What might happen next? Why do I/you think that? What helped me/you make that prediction?Were my/your predictions accurate? How did I/you confirm my/your predictions?Have I/you read/seen/heard about this topic anywhere else?

Example teaching ideaBefore and after chart: Students list predictions before and during reading. As they read students either confirm or reject their predictions.

3. Questioning.- Learners pose and answer questions that clarify meaning and promote deeper understanding of the text. Questions can be generated by the learner, a peer or the teacher.

Example questions/statementsWhat in the text helped me/you know that?How is this text making me/you feel? Why is that?When you read/viewed/ listened to that text did it remind me/you of anything I/you know about? Why did it remind me/you of that?What did the composer of the text mean by …?Whose point of view is this? What points of view are missing?

Example teaching ideaWonderings: Using post-it notes, students list all the questions they have about the text. As they read students continue to write questions. When an answer is found for the wondering students remove the post-it note.

4. Monitoring.- Learners stop and think about the text and know what to do when meaning is disrupted.

Example questions/statementsIs this making sense?What have I/you learned?

Should I/you slow down? Speed up?Do I need to re-read/view/listen?What can help me/you fill in the missing information?What does this word mean?What can I use to help me understand what I’m/you’re reading/viewing/hearing?

Example teaching ideaCoding: As they read students code the text with post-it notes√ I understand? I don’t understand! I fixed it up myself

5. Visualising.- Learners create a mental image from a text read/viewed/heard. Visualising brings the text to life, engages the imagination and uses all of the senses.

Example questions/statementsWhat are the pictures I/you have in my/your head as I/you read/view/listen to this text?Can I/you describe the picture or image you made while you read/heard that part?How did the pictures in my/your head help me/you to understand thetext?

Example teaching ideaSketch to stretch: As a passage/story is read students sketch their visualisation. In groups they share their sketches and discuss reasons for their interpretation.

6. Summarising.- Learners identify and accumulate the most important ideas and restate them in their own words.

Example questions/statementsWhat things will help me/you summarise this text – list, mind map, note-taking, annotations, etc?What are the main ideas and significant details from the reading/viewing/listening?If you were to tell another person about the text read/viewed/heard in a few sentences, what would you tell them?What is the main theme? How is it connected to the world beyond the text?In what significant ways does this text relate to/elaborate on the topic that you have been investigating?Can you create a metaphor for the text that you have read?

Example teaching ideaKey words: Students highlight words they believe are key to understanding the passage. These words are written on post-it notes and placed on the page. After reading the students close the book and arrange the key words in an order that supports a cohesive summary.

EXPLICIT INSTRUCTION OF COMPREHENSION STRATEGIES

Step 1: Select a textTexts can range from easy to challenging. The criteria for text selection should focus on text usefulness for teaching a particular strategy or set of strategies, student interests and connections to literacy themes. If the text is challenging use ‘read-aloud’ when modelling.

Step 2: Explain the strategyFocus on the two questions:What is it?Why is it helpful/necessary for comprehension?Provide examples to assist this explanation and wherever possible make connections to students’ background knowledge and prior learning.

Step 3: Model the strategyRead a section of the text aloud and use a Think Aloud and a visual (symbol, chart, etc) to share ideas with students.NB: Think Aloud involves orally explaining precisely what is triggering thoughts and how it is affecting understanding.Explain thinking so that students have a clear idea of the cognitively active process readers experience. If a strategy requires a written or sketched response, model that during this step.

Step 4: Guided supportRead the next section of the text aloud and ask students to work with a partner to apply the new strategy. Discuss the response from paired students and read aloud another section of the text.

Step 5: Independent practiceMonitor as students work independently within the whole group. Either continue reading sections of the text with reduced teacher support or invite students to read independent texts on their own. Regardless, students independently use the strategy. Differentiate instruction by providing scaffolding for those students who need more support (through further modelling or guided support), and by releasing the task to those students who are ready to use it. The goal is to ensure that students know the strategy and the process for using it. Ultimately studentsdevelop a range of strategies that they can use as needed when they are reading on their own.

