The candidate card
Setting
Palliative outpatient clinic, UK
Candidate
You are a doctor in this original independent practice scenario; the patient details are fictional case facts. Mr Fintan Mulvenna, aged 48, has advanced bowel cancer and attends for symptom support alongside ongoing oncology treatment. He is clinically stable today, his existing treatment is continuing, and no CPR decision has been recorded. After hearing that today's appointment could include planning future care, he has become worried; your purpose is to explore his priorities and understanding, without seeking a treatment decision today.
Task (interlocutor: patient)
- Find out what Mr Mulvenna understood about planning future care, what worries him and whether he is comfortable discussing it
- Explore what matters most to him in daily life and what he would want the team to understand if he became more unwell
- Explain briefly what CPR means and distinguish a decision about CPR from decisions about other appropriate treatment and symptom support
- Reassure him that discussing his wishes does not itself stop treatment, while explaining that future treatment recommendations require individual clinical assessment
- Agree what he would like recorded, whom he wants involved and whether to arrange a further conversation, checking his understanding
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.
Prepare this card, then say it out loud.
Plan your opening and the tasks below. Keep these notes when you move to the AI role-play.
You are a doctor in this original independent practice scenario; the patient details are fictional case facts. Mr Fintan Mulvenna, aged 48, has advanced bowel cancer and attends for symptom support alongside ongoing oncology treatment. He is clinically stable today, his existing treatment is continuing, and no CPR decision has been recorded. After hearing that today's appointment could include planning future care, he has become worried; your purpose is to explore his priorities and understanding, without seeking a treatment decision today.
Getting your plan ready…
Preparation is free without an account. AI conversation and marking need sign-in; your first role-play is free. Notes are saved on this device when available. This checklist is your plan, not a score.
How to approach this card
- A likely worry is that planning signals withdrawal of care, but do not assume this. Ask what the invitation meant to him and whether he wants to discuss it; understanding his interpretation first helps prevent an explanation that misses his concern.
- If he is comfortable continuing, begin with everyday priorities before hypothetical treatment choices. Invite an example of what makes a day worthwhile, then explore its meaning; this gives his preferences context without turning a personal conversation into a checklist.
- Explain CPR briefly as emergency attempts to restart the heart and breathing if they stop. Separate this specific intervention from other appropriate treatment and symptom support; the usual trap is allowing a CPR discussion to sound like a decision about all care.
- Anchor reassurance in what is known: he is clinically stable today and his existing treatment continues. Avoid promising that every future treatment will be appropriate; individual assessment remains necessary, and reassurance should not become a prediction about his illness.
- Close by checking his understanding, what he wants recorded and whom he wants involved, without seeking a treatment decision today. If time is short, prioritise his main concern and an agreed next step over covering every possible planning topic.
Model route: what a strong candidate might say
Example lines in a workable order for about 5 minutes: opening, key questions, the patient's concern, explaining, then the close. Use them to plan, not to memorise: the patient's replies are not scripted here, and your next line should follow what they actually say.
1. Opening
- “Hello Mr Mulvenna, I'm one of the doctors in the palliative clinic. I'm here to help with your symptoms alongside your cancer treatment.”
- “I understand you heard today might include planning future care. What did you understand by that?”
2. Key questions
- “How are you feeling about talking about this today, and is it all right to go on?”
- “What worries you most when you hear 'planning future care'?”
- “What matters most to you in your day-to-day life at the moment?”
- “If you became more unwell, what would you want the team to understand about you?”
3. Handling the patient's concern
Likely concern: He is likely to worry that discussing future care means treatment will stop or that he is being given up on.
- “It sounds unsettling to have this raised unexpectedly, and thank you for telling me. You can say stop or slow down at any point.”
- “I'm not here to ask you to make a decision today. I'd like to understand what matters to you so the team can support you well.”
4. Explaining
- “CPR means chest compressions and other emergency treatment to try to restart the heart if it stops. A decision about CPR is separate from other appropriate treatment and symptom support. No CPR decision has been recorded. Is that clear?”
- “Talking about your wishes doesn't stop your current treatment, which is continuing. Any future treatment recommendation depends on assessing you at that time. Would you like me to go over any part again?”
5. Closing
- “So, today you've told me what matters to you. Is there anything you'd like me to record, and who would you like involved in these conversations, such as family or your oncology team?”
- “Would you like another conversation, and if so, when? Let me check I've understood: no decisions today, your treatment continues, and we'll record only what you're comfortable with. Is that right?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- It sounds unsettling to have this raised unexpectedly.
- Would smaller pieces of information feel more manageable?
- You can tell me if I have misunderstood you.
- Would you like a moment before we go on?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| CPR | Emergency attempts to restart your heart and breathing if they stop. |
| Palliative care | Care focused on symptoms and support alongside your ongoing cancer treatment. |
| Oncology treatment | Treatment for your cancer. |
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). See the AI Speaking practice guide for what each criterion looks for.
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All sets: nurses, doctors, other professions. Your profession's guide: OET Medicine.
Questions about this role-play
What if he asks whether CPR would work for him?
Do not estimate his chances from the diagnosis alone or introduce statistics. Explain that you cannot give a personalised answer from the information available in this conversation. Ask what he means by working, so any further discussion addresses the outcome he is asking about.
Should I describe this appointment as end-of-life care?
Use the appointment's stated purpose: symptom support alongside ongoing oncology treatment. The card does not establish that he is approaching death. Avoid introducing an end-of-life label yourself; if he uses it, ask what that expression means to him before responding.
What if he expresses priorities that seem contradictory?
Reflect both statements neutrally and ask how they fit together for him. For example, ask whether they relate to different situations. Do not force consistency or interpret uncertainty as refusal; leave room for him to clarify, reconsider or remain unsure.
What if he becomes upset or wants to stop the conversation?
Pause, acknowledge his feelings and offer a moment. Remind him that nothing has to be decided today. Offer to continue later or in smaller pieces, and make sure he knows how to contact the team. Respecting his pace is part of the task.
How do I explain CPR without it sounding like a recommendation?
Describe what it is in a sentence or two, then say clearly that it's one separate decision and that no decision has been recorded. Avoid saying whether it would or wouldn't work for him. Ask what he understood, and invite questions.
Sources
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