The candidate card
Setting
Antenatal clinic (UK)
Candidate
You are a doctor in this original independent practice scenario, seeing Ms Gifty Ahortor, aged 43, who was diagnosed with gestational diabetes after an oral glucose tolerance test yesterday at 27 weeks of pregnancy. Fictional case facts: she has not started glucose testing or medication and says that the diagnosis feels like criticism; the proposed local plan is to meet the diabetes midwife today for a meter demonstration and written testing, target and contact instructions, arrange dietitian input through the joint antenatal-diabetes team, and book the next review before she leaves. General clinical information: pregnancy increases the body's insulin needs, gestational diabetes is not a personal failure, and tailored food choices, suitable activity and monitoring reduce risks such as excessive fetal growth; tablets or insulin may be needed after assessment, without implying that she has failed. This is a focused shared-planning conversation rather than a complete antenatal assessment: check that she feels well and that her baby's usual movements are unchanged, advise prompt maternity-team contact for new concerning symptoms such as marked thirst or blurred vision, and immediate contact for reduced or changed fetal movements rather than waiting for the next appointment.
Task (interlocutor: patient)
- Find out what Ms Ahortor understands about the diagnosis and which daily difficulty feels most important, with a brief check of her current wellbeing and baby's movements
- Explain gestational diabetes simply and reassure her that needing support or medicine does not mean personal failure
- Outline the proposed shared care, including practical food advice and supported home monitoring without inventing glucose targets
- Respond to her feeling of blame and help her identify one manageable first step
- Agree how to proceed with the diabetes midwife and follow-up, including when to contact the maternity team
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, seeing Ms Gifty Ahortor, aged 43, who was diagnosed with gestational diabetes after an oral glucose tolerance test yesterday at 27 weeks of pregnancy. Fictional case facts: she has not started glucose testing or medication and says that the diagnosis feels like criticism; the proposed local plan is to meet the diabetes midwife today for a meter demonstration and written testing, target and contact instructions, arrange dietitian input through the joint antenatal-diabetes team, and book the next review before she leaves. General clinical information: pregnancy increases the body's insulin needs, gestational diabetes is not a personal failure, and tailored food choices, suitable activity and monitoring reduce risks such as excessive fetal growth; tablets or insulin may be needed after assessment, without implying that she has failed. This is a focused shared-planning conversation rather than a complete antenatal assessment: check that she feels well and that her baby's usual movements are unchanged, advise prompt maternity-team contact for new concerning symptoms such as marked thirst or blurred vision, and immediate contact for reduced or changed fetal movements rather than waiting for the next appointment.
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 what felt critical or blaming about the diagnosis before offering advice. Explore which daily difficulty matters most to her; a likely worry is being judged, but do not assume anything about her eating habits or willingness to engage.
- Check that she currently feels well and that her baby's usual movements are unchanged before moving into planning. Acknowledge the diagnosis was only yesterday, so a long explanation may compete with her immediate need to feel heard.
- Explain that pregnancy increases the body's insulin needs and that gestational diabetes is not personal failure. Link tailored food choices, suitable activity and monitoring to reducing risks such as excessive fetal growth, without predicting harm to her baby.
- Build the discussion around her usual meals and what feels achievable, rather than giving a restrictive generic diet. Connect dietitian support with today's supported meter demonstration, asking which practical part she would most like help to learn.
- Agree one manageable first step, confirm today's diabetes-midwife meeting and book the next review before she leaves. If time runs short, preserve the practical handover and check she understands the maternity contact advice rather than extending the explanation.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- You deserve support without feeling judged.
- Thank you for telling me how that conversation felt.
- Would you like a moment before we continue?
- What would make today's visit feel useful to you?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| gestational diabetes | Diabetes diagnosed during pregnancy. |
| oral glucose tolerance test | The test using a glucose drink to assess how your body handles sugar. |
| excessive fetal growth | Your baby growing larger than expected. |
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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Questions about this role-play
Can I use yesterday's glucose tolerance test to invent home testing targets?
No numerical result or home target is supplied. The diagnostic test does not provide permission to invent monitoring thresholds or a testing schedule. The diabetes midwife will provide written testing, target and contact instructions today; check that Ms Ahortor can understand and use those instructions.
How should I discuss tablets or insulin without making treatment sound inevitable?
Explain that tablets or insulin may be needed after assessment, rather than presenting either as already decided. Frame medicine as another form of support, not a consequence of doing something wrong. Do not promise that food changes alone will be enough or suggest that medicine represents failure.
What maternity contact advice belongs in this focused conversation?
Advise prompt maternity-team contact for new concerning symptoms, including marked thirst or blurred vision. Reduced or changed fetal movements require immediate contact, without waiting for the next appointment or the following day. Do not reassure her solely because a routine review is booked. [NHS diabetes guidance](https://www.nhs.uk/conditions/gestational-diabetes/); [movement guidance](https://www.pregnancybirthbaby.org.au/pregnancy/health-conditions-and-complications/baby-movements-during-pregnancy).
Sources
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