The candidate card
Setting
General practice, UK
Candidate
You are a GP in this original independent practice scenario; the patient details and documented assessment below are fictional case facts. Ms Miriam Hornig, aged 49, has recently had atrial fibrillation confirmed by ECG, has hypertension and feels well today. Her documented individual assessment recommends offering an oral anticoagulant because the expected stroke-prevention benefit outweighs the assessed bleeding risk; she has not started treatment. She understands these benefits and bleeding considerations but wants immediate protection without ongoing tablets, and a prescribing review is available today to discuss her decision and, if she accepts treatment, select the medicine and provide individual instructions.
Task (interlocutor: patient)
- Find out what immediate protection and avoiding ongoing tablets mean to Ms Hornig, and which priority matters most to her
- Explain the distinction between stroke prevention and treatment of the heart rhythm, without promising complete protection or a tablet-free solution
- Explore the trade-off between her preferences and the documented recommendation, acknowledging her understanding rather than repeating a general warning
- Agree an informed next step using today's prescribing review, checking her understanding and respecting her decision
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 GP in this original independent practice scenario; the patient details and documented assessment below are fictional case facts. Ms Miriam Hornig, aged 49, has recently had atrial fibrillation confirmed by ECG, has hypertension and feels well today. Her documented individual assessment recommends offering an oral anticoagulant because the expected stroke-prevention benefit outweighs the assessed bleeding risk; she has not started treatment. She understands these benefits and bleeding considerations but wants immediate protection without ongoing tablets, and a prescribing review is available today to discuss her decision and, if she accepts treatment, select the medicine and provide individual instructions.
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
- Start by separating her two priorities, since immediate protection and avoiding ongoing tablets may require different discussions. Ask what each would mean in practice and which she would prioritise if both cannot be achieved together.
- Acknowledge that she already understands the benefit and bleeding considerations before offering explanations. Ask what remains unresolved; a likely concern is the commitment of ongoing treatment, but explore this rather than assigning her a motive.
- Separate preventing a stroke from treating the heart rhythm early, so a discussion about rhythm does not become an implied alternative to prevention. Use everyday language and avoid suggesting either complete protection or a guaranteed tablet-free solution.
- Frame the documented recommendation as an individual assessment whose expected prevention benefit outweighs assessed bleeding risk. Discuss how that recommendation fits her priorities without using repetition of risks to pressure her into agreement.
- Reserve time to establish what she wants from today's prescribing review and check her understanding of the remaining choices. If time is short, prioritise the unresolved trade-off and her decision; leave medicine selection and individual instructions to that review.
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 Hornig, I'm one of the GPs here. Thanks for coming in. I'd like to talk through your heart rhythm result and the choices in front of you.”
- “You've told us you feel well today. How have you been feeling about the atrial fibrillation diagnosis since it was confirmed?”
2. Key questions
- “You mentioned wanting immediate protection. What does that look like for you, and what are you most hoping to be protected from?”
- “And when you say you'd rather avoid ongoing tablets, what is it about taking them long term that concerns you?”
- “If you had to choose, which matters more to you right now: protection straight away, or not being on regular tablets?”
- “What have you already heard or read about treatment for atrial fibrillation that is shaping how you feel?”
3. Handling the patient's concern
Likely concern: She may feel that regular tablets are not an acceptable price for protection, and that a quick one-off fix should exist.
- “You clearly understand the benefits and the bleeding risks already, so I won't repeat the warnings. It makes sense to want protection without a long-term commitment.”
- “Let's look at how those two wishes fit together. Tell me if anything I say doesn't match what matters most to you.”
4. Explaining
- “There are two separate questions. One is lowering your chance of a stroke. The other is treating the heart rhythm itself. Treating the rhythm doesn't answer the stroke question, and no option gives complete protection.”
- “Your assessment suggests the stroke-prevention benefit of an anticoagulant tablet is greater than your bleeding risk. Given what you've told me, I'd recommend you consider taking it, though it would mean ongoing tablets. How does that sit with you?”
5. Closing
- “So you want protection soon but are uneasy about long-term tablets. We have a prescribing review available today to go through the options. Would you like to use it?”
- “Whatever you decide, it's your decision and we'll support it. If you accept treatment, the review can choose the medicine and give you individual instructions. Is there anything I haven't covered?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- It sounds as though these two priorities are pulling you in different directions.
- Would it help to pause before we discuss the options further?
- What would make this decision feel more manageable?
- You can tell me if my explanation has missed your main concern.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| atrial fibrillation | An irregular heart rhythm. |
| oral anticoagulant | Medicine taken by mouth that reduces blood clotting. |
| ECG | A recording of the heart's electrical activity. |
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 should I respond if she says feeling well means she does not need treatment?
Distinguish how she feels today from the purpose of preventive treatment. Her documented recommendation concerns stroke prevention, even though she currently feels well. Do not suggest that feeling well changes the assessment or proves that her rhythm has returned to normal.
What if she asks exactly when protection would begin?
Explain that no medicine has yet been selected, so you cannot give an individual timing answer from this card. Make that question explicit for today's prescribing review. Avoid supplying a general onset estimate that could sound like a promise about her treatment.
Should I offer a temporary course as a compromise?
Do not invent a treatment duration or suggest that a short course resolves her competing preferences. The card provides an individual recommendation and access to a prescribing review, but no agreed medicine or duration. Clarify her question and take it into that discussion.
How should I split the five minutes?
Spend roughly the first half exploring her two priorities and listening, then move to the explanation once you know which matters most. Keep the last minute for agreeing the next step. Linking each point back to her words keeps the explanation short.
What if she says she definitely won't take any tablets?
Acknowledge her decision calmly and don't push. Check she has understood what declining means, offer the prescribing review today in case she wants to talk it through, and leave the door open to revisit the decision later.
Sources
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