Step 6: ReflectAsk students to reflect on how using the strategy helped them to understand the text. Invite them to share their reflections in small groups or with the whole class. Discuss how they can use the strategy when they are reading on their own.

THE MEDICAL HISTORY

‘The medical history’ is a structured assessment conducted to generate a comprehensive picture of a patient’s health and health problems. It includes an assessment of:

the patient’s current and previous health problemscurrent and previous medical treatmentthe patient’s health in generalfactors which might affect the patient’s health and their response to prevention or treatment of health problems (e.g. risk factors, lifestyle issues)their family’s health

Taking together the history, information from the physical examination and any investigations or tests, this should provide all the information needed to make a diagnosis (i.e. to identify the nature of a health problem). Making a diagnosis is often a preoccupation of clinical students, however, it is important to remember that a clerking (i.e. an assessment in which a medical history is taken) provides much more information than this.

Common Misconceptions

There is often confusion about what ‘a medical history’ is, because the term is used for different things. It can mean:

the whole consultation in which information is gathered (i.e. including both the process of communication, and the content, i.e. the information gathered)

only the clinical content (the medical information) which is gleaned during the consultation

a written or presented version of the information gathered (e.g. in medical notes, a student case presentation)

These are all very different – the key point being that how you conduct a consultation to gather information to obtain ‘a medical history’ is not the same as how you subsequently record it or communicate it to colleagues.

Process

Initiating the consultation

1. Check the setting

Find a chair (do not sit on the bed, do not stand over the patient)Consider ambient noise and privacy (can you be overheard?)

2. Establish initial rapport

Be approachable and friendly – it helps to begin with a smile and an ice-breaker (i.e.a comment about a non-medical topic) Greet the patient with their title and surname, and check you are using their preferred form of address

Introduce yourself – full name and role (e.g. third year medical student)Explain reason for interview (e.g. to practise gathering information)Seek consent - if they decline, thank them and leave

3. Identify the reason for their attendance

Open question to identify the patient’s current problem/reason for attending Listen attentively to the opening statement without interruptionAcknowledge problem(s) mentioned (i.e. reflect back)Do not engage in detailed questioning at this point – you are establishing a problem listQuery whether there are other problems – acknowledge and repeat until no further problems are mentionedWrite down each problem as it is mentioned

Gathering information

1. Explore the patient’s problems

Encourage the patient to tell the story from when it first startedUse open questions at the start, clarifying with closed questions laterShow that you are listening – make eye contact while the patient is talking, tailor your questions to the information being given, reflect back what the patient is saying and periodically summarise Encourage the patient to talk – if you leave space, the patient will talk

2. Understand the patient’s perspective

Determine, acknowledge and appropriately explore:the patient’s ideas and concernsthe patient’s expectationshow each problem affects the patient’s life Encourage expression of the patient’s feelings

Ending the consultation

The end of a consultation is important for two reasons:

you need to check that the information you have is complete and accuratethe patient needs to know what will happen next

CONTENT OF THE HISTORY

IDENTIFYING DATA (obtain for the patient write up only):

Date, time and patient record number

Source and reliability of history

SETTING THE STAGE FOR THE INTERVIEW:

Introduce self and identify role; asks the patient’s name; use the patient’s name; asks patient’s age. Ensure the patient readiness, comfort, privacy; remove barriers to communication. Elicit or comment on some personal quality or observation about the patient to establish rapport

OBTAINING THE AGENDA AND CHIEF CONCERN:

Indicate time available; indicate own needs. Elicited full list of patient concerns starting with presenting concern. Summarize and finalize the agenda (negotiate specifics if too many items are on the agenda

HISTORY OF PRESENT ILLNESS:

(Listen; use “nonfocusing” open-ended skills: silence, neutral utterances, nonverbal encouragement. Observe nonverbal cues, physical characteristics, autonomic changes, accoutrements and environment. Consider attribution: what patient thinks is wrong; Consider motivation: why seeking treatment now; who is concerned/affected – patient, family,employer, etc.)

