The candidate card
Setting
Residential aged care facility
Candidate
You are the registered nurse in charge of the shift. Mr Albert Novak, aged 88, moved into the facility six weeks ago after a stroke that left him with swallowing difficulty (dysphagia). The speech pathologist has prescribed a minced and moist diet and mildly thick fluids, with supervision at meals. Two weeks ago he was treated for aspiration pneumonia. Today a care worker found his son, Mr Peter Novak, giving his father a ham sandwich and a cup of tea. You have asked to speak to Mr Novak.
Task (interlocutor: relative)
- Find out what Mr Novak understands about his father's swallowing problem and why he brought the food
- Explain the risk of choking and aspiration pneumonia with normal food and thin drinks
- Acknowledge his concerns about his father's quality of life and enjoyment of food
- Explain the options (speech pathology review, making modified food more appealing, family meeting to discuss his father's wishes and the risks)
- Agree on what Mr Novak can safely bring in and how he can help at mealtimes
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
- First make sure his father is not still being given food and that he is comfortable and breathing normally, then speak to the son privately. Start by asking what he understands about the swallowing problem and why he brought the food, without accusing him.
- Explain the risk concretely: ordinary food and thin drinks can go down the wrong way, causing choking or a chest infection, and his father has already been treated for aspiration pneumonia. Avoid saying the sandwich was dangerous in a blaming way.
- Acknowledge his view before offering solutions. Find out what is behind the visit with food, as it may involve wanting his father to enjoy meals. Name that enjoyment and dignity matter, so the plan feels like a shared goal.
- Offer the options as things you can do together: a speech pathology review, ways to make modified food more appealing, and a family meeting about his father's wishes and the risks. Do not overrule the speech pathologist's current plan.
- Agree specifically what he can bring and how he can help at meals, such as checking with staff first and following the supervision plan. Close by confirming he feels heard. If time is short, cover risk, empathy and the safe plan.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- I can see you want your dad to enjoy his food. Tell me what you were hoping for.
- Your father's swallowing makes normal food and thin drinks risky for him.
- We can ask the speech pathologist to review and look at ways to make meals nicer.
- Can we agree what you can safely bring in and how you would like to help?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| dysphagia | difficulty swallowing safely |
| aspiration pneumonia | a chest infection caused by food or drink going into the lungs |
| minced and moist diet | soft, finely minced food with sauce so it is easier to swallow |
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 Nursing.
Questions about this role-play
Should I address the sandwich and tea straight away?
Yes, in the moment: calmly pause the feeding and check how his father is, then talk privately with Mr Novak. Treat it as a chance to understand him, not an incident to reprimand. Keep your tone factual and caring.
What if Mr Novak says his father would rather eat normally and accept the risk?
Acknowledge that his father's wishes matter and explain that this is exactly what the family meeting is for. Do not agree to normal food on your own authority. Arrange the speech pathology review and meeting so the risks and wishes are discussed properly.
How do I stop the conversation sounding like blame?
Use we and focus on his father's safety and enjoyment as shared goals. Avoid phrases like you should not have. Thank him for caring and for being open about why he brought the food, then move to what he can do.
Sources
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