The candidate card
Setting
Paediatric clinic, UK
Candidate
You are a doctor in this original independent practice scenario; the family details and assessment below are fictional case facts. Mr Derick Shanahan, aged 42, is attending with his seven-year-old son, whose assessment today supports functional constipation with overflow soiling after painful, hard stools and recurrent underwear staining. The clinic's proposed care plan is an individual laxative prescription and explanation from the paediatric prescriber before departure, relaxed toilet sitting after meals with supported feet, praise for participation, adequate drinks and fibre-containing foods, and follow-up arranged before the family leaves; no medicine or dose has yet been selected. Mr Shanahan believes his son is being deliberately dirty and doubts that a supportive approach will help.
Task (interlocutor: relative)
- Find out what Mr Shanahan has noticed, how he explains the accidents and how the family currently responds
- Explain overflow soiling and the cycle of painful stools and withholding in simple, non-blaming language
- Explain the supplied care plan and encourage a calm approach that rewards participation rather than clean underwear
- Agree practical steps for home and school, confirm the prescribing discussion and follow-up arrangements, and check 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 family details and assessment below are fictional case facts. Mr Derick Shanahan, aged 42, is attending with his seven-year-old son, whose assessment today supports functional constipation with overflow soiling after painful, hard stools and recurrent underwear staining. The clinic's proposed care plan is an individual laxative prescription and explanation from the paediatric prescriber before departure, relaxed toilet sitting after meals with supported feet, praise for participation, adequate drinks and fibre-containing foods, and follow-up arranged before the family leaves; no medicine or dose has yet been selected. Mr Shanahan believes his son is being deliberately dirty and doubts that a supportive approach will help.
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
- Explore what happens around an accident before challenging his interpretation. Ask what he notices and what adults say or do afterwards; concern that a supportive response rewards the behaviour is possible, but should be checked.
- Explain the connection between painful hard stools, holding back and accidental staining before discussing behaviour. This order gives him a reason to reconsider blame; avoid describing either his son as naughty or his parenting as the cause.
- Present the linked plan: individual laxative prescribing and explanation before departure; relaxed toilet sitting after meals with supported feet; praise for participation; adequate drinks and fibre-containing foods; and follow-up arranged before leaving. Avoid making any element sound optional.
- Make participation the practical target for praise, because judging success by clean underwear would recreate the misunderstanding you are addressing. Ask which home routines and school arrangements could support the plan without assuming either setting is already cooperative.
- Close by asking him to explain how he would respond to another stained pair of underwear. If time is short, prioritise the non-blaming explanation, the prescribing discussion and confirmation that follow-up is arranged before departure.
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 Shanahan, I'm the doctor in the children's clinic. Thank you for bringing your son in today. I'd like to hear your side of things first.”
- “What have you noticed about your son's toilet habits and the stained underwear?”
2. Key questions
- “How do you make sense of the accidents, and what do you think is behind them?”
- “When he has an accident, what do you and the rest of the family usually do?”
- “Can you tell me about his bowel movements, including whether they've been hard or painful?”
- “What worries you most about trying a supportive approach?”
3. Handling the patient's concern
Likely concern: He is likely to feel his son is being deliberately dirty and doubt that a supportive approach will help.
- “It's clear how frustrating the accidents are, and you've been watching closely. What I found today fits constipation with overflow soiling, a bowel problem rather than him doing this on purpose.”
- “Your doubt is understandable. A calm approach goes together with treatment. The prescriber will explain his laxative before you leave, and we'll book a follow-up so we can see how it's going.”
4. Explaining
- “When stools are hard and painful, children often hold on to avoid the pain, which makes the stool harder still. Softer stool can then leak around it, staining underwear without him meaning to. Does that make sense?”
- “The plan is a laxative from the prescriber, relaxed toilet sitting after meals with his feet supported, plenty of drinks and fibre foods, and praise for trying rather than for clean underwear. How does that sound?”
5. Closing
- “So at home he'll sit after meals, you'll praise him for taking part, and you'll respond calmly to accidents. What would help at school, such as easy access to the toilet?”
- “The prescriber will explain his laxative before you leave, and we'll book a follow-up first. Could you tell me in your own words what you'll do at home?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- What difficulties have these accidents caused for your family?
- We can take your observations seriously without blaming him.
- Which part feels hardest to put into practice?
- Would you like me to go over that connection again?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| functional constipation | Difficulty passing stools, as supported by today's assessment. |
| overflow soiling | Accidental underwear staining associated with constipation. |
| laxative | Medicine to help with constipation. |
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
How can I include the child without undermining his father?
Use language that the seven-year-old can understand and invite him to describe what passing stools feels like. Keep the discussion respectful of his father while avoiding agreement with accusations. Do not assume the child's account or feelings before hearing them.
What if his father asks which laxative to buy immediately?
No medicine or dose has been selected. Explain that the paediatric prescriber will provide the individual prescription and explanation before they leave. Do not fill that gap with a familiar product, dosing schedule or treatment duration of your own.
What should I say if he asks when the staining will stop?
Explain that improvement takes time and soiling may temporarily increase when laxative treatment starts. This does not mean his son is choosing to soil or that an accident signals treatment failure. Encourage continued calm, non-blaming support and follow-up according to the individual care plan, without promising a recovery date or immediate clean underwear. Do not assume all worsening is an expected treatment effect: a swollen abdomen with vomiting requires urgent medical assessment through an urgent GP appointment or NHS 111. The paediatric prescriber will provide the individual medicine and dose instructions before they leave.
What if he says praise is rewarding bad behaviour?
Explain that you're praising what his son can control, such as sitting and trying, rather than clean underwear, which he can't fully control while the bowel problem persists. This keeps the focus on participation and avoids blaming him for accidents.
Can I name the laxative or dose to reassure him?
No. No medicine or dose has been selected yet. Say that the paediatric prescriber will choose it and explain it before the family leaves. Focus instead on what you can explain now: why treatment is part of the plan and that you'll review how it is going.
Sources
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