C –Characteristics (quality, severity) L – Location and radiation O –Onset and duration (gradual, sudden, continuous, progressive, intermittent) S – Symptoms associated with the concern E – Exacerbating factors R – Relieving factors (include what the patient has tried as therapeutic maneuvers)

PAST MEDICAL HISTORY:

Allergies: verify allergies and drug reactions: allergic diseases (e.g., asthma, hay fever) drugs, foods, environmental

Medications: current/recent prescribed, over the counter, alternative therapies and health care

Medical history: screen for major diseases: diabetes mellitus, cancer, heart attack, stroke; screen for major treatments in the past (cortisone, blood transfusions, insulin, digitalis, anticoagulants); toxins and/or industrial exposures; visits to the doctor in the last year

Surgical history: surgical procedures both inpatient and outpatient and date Hospitalizations: surgical, nonsurgical, psychiatric, obstetric, rehabilitation, other and date

Gynecological/Obstetric (female): Menstrual history (onset of menses, cycle length, number of pads daily); pregnancy/childbearing (births, spontaneous or induced abortions); complications of pregnancy; menopause (onset); contraception (birth control pills and/or other means; hormonal preparations); sexually transmitted diseases; mammogram; last pap smear Immunizations: tetanus-diphtheria in all patients; Measles-Mumps-Rubella in children; influenza and pneumococcal in patients with certain chronic illnesses (cardiovascular, pulmonary, metabolic, renal, hematologic, immunosuppression) and in patients over the age of 65

Diet: What did the patient eat the day before including meals and snacks; salt intake, fiber intake, caffeine intake, sugar intake in patients who have diabetes

Trauma history: prior history of injury and how injury was treated

Growth and development/childhood diseases/birth history: younger age groups

FAMILY MEDICAL HISTORY:

Summary of ages and states of physical and mental health of immediate family members (including depression or substance abuse, whether parents and siblings are alive, and causes of death). Family members with similar symptoms and signs. Presence of chronic and/or infectious diseases in family members. Family relationships (note family interaction patterns-happy, successful, competitive, distant, dysfunctional, love, anger)

PERSONAL/SOCIAL HISTORY:

Marriage/other relationships and outcome: (spouse, partner, children, number of living children)

Household composition/living situation: alone or with others; relationships; care giving

Ethnicity

Sources of social support: friends, community, organizations, pets, spiritual beliefs or community

Personal background: education, occupation, military, travel, religion, dwelling, financial, stress

Directives for care: living will, health care Power of Attorney, CPR, transfusions, known health risks

PREVENTION/RISK FACTORS:

Prevention: recreation, exercise, firearms, seat belts, smoke detectors, current stressors, sleep,periodic health examinations

Tobacco, alcohol, recreational drugs: current use/ past use

Sexual History: sexually active, partners (male/female/both), practice safe sex; Male: History of sexually transmitted disease (female ask in past medical history)

Occupational hazards/environmental exposures

Violence risk (Ex: Do you feel safe? Are you afraid of anyone? Has anyone hurt you?)

REVIEW OF SYSTEMS

General: change in weight; change in appetite; overall weakness; fatigue; fever, chills or sweats; anhedonia

Skin: sores; itching or rashes; color or texture changes; hair or nail changes; change in mole(s)

Endocrine: thyroid enlargement; heat or cold intolerance; loss of libido; salt cravings; excessive thirst; enlarging hat or glove size

Hematopoietic: lymphadenopathy; enlarging glands; bleeding or bruising tendencies; frequent or unusual infections

Musculoskeletal: frequent fractures; joint pain, stiffness, or swelling; muscle pain or weakness; low back pain; difficulty moving or walking; claudication

Head and Neck: headaches; trauma; neck stiffness

Eyes: bright flashes of light; changes in vision; scintillating scotomata; floaters; diplopia; pain

Ears, Nose, Sinuses, Mouth and Throat: sore throat; painful tooth; decrease or change in sense of taste; difficult speech; hoarseness; epistaxis; change or loss of hearing; tinnitus

Breasts: pain; masses; discharge

Respiratory: cough; dyspnea; wheezing; hemoptysis; pleurisy

Cardiovascular: chest pain; orthopnea; paroxysmal nocturnal dyspnea; edema; palpitations; syncope

