Lastly, proficiency. The aim of a proficiency test is to assess the student's ability to apply in actual situations what he has learned. It seeks to answer the question: "Having learned this much, what can the student do with it?" This type of test is not usually related to any particular course, because it is concerned with the student's current standing in relation to his future needs. Efforts must be made to use in the tests the kind of language which actually occurs in the situation the student will meet. For example, a test which sets out to assess the proficiency of a student hoping to follow a university course in an English-speaking country would need to take into account not only his level of skill in listening to lectures, but also his ability to take notes, to make full use of what is gained from the lecture in his subsequent writing. An important element in proficiency testing is to assess in some way the student's ability to repair breakdowns in communication, by asking for a repetition or an explanation, for example, or by rephrasing what he has just tried to say. A rather typical example of a standardized proficiency test is the Test of English as a Foreign Language or TOEFL. It is used by nearly 1,000 institutions of higher education in the United States as an indicator of a prospective student's ability to undertake academic work in English.