The candidate card
Setting
Paediatric outpatient clinic, UK
Candidate
You are a doctor in a paediatric outpatient clinic in this original independent practice scenario. In this fictional case, Ms Hadiza Saidu, aged 42, is discussing her seven-year-old son's repeated blinking and shoulder movements, which your assessment identifies as motor tics; he has no pain or difficulty completing schoolwork. She believes firmer discipline could stop the movements before a school performance next week and is considering taking away a favourite activity whenever they occur. You need to explore family responses and her son's experience, explain the involuntary nature of tics and agree observation and support; no diagnosis of Tourette syndrome has been made.
Task (interlocutor: relative)
- Find out how the family responds to the movements, why Ms Saidu thinks punishment might help and how the movements affect her son's feelings and activities
- Explain that tics are involuntary and that briefly holding them back does not mean a child can reliably stop them
- Encourage her to avoid punishment and repeated reminders, addressing her worry that a calmer response means allowing the movements to continue
- Explain how observation and support can help, with further assessment or treatment guided by the child's distress and daily functioning
- Agree practical support at home and school, involving her son in decisions about the performance, and arrange review with advice on when to seek earlier reassessment
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 a paediatric outpatient clinic in this original independent practice scenario. In this fictional case, Ms Hadiza Saidu, aged 42, is discussing her seven-year-old son's repeated blinking and shoulder movements, which your assessment identifies as motor tics; he has no pain or difficulty completing schoolwork. She believes firmer discipline could stop the movements before a school performance next week and is considering taking away a favourite activity whenever they occur. You need to explore family responses and her son's experience, explain the involuntary nature of tics and agree observation and support; no diagnosis of Tourette syndrome has been made.
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
- Ask how family members respond to the movements and why she thinks punishment might help. Explore her son's feelings, participation and daily functioning rather than assuming that visible movements trouble him or that normal schoolwork means he has no difficulties.
- Establish what she understands about tics and their control. Explain that a child may briefly hold back an involuntary tic with effort without being able to stop it reliably. Pause and invite her response, especially if she interprets brief suppression as proof of deliberate behaviour.
- Acknowledge the intention behind her proposed discipline, then clearly advise against punishing tics or repeatedly telling him to stop. Ask about his feelings and willingness to participate in the performance. If she discloses distress or reluctance, explore it before discussing support rather than assuming how he feels.
- Explain that observation includes checking his wellbeing and daily functioning while responding calmly to the movements. Avoid equating reduced attention to tics with ignoring the child. Discuss further assessment according to his needs; any medicine requires specialist referral and advice, and neither medicine nor behavioural treatment guarantees an immediate result.
- Agree consistent responses at home and, with family agreement, at school. Involve her son in choosing support, such as an optional break or an adjustment to participation if wanted. Agree review arrangements and reasons for earlier reassessment, then ask her to describe the next steps in her own words.
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 Ms Saidu, I'm the paediatric doctor. Thank you for bringing your son in today.”
- “Could you tell me what you've noticed with his blinking and shoulder movements, and how you've been feeling about them?”
2. Key questions
- “When the blinking or shoulder movements happen, how does the family respond, and what does he do?”
- “What makes you think firmer discipline might stop them before the performance?”
- “How does he seem to feel about the movements, and has he avoided anything because of them?”
- “How is he feeling about next week's performance, and what would he like to do?”
3. Handling the patient's concern
Likely concern: She likely worries that a calmer response means allowing the movements to carry on.
- “That's a fair worry, and wanting to help him before next week makes sense. Staying calm isn't ignoring the movements.”
- “It means he isn't blamed for something he doesn't control, and he can feel supported at home. That is a real way of helping him.”
4. Explaining
- “Tics are involuntary movements. A child may hold them back briefly, but that doesn't mean he can reliably stop them. Punishing him or repeatedly reminding him isn't helpful. Does that fit what you've seen?”
- “For now, observation and support is the right approach. We'd consider further assessment or treatment if the movements cause him distress or interfere with daily life. No diagnosis of Tourette syndrome has been made. How does that sound?”
5. Closing
- “So at home, no punishment or reminders, and we'll involve him in deciding about the performance and what school could do. I'll arrange a review. Could you tell me what we've agreed?”
- “Please bring him back sooner if the movements start to upset him, cause pain, or get in the way of schoolwork or daily activities, or if anything new worries you. Any questions?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- What do you usually do when the movements happen, and how does he respond?
- What has he said about taking part in the performance?
- Holding a tic back briefly does not mean he can choose to stop it whenever he wants. Punishing him for it would not be appropriate.
- Could you talk me through what we have agreed for home, school and his review?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| motor tics | Repeated movements, such as his blinking and shoulder movements, that are difficult to control. |
| behavioural treatment | Guided practice in skills that may help manage tics; it does not mean the movements are deliberate. |
| reassessment | Checking him again if the situation changes or concerns arise. |
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 she asks whether this means Tourette syndrome?
State that the assessment identifies motor tics and that Tourette syndrome has not been diagnosed. Ask what she understands that name to mean. Avoid introducing diagnostic duration thresholds, predicting another diagnosis or giving a categorical assurance that he could never receive it. NHS information.
How do I respond if she says he can stop when told?
Acknowledge her observation. Explain that some children can hold back a tic briefly with effort, but this does not make it deliberate or mean they can keep it stopped. Advise against punishment and repeated reminders, which may add pressure and worsen tics. Agree calm, consistent responses at home and school while paying attention to his wellbeing. RCH parent guidance; GOSH classroom support guidance.
When should she request reassessment?
Ask about the child's feelings, willingness to participate and practical difficulties during this consultation. If distress or reduced participation is disclosed, address it now and assess whether further support is needed. Observation may be appropriate when tics are not troublesome; consider the appropriate specialist pathway if quality of life is significantly affected. Agree review arrangements and request earlier review for worsening movements, pain or increasing interference with daily life. Seek prompt assessment for loss of previously acquired skills or other new neurological symptoms. NICE referral guidance; RCH specialist guidance.
What if she insists on taking away his favourite activity?
Don't argue. Ask what outcome she hopes for, then explain that he doesn't choose the movements, so a consequence can't reliably teach him to stop and he may feel blamed. Offer calm, supportive alternatives and ask her to hold off until the review.
How do I involve a seven-year-old in decisions about the performance?
If he is in the room, invite him gently to say how he feels and what would help. If not, ask his mother to have a calm, private conversation with him. Let his answers shape the plan for the performance and school support.
Sources
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