Gastrointestinal: dysphagia; reflux; nausea; vomiting; hematemesis; eructation; flatulence; constipation; diarrhea; melena; abdominal pain; jaundice; pruritis ani

Urinary: frequency; urgency; dysuria; hematuria; nocturia; incontinence; renal stones; hesitancy

Female reproductive: vaginal pain; discharge; sore or lesions on vagina; menometarrhagia; irregular periods; amenorrhea; hot flashes

Male reproductive: scrotal mass; hernia; scrotal pain; urethral discharge; penile sores; retrograde, bloody or premature ejaculation; erectile dysfunction

Neurologic: weakness; numbness; seizures; headaches; incoordination; alternating consciousness; sleep disorders; memory disorders; tremor; dizziness

Psychiatric: anxiety; depression; mania; intrusive thoughts; loss of good judgment and/or insight; hallucinations

PHYSICAL EXAMINATION

General Tips on How to Perform an Examination

To begin the Examination

Wash your hands. Introduce yourself to the patient (first name, surname, medical

studentstatus) Greet the patient (title and surname).called. Explain what you would like to do and seek consent for the

examination. Explain what you are about to do at each stage without using jargon. PThenosition the patient appropriately (45 degrees for cardiovascular

and respiratory, flat for abdominal). Then expose the relevant part of the patient ensuring as much privacy

as possible. Perform a general inspection from the end of the bed. Don’t forget to

look at the surroundings (for sputum pot, central line, walking stick, etc.).

During the Examination

Have a methodical approach to examination. Although each system is slightly different the standard order is:

Inspect PalpatePercussAuscultate

To end the Examination

1) Consider whether you need to examine any system in more depth (e.g. a full examination of joints in a patient with rheumatoid arthritis).2) Re-examine any aspect that you are unsure about.

3) Tell the patient that you have completed your examination. Thank them and help them get dressed if needed.4) Wash your hands once more.

CONTENT

Vital Signs: temperature; pulse; respiratory rate; blood pressure: sitting and standing (orthostatic hypotension); weight; height; BMI

General Appearance: apparent health; developmental status; apparent physiologic age; habitus; hygiene; nutrition; gross deformities; mental state and behavior; facies; posture

Skin: color; texture; moisture; turgor; eruptions; abnormalities of hair and nails (pallor, pigmentation, cyanosis, clubbing, edema, spider nevi, petechiae)

Head: symmetry; deformities of cranium, face, or scalp (tenderness, bruits)

Eyes: visual acuity; visual fields; extraocular movements; conjunctive; sclera; cornea; pupils including size, shape, equality and reaction; ophthalmoscopic exam including lens, media, disks, retinal vessels and macula; tonometry (pallor, jaundice, proptosis, ptosis)

Ears: hearing acuity; auricles; canals; tympanic membranes (mastoid tenderness, discharge)

Nose: nasal mucosa and passages; septum; turbinates; transillumination of sinuses (tenderness over sinuses)

Mouth and Throat: breath; lips; buccal mucosa; salivary glands; gingival; teeth; tongue

Neck: range of motion; thyroid; trachea; lymph nodes; carotid pulses (venous distension, abnormal arterial and venous pulsations, bruits, tracheal deviation)

Lymph Nodes: cervical, supraclavicular, axillary, epitrochlear and inguinal nodes (enlargement, consistency, tenderness, and mobility)

Breasts: symmetry; (nodules including size, consistency, tenderness, mobility, dimpling; nipple discharge and lymph nodes)

Thorax and Lungs: configuration; symmetry; expansion; type of respiration; excursion of diaphragms; fremitus; resonance; breath sounds (retraction, labored breathing, prolonged expiration, cough, sputum, adventitious sounds including crackles, wheezes, rhonchi, and rubs)

Cardiovascular system: precordial activity; apical impulse; size; rate and rhythm of heart sounds; abdominal aorta; peripheral arterial pulses including

carotid, radial, femoral, posterior tibial, and dorsalis pedis pulses; (thrills; murmurs; friction rubs; bruits; central venous distension; abnormal venous pulsations)

