The candidate card
Setting
Palliative home visit, England
Candidate
In this original independent practice role-play, you are a community nurse visiting Mr Clemente Checa, aged 38, whose wife, aged 40, has advanced incurable cancer and has consented to you discussing her care with him. She is comfortable today and wants the individually prescribed anticipatory medicines available at home, but he worries that accepting them means giving up. Her documented plan is for a trained nurse to assess symptoms, agree treatment with her, give an injection only if needed under her prescription and review its effects. You can give him the community palliative care service's round-the-clock contact details.
Task (interlocutor: relative)
- Find out what Mr Checa understands about keeping the medicines at home and what worries him most.
- Explain their purpose and the short sequence before and after use: nurse assessment, agreement with his wife, treatment if needed and review.
- Reassure him about his main concern, explaining how preparing for symptom relief supports his wife's care and choices.
- Agree a simple plan for contacting the community palliative care service if symptoms develop or concerns remain.
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.
In this original independent practice role-play, you are a community nurse visiting Mr Clemente Checa, aged 38, whose wife, aged 40, has advanced incurable cancer and has consented to you discussing her care with him. She is comfortable today and wants the individually prescribed anticipatory medicines available at home, but he worries that accepting them means giving up. Her documented plan is for a trained nurse to assess symptoms, agree treatment with her, give an injection only if needed under her prescription and review its effects. You can give him the community palliative care service's round-the-clock contact details.
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
- Begin with what having the medicines at home represents to him. Ask what he understands and what worries him most, then allow him to explain. His wife is already described as comfortable today, so a separate symptom history is not required.
- Give one short explanation of the plan: the medicines are available if needed; a nurse assesses symptoms, agrees treatment with his wife, gives medicine only when indicated under her prescription and reviews its effects. Pause for his response rather than expanding into medicine details.
- Respond to the main concern he actually reveals, checking that you have understood it correctly. Use the documented plan to explain what can be addressed, and offer to clarify unresolved questions with the care team. Avoid unsupported assurances.
- Respect his wife's stated choice to keep the medicines available. Reassurance should respond to his concern without promising freedom from side effects, predicting survival or pressuring him to feel reassured.
- Finish with one practical plan: provide the service's round-the-clock contact details and agree when he would use them. Check that the route to help is clear. Detailed prescriber questions and wider care planning can be left for a further discussion.
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 Mr Checa, I'm the community nurse. Thank you for seeing me. Your wife has agreed that I can talk with you about her care.”
- “What do you understand about keeping these medicines at home?”
2. Key questions
- “What worries you most about having these medicines in the house?”
- “What does having them here mean to you?”
- “Is there anything you have heard about them that concerns you?”
3. Handling the patient's concern
Likely concern: He likely fears that accepting the medicines means giving up on his wife's care or hope.
- “It's understandable to find this hard. Can you tell me more about what having them at home means to you? We can pause if you need a moment.”
- “Having them at home isn't giving up. It means symptom relief is ready if she needs it, which supports her comfort and her choices, and she has asked for them.”
4. Explaining
- “These medicines are prescribed for your wife to ease symptoms if they develop. A trained nurse first assesses her symptoms and agrees the treatment with her.”
- “An injection is given only if needed, under her prescription, and the nurse then reviews how it has worked. Does that make sense, or shall I explain it differently?”
5. Closing
- “So if symptoms develop or you're worried, you'll phone the community palliative care service, which is available round the clock. I'll write the contact details down for you.”
- “Does that plan feel manageable? Is there anything else you'd like to ask before I go?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Thank you for telling me how difficult accepting these medicines feels.
- We can pause if you need a moment.
- Which part would you like me to explain differently?
- Is there a question you have been hesitant to ask?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| anticipatory medicines | Medicines prescribed ahead of time in case symptoms need treatment. |
| distressing agitation | Restlessness or difficulty settling that causes distress. |
| individual prescription | Instructions written specifically for your wife's medicine treatment. |
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
What if he asks how long his wife has left?
Do not use the presence of anticipatory medicines to estimate survival. The card gives no prognosis beyond advanced incurable cancer. Acknowledge the uncertainty and ask what knowing a timeframe would help him discuss, without suggesting an answer the notes do not support.
How should I use the couple's ages in this conversation?
Their ages do not tell you whether they have children, particular family responsibilities or specific beliefs about illness. Let him identify relevant circumstances himself. Avoid comments about being too young, which introduce your judgement and may distract from what he wants to discuss.
What safety-netting should I give in this England scenario?
Agree prompt contact with the community palliative care service for new or worsening symptoms, unwanted effects or continuing concerns, and provide its round-the-clock contact details. If a sudden life-threatening emergency is raised, advise calling 999. A detailed emergency discussion is not required for this role-play about advance preparation.
What if he says he doesn't want the medicines in the house?
Don't argue. Acknowledge his feelings and gently note that his wife wants them available. Offer to talk it through with them both, and make sure he has the round-the-clock contact details whatever he decides.
How do I discuss this without being blunt about his wife's illness?
Follow his own words and pace. Ask whether it's alright to talk about what is worrying him, and stay with the medicines and the plan rather than introducing new information. Pause when he needs to, and check how he is feeling.
Sources
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