The candidate card
Setting
General practice
Candidate
You are a GP. Mr Aiden Walsh, aged 30, a chef, is attending for follow-up after an emergency department visit two weeks ago for an asthma attack, where he was given a five-day course of prednisolone. He uses only a salbutamol reliever inhaler. He was prescribed a preventer last year but stopped using it. You plan to start budesonide-formoterol 200/6 micrograms (a dry-powder inhaler) as a combined preventer and reliever, replacing salbutamol and give him a written asthma action plan.
Task (interlocutor: patient)
- Find out how his asthma has been since the emergency visit and how often he uses his reliever
- Find out why he stopped using his preventer
- Explain the difference between a reliever and a preventer and why relying on salbutamol alone is risky
- Explain the new inhaler (one inhalation twice a day, plus one inhalation when needed for symptoms, maximum 12 inhalations a day; rinse mouth after use) and check his technique
- Explain the written asthma action plan and when to seek urgent help
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
- Ask about reliever use with specific, non-judgemental questions, such as a typical week or what limits him. Honest answers come more easily if you show curiosity, not disapproval, about the emergency visit.
- Ask why he stopped the preventer as an open question and listen for the real reason before correcting anything. Avoid labelling him non-adherent. Whatever he says, make your explanation of the new inhaler answer it directly.
- Explain reliever versus preventer with a simple picture, then link the risk of relying on salbutamol alone to what has already happened: an emergency visit needing a prednisolone course. Let him draw the conclusion himself where possible.
- Make clear the new inhaler replaces salbutamol, so there is no confusion about which to reach for. Give dosing in the card's order: regular twice daily, extra when needed, daily maximum of 12 inhalations, then rinse his mouth. Watch his technique.
- Explain the emergency steps explicitly: sit upright and call 000 if breathing worsens quickly, he struggles to speak, or the reliever is not helping. Keep using the budesonide-formoterol reliever while waiting, following the written action plan. Do not wait to reach the daily maximum before calling. Have him repeat the plan back.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- A lot of people find preventers hard to keep up. I would like to understand what happened for you.
- Going to emergency with your breathing is stressful. How have you been since?
- Show me how you would use it, and I will give you some tips.
- This replaces your salbutamol, so this is the only inhaler you need to carry.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| preventer | A daily inhaler that keeps your airways calm to help stop attacks. |
| reliever | A quick-acting inhaler that opens your airways when you have symptoms. |
| prednisolone | A short course of steroid tablets to settle a bad flare-up. |
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.
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All sets: nurses, doctors, other professions. Your profession's guide: OET Medicine.
Questions about this role-play
He says he feels fine, so why use a daily inhaler?
Explain that the preventer's job is to keep his airways calm even when he feels well, and link it to his recent attack. Do not argue. Ask what would make a routine realistic around a chef's working hours.
How do I check technique in the role-play?
Ask him to show you with a device, watch, and give two or three feedback points, not a long list. Praise what he does well first. Then ask him to repeat it. Showing is more reliable than asking whether he knows how.
How do I explain the as-needed puffs without encouraging overuse?
Explain that 12 inhalations in a day is the total, including the regular doses. If he needs more, he needs same-day medical assessment rather than continuing on his own. Call 000 immediately for rapidly worsening breathing, difficulty speaking or little relief; do not wait for the daily limit. Ask him to repeat these actions back.
Sources
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