Abdomen: contour; bowel sounds; abdominal wall tone; palpable organs including liver, spleen, kidney, bladder, and uterus; liver span; (scars; dilated veins; tenderness; rigidity; masses; distension; ascites; pulsations; bruits)

Musculoskeletal: symmetry; range of motion of joints; peripheral arterial pulses; color; temperature; (curvatures of spine; costovertebral angle tenderness; joint deformities; muscle tenderness; edema; ulcers; varicosities)

Neurologic exam: cranial nerves; station; gait; coordination; sensory and motor systems; muscle stretch reflexes; (paresthesias, weakness, muscle atrophy, fasciculations, spasticity, abnormal reflexes, tremors)

Genitourinary:

female- external genitalia; vagina; cervix; cytology smear; fundus; adnexae; rectovaginal exam (vaginal discharge, tenderness)

male- penis; scrotal contents; urethral discharge; hernias; prostate

Rectum: sphincter tone; test for occult blood; (hemorrhoids, fissures; masses)

Mental state exam: appearance; attitude; motor behavior; mood and affect; intellectual functions; thought content and processes; insight into mental functioning; judgment

BIBLIOGRAPHY

- Indiana University. School of Medicine. History and Physical Examination Outline - University College London. School of Medicine. GUIDE TO HISTORY TAKING AND EXAMINATION. 2012-2013- NSW Department of Education and Training. Teaching Comprehension strategies. 2010

WEBGRAPHY

- https://sites.google.com/site/medicaltranscriptionsamples/review-of-systems-template-format-examples- http://www.revise4finals.co.uk/medicine/learn/examinecvs.php- https://sites.google.com/site/medicaltranscriptionsamples/discharge-summary-medical-transcription-sample-report

THE MEDICAL HISTORY

1) Join with lines

2) Complete system applicable to device or the following statements:a) Thyroid enlargemet: Endocrineb) Lymphadenopathy: Hematopoieticc) Frequent fracture: Musculoskeletald) Dyspnea: Respiratorye) Chest Pain; orthopnea: Cardiovascularf) Disuria, hematuria: Urinary

Temperature; pulse; respiratory rate; blood pressure

Screen for major diseases: diabetes mellitus, cancer, heart attack, stroke

Summary of ages and states of physical and mental health of immediate family members

Apparent health; developmental status; apparent physiologic age; habitus; hygiene; nutrition.

Medical History

General Appareance

Family medical hystory

Vital Signs

3. Complete the crossword with the information of the “COMPARTMENTS OF THE BODY”

¹T ⁵MH E ⁶F A TR S²E N ³E R G Y R E S E R V E EE P N

I ⁸C A R B O H Y D R ⁷A T E ST H EH Y RE M O⁴L I G A M E N T S A BI L IA CL E

XERCISE

DOWN:1. Compartments of the body are:3. Type of tissue found in the human body5. Origin of most cells of the connective tissue7.One ways to teach the body to use more fat

ACROSS:

4. Find the words that apply to reading in this word search puzzle

M F H K Ñ K L V F G H O H R C G

N E G L Y C O L I S I S G E H H

E D S V N E T J F J L T R W O J

U D V E S F G H C V H E Y S N J

R F V A N A A D I C N O I A D M

O H I S Y C D F Y V H C J O R U

G B U X R T H D T B N Y M I O G

L B U C A Z V Y G Y S T L Y C G

I M U C F J J E M J E E M T Y Y

A G L Y C O L I A D S N F T L

F G J L Ñ P O 9 O J L J G J E S

S U P P O R T I N G T I S S U E

W E T T R U G F G J F G J L O G

D A I L Y N U T R I T I O N B

G J K R E H J N T U O 0 0 G F B

DOWN:1. Compartments of the body are:3. Type of tissue found in the human body5. Origin of most cells of the connective tissue7.One ways to teach the body to use more fat

ACROSS:

