The candidate card
Setting
Hospital renal dialysis unit
Candidate
You are a renal dietitian. Mrs Njeri Meredith, aged 46, started haemodialysis three times a week four months ago. She has repeatedly arrived for her sessions with large fluid weight gains and potassium levels above the target range. The nursing team says she often has cramps while fluid is removed, and they have asked you to review her diet during today's session. You are seeing her while she is on the machine.
Task (interlocutor: patient)
- Find out about her usual eating and drinking between sessions and how she is feeling physically (work days, home, any symptoms)
- Explain in simple terms why extra fluid and high potassium are a risk for her
- Respond to her frustration and her reluctance to make changes
- Suggest practical ways to manage thirst and reduce high-potassium foods that fit her routine
- Agree one or two realistic goals and arrange follow-up
In the test you get 3 minutes to read the card and plan, then about 5 minutes to talk. This card is original, written for this site; the interlocutor's card is not shown.
How to approach this card
- Check how she feels right now and about cramps first, because you are speaking while she is on the machine. Then ask about her work days, home routine, drinking and eating between sessions.
- Explain in plain words why extra fluid and high potassium are risks for her, keeping it to a couple of sentences. Avoid frightening her or sounding like you are scolding her about her results.
- Respond to her frustration before suggesting changes. Ask what is hardest about the restrictions, and acknowledge that the changes affect her work and social life, because pushing advice at a frustrated patient will fail.
- Offer a few practical ideas for managing thirst and reducing high-potassium foods that fit her routine, built from what she told you. Avoid generic lists she cannot picture using.
- If time is short, prioritise her frustration and one achievable goal rather than several. Close by agreeing one or two goals in her words and arranging follow-up at a future session.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Four months into dialysis is a big adjustment, and it's fine to feel fed up.
- How are you feeling during sessions, and when do the cramps happen?
- What does a work day look like for you in terms of drinks and meals?
- Which of these goals feels realistic for you before the next session?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| fluid weight gain | Extra weight from fluid that builds up between dialysis sessions. |
| potassium | A mineral in many foods that can build up in the blood when kidneys aren't working. |
| haemodialysis | A treatment where a machine cleans your blood and removes extra fluid. |
How this card is marked
Two assessors mark the recording on nine criteria: intelligibility, fluency, appropriateness of language and resources of grammar and expression (each 0–6), then relationship building, understanding and incorporating the patient's perspective, providing structure, information gathering and information giving (each 0–3). Grade B usually means 5 on each language criterion and 2 on each clinical one. See the AI Speaking practice guide for what each criterion looks for.
More Dietetics role-play cards
- Toddler with iron deficiency and high milk intake Paediatric outpatient clinic
- Dietitian: first dietary advice after a type 2 diabetes diagnosis Community health centre (dietetics clinic)
- Weight loss in an aged care resident Aged care facility
All sets: nurses, doctors, other professions. Your profession's guide: OET Dietetics.
Questions about this role-play
How do I deal with her reluctance without lecturing?
Ask what makes changes hard, reflect it back, and let her choose the starting point. A goal she picks is more likely to happen than one you set, and she will probably feel you are on her side.
Should I link her cramps to her fluid gains?
The nurses say she often has cramps while fluid is removed. Ask how she experiences them and whether she sees a connection, and say you will share her account with the team. Do not claim a cause that the card does not state.
What can I realistically cover while she is on the machine?
Keep it short. She may be tired or uncomfortable, so cover her symptoms, her frustration, one explanation and one or two goals. Offer to continue at the next session, and avoid handing her a long list to read alone.
Sources
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