The candidate card
Setting
Oncology ward
Candidate
You are a nurse on an oncology ward in this original independent practice scenario. Ms Rosario Manansala, aged 61, is an inpatient whose most recent chemotherapy was a week ago; she has just mentioned mouth soreness that began yesterday. You have not yet assessed her mouth or intake, and no treatment has been prescribed for this new symptom. You can assess her mouth and observations and contact the ward oncology clinician now for review and symptom support; decisions about further chemotherapy belong to the treating team.
Task (interlocutor: patient)
- Find out about her mouth soreness, its effect on eating and drinking, and any difficulty swallowing, fever, shivering or feeling unwell.
- Explain that chemotherapy can cause mouth soreness and that reporting symptoms allows the team to assess the problem and offer support.
- Explore her worry about reporting pain and reassure her without promising that chemotherapy will continue unchanged.
- Explain the proposed assessment and request for symptom relief, including review of her ability to eat and drink.
- Agree to contact the oncology clinician now, check her understanding and explain how to obtain immediate help if her condition worsens.
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 nurse on an oncology ward in this original independent practice scenario. Ms Rosario Manansala, aged 61, is an inpatient whose most recent chemotherapy was a week ago; she has just mentioned mouth soreness that began yesterday. You have not yet assessed her mouth or intake, and no treatment has been prescribed for this new symptom. You can assess her mouth and observations and contact the ward oncology clinician now for review and symptom support; decisions about further chemotherapy belong to the treating team.
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 her experience of the soreness and its effect on eating and drinking. Ask about swallowing difficulty, fever, shivering and feeling unwell before exploring concerns, so discussion of chemotherapy does not delay identifying immediate needs.
- A likely concern is what reporting pain could mean for her treatment, but let her explain. Ask what worries her about telling the team, then address her actual answer without assuming she fears chemotherapy being stopped.
- Explain briefly that chemotherapy can cause mouth soreness, while keeping the cause of her particular symptoms unconfirmed. Avoid calling it normal or harmless; connect reporting symptoms with assessment and access to support rather than automatic reassurance.
- Describe checking her mouth, observations and ability to eat and drink before requesting symptom relief from the oncology clinician now. Distinguish what you can arrange from treatment decisions belonging to the team; do not promise a particular prescription.
- If time runs short, prioritise assessment and contacting the clinician over a lengthy explanation of side effects. Close by checking her understanding of the next steps and immediate ward help, without promising that further chemotherapy will remain unchanged.
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
- “Good morning, Ms Manansala. I'm one of the nurses on the ward, and I'm glad you mentioned your mouth to me.”
- “Can you tell me about the soreness and how it has been since it started yesterday?”
2. Key questions
- “Where in your mouth is it sore, and how much does it hurt when you are resting and when you eat?”
- “How has it affected your eating and drinking since it began?”
- “Is it difficult or painful to swallow?”
- “Have you had a fever or shivering, or felt generally unwell?”
3. Handling the patient's concern
Likely concern: She may worry that reporting pain could lead to her chemotherapy being changed or stopped.
- “It's understandable to wonder what telling us might mean. Is that on your mind at all? I'd like to hear what concerns you most.”
- “Decisions about chemotherapy are made by your treating team, so I can't promise it will stay exactly the same. But telling us early lets us help you feel more comfortable.”
4. Explaining
- “Chemotherapy can cause a sore mouth. When you tell us, the team can look at what is going on and offer support. I'd like to check your mouth and observations now. Is that alright?”
- “I'll also look at how well you can eat and drink, then contact the oncology clinician now to review you and ask about relief for the soreness. Nothing has been prescribed for it yet.”
5. Closing
- “So I'll check your mouth and observations, see how you are managing to eat and drink, and call the oncology clinician now. Have I got that right?”
- “If anything gets worse or you feel unwell in any way, press your call bell straight away. Is there anything you'd like me to go over again?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Thank you for telling me about this today.
- We can take this one step at a time.
- Have I understood what matters most to you?
- Is there anything you would like me to explain differently?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| chemotherapy | medicine used to treat cancer |
| observations | checks of how your body is doing |
| oncology clinician | a member of the team treating your cancer |
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
How should I obtain permission to examine her sore mouth?
Explain what you would like to examine and ask permission before starting. Invite her to tell you if the examination is uncomfortable or she needs a pause. If she declines, explore her concern respectfully and explain this when contacting the clinician.
How can I clarify her intake without inventing a fluid target?
Ask what she has actually managed to eat and drink since the soreness began, and what she could not manage. Distinguish discomfort while swallowing from being unable to swallow. Describe her account accurately without assigning an unsupported intake target or concluding she is dehydrated.
What immediate-help advice fits this inpatient setting?
Use the call bell immediately for fever, shivering, feeling unwell, swallowing difficulty, uncontrolled pain, inability to eat or drink, uncontrolled mouth bleeding, inability to open the mouth, facial swelling or breathing difficulty. Do not wait for rounds; breathing difficulty requires an immediate ward emergency response. Sources: Cancer Council mouth guidance, chemotherapy guidance.
How do I ask about fever and shivering without alarming her?
Ask in the same calm tone as your other questions, as part of checking how she is overall. Place them after the questions about her mouth and eating. If she reports either, tell her you will pass that on when you contact the clinician.
What if she says she does not want me to contact the clinician?
Explore her reasons first and acknowledge the fear. Explain that the clinician can only offer symptom support if told about the problem, and that chemotherapy decisions belong to her treating team. Don't pressure her. Leave the door open and tell her you are there if she changes her mind.
Sources
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