1. Neuroglia2. Supporting Tissue3. Mesenchymal4. Osteocytes5. Chondrocyte6. Daily nutrition7. Glycolysis

5. JOIN WITH LINES

Supporting tissue known as cell mass

Active tissue consists of fat

Energy reserve composed of bone minerals, extracellular

proteins

6. COMPLETE THE PERCENTAGES

55% cell mass

30% supporting tissue

15% energy reserve

7. LOCATE THE COMPARTMENT OF THE BODY

energy reserve

cell mass

supporting tissue

READING COMPREHENSION TECHNIQUES

8. Complete the following exercise with correct relative pronouns, choosing from the items given.

1. Jake and Jessica Carter, WHO (that / who) got married about a year ago, recently bought a new house.

2. The neighborhood IN WHICH (that / in which) they have been living is a somewhat dangerous one.

3. The neighborhood THAT (that / who) they are moving into is much safer.

4. Their new house WHICH (that / which) they bought quite cheaply, does need some fixing up.

5. However, they will be receiving some help from their neighbors, most of WHOM (who / whom) they like.

Defining Relative Clauses

9. Make one sentence from the two short ones. The sentence in italics should become the relative clause. The relative pronoun is the subject of the relative clause.

1. She worked for a man. The man used to be an athlete.

_______________________________________________________________

2. They called a lawyer. The lawyer lived nearby.

_______________________________________________________________

3. I sent an email to my brother. My brother lives in Australia.

_______________________________________________________________

4. The customer liked the waitress. The waitress was very friendly.

_______________________________________________________________

5. We broke the computer. The computer belonged to my father.

_______________________________________________________________

Answers:

1. She worked for a man who / that used to be an athlete.

2. They called a lawyer who / that lived nearby.

3. I sent an email to my brother who / that lives in Australia.

4. The customer liked the waitress who / that was very friendly.

5. We broke the computer which / that belonged to my father.

Defining Relative Clauses

10. Make a new sentence by joining the two short sentences. The sentence in italics should become the relative clause, and the relative pronoun is the object.

1. We ate the fruit. I bought the fruit.

_______________________________________________________________

2. She bought the computer. Her brother had recommended the computer.

_______________________________________________________________

3. He lost the money. I had given him the money.

_______________________________________________________________

4. We called the taxi company. Julie often uses the taxi company.

_______________________________________________________________

5. John met a girl. I used to employ the girl.

_______________________________________________________________

Answers:

1. We ate the fruit (which / that) I bought.

2. She bought the computer(which / that) her brother had recommended.

3. He lost the money (which / that) I had given him.

4. We called the taxi company (which / that) Julie often uses.

5. John met a girl (who / that) I used to employ.

Defining Relative Clauses

11. Make one sentence by changing the sentence in italics into a defining relative clause.

The relative pronoun can be the subject or the object of the relative clause.

1. They found the money. I dropped the money.

_______________________________________________________________

2. I broke the plate. The plate was a wedding present.

_______________________________________________________________

3. The police arrested the man. I saw the man steal a handbag.

_______________________________________________________________

4. The Queen fired the chef. We had met the chef.

_______________________________________________________________

5. She wrote to her friend. Her friend lives in Vietnam.

_______________________________________________________________

Answers:

1. They found the money (which / that) I dropped.

2. I broke the plate which / that was a wedding present.

3. The police arrested the man (who / that) I saw steal a handbag.

4. The Queen fired the chef (who / that) we had met.

5. She wrote to her friend who / that lives in Vietnam.

12. Make one sentence by changing the sentence in italics into a defining relative clause.The relative pronoun can be the subject or the object of the relative clause.

1. The man was late. Julie invited the man.

_______________________________________________________________

2. The doctor was sick. I wanted to see the doctor.

_______________________________________________________________

3. The accountant was arrested. The accountant works for my father’s company.

_______________________________________________________________

4. I wrote to the friend. You met the friend last week.

_______________________________________________________________

5. The mobile phone can’t be fixed. The mobile phone is broken.

_______________________________________________________________

Answers:

1. The man (who / that) Julie invited was late.

2. The doctor (who / that) I wanted to see was sick.

3. The accountant who / that works for my father’s company was arrested.

4. I wrote to the friend (who / that) you met last week.

5. The mobile phone which / that is broken can’t be fixed.