The candidate card
Setting
Hospital ward
Candidate
You are a resident doctor on a medical ward. Mr Laurence Langley, aged 67, a retired bus driver, was admitted three days ago with breathlessness and swollen ankles. An echocardiogram has confirmed heart failure, and his breathing and swelling have improved with diuretic treatment. Since hearing the diagnosis on the ward round this morning, he has become quiet and withdrawn, and the nurse has asked you to talk with him.
Task (interlocutor: patient)
- Find out what Mr Langley understood from the ward round and how he is feeling (worries, what 'heart failure' means to him)
- Explain in simple terms what heart failure is and why his symptoms happened
- Reassure him about his outlook and the treatment available (medicines, monitoring, support from the heart failure team)
- Explain what he can do himself at home (e.g. weighing daily, warning signs, when to seek help)
- Agree the next steps before discharge
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.
How to approach this card
- Start by asking what he took from the ward round, in his own words, and what 'heart failure' sounds like to him. His silence may come from taking the word literally, so let him say it before you correct anything.
- Use one simple picture, such as a pump that is not working as strongly as it should, and tie it straight to his breathlessness and ankle swelling. Keep it short, because he is probably still absorbing the diagnosis.
- Reassure only with what the card supports: his symptoms have already improved with treatment, and medicines, monitoring and the heart failure team are available. Do not promise a cure or a timeline. He is likely to notice false cheerfulness.
- Put the home self-care list after the reassurance, not before it, since a list of duties can sound like confirmation of a bleak outlook. Present daily weighing and warning signs as ways to stay in control, and say who to call.
- If time runs short, prioritise his understanding of the term, the simple explanation and one clear next step. Close by asking him to repeat the plan back, and invite questions now or later, including from family.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- You have gone quiet since this morning, and that is understandable. What has been going through your mind?
- Heart failure sounds frightening. It does not mean your heart has stopped.
- Let me check I have explained this clearly. What would you tell your family?
- Next, I will go through what you can do at home to keep an eye on things.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| heart failure | The heart is not pumping as strongly as it should. It has not stopped working. |
| diuretic | A water tablet that helps your body get rid of extra fluid. |
| echocardiogram | An ultrasound scan that shows how your heart is moving and pumping. |
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). Grade B usually means 5 on each language criterion and 2 on each clinical one. See the AI Speaking practice guide for what each criterion looks for.
More Medicine role-play cards
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All sets: nurses, doctors, other professions. Your profession's guide: OET Medicine.
Questions about this role-play
What if he says he thinks he is dying?
Acknowledge the fear, then ask what makes him think so. Respond honestly with what is known: his symptoms have improved with treatment and there is a plan with a specialist team. Avoid false promises or predicting how long he will live.
How much detail should I give about daily weighing?
Explain that weight gain can signal fluid build-up. Weigh each morning in similar clothing and record it. Contact the GP or heart failure team promptly if weight rises by more than 2 kg in two days, breathing or swelling worsens, or he needs more pillows to breathe. Call 000 for severe breathlessness, chest pain or collapse. Confirm his individual plan before discharge.
What if he does not want to talk?
Name the silence gently, offer a choice of how much to hear now, and ask permission to continue. Short open questions and a pause usually work better than reassurance too early. Offer to speak again, with family present if he wishes.
Sources
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