The candidate card
Setting
Renal outpatient clinic
Candidate
You are a renal nurse seeing Mr Asif Gilani, aged 60, who has chronic kidney disease and is thirsty and worried about dehydration. In this fictional case, his renal clinician's existing written plan is to measure and record his usual drinks and liquid foods, avoid deliberately drinking extra to flush his kidneys, and discuss any fluid restriction with the renal clinician before starting it; no daily fluid maximum has been prescribed, and the clinician can review his concerns today. General clinical information: fluid advice depends on the individual, because impaired kidneys may allow fluid to accumulate, while insufficient fluid can cause dehydration; new breathlessness, markedly reduced urine or dizziness needs prompt clinical assessment, and severe breathing difficulty requires emergency help. Your purpose is to explain this monitoring plan, check whether he has misunderstood it, and arrange review rather than calculate or invent a daily allowance.
Task (interlocutor: patient)
- Find out how Mr Gilani understands and follows his written plan, and whether his thirst is accompanied by new breathlessness, reduced urine or dizziness
- Explain why fluid advice is individual and clarify that his current plan records intake rather than prescribing a daily fluid maximum
- Respond to his fear of dehydration and explore a manageable way to record drinks and liquid foods without imposing his own restriction
- Agree a review with the renal clinician today and explain how to obtain prompt help if concerning symptoms develop
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 renal nurse seeing Mr Asif Gilani, aged 60, who has chronic kidney disease and is thirsty and worried about dehydration. In this fictional case, his renal clinician's existing written plan is to measure and record his usual drinks and liquid foods, avoid deliberately drinking extra to flush his kidneys, and discuss any fluid restriction with the renal clinician before starting it; no daily fluid maximum has been prescribed, and the clinician can review his concerns today. General clinical information: fluid advice depends on the individual, because impaired kidneys may allow fluid to accumulate, while insufficient fluid can cause dehydration; new breathlessness, markedly reduced urine or dizziness needs prompt clinical assessment, and severe breathing difficulty requires emergency help. Your purpose is to explain this monitoring plan, check whether he has misunderstood it, and arrange review rather than calculate or invent a daily allowance.
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
- Ask him to describe what he thinks the plan requires and what he actually does when thirsty. A likely worry is that recording intake means drinking less; establish whether that misunderstanding exists before correcting it.
- Check all symptoms listed on the card early so that explanation does not delay assessment. Then distinguish recording his usual intake from prescribing a limit; explicitly state that his current plan contains no daily fluid maximum.
- Explain the balance in ordinary language: impaired kidneys may allow fluid to accumulate, while insufficient fluid can cause dehydration. Avoid turning either possibility into a diagnosis for him or treating thirst as proof that extra fluid is needed.
- Build the recording method around his usual routine, including both drinks and liquid foods. Explain that he should not deliberately drink extra to flush his kidneys or start a restriction without discussing it with the renal clinician.
- Arrange today's clinician review and check that he can explain the purpose of recording intake. If time is short, protect the symptom check and review arrangement; do not spend the encounter calculating an allowance the card does not authorise.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Your concern about dehydration deserves a careful discussion.
- Could we look at what the word monitoring means to you?
- Does this feel manageable, or is something still unclear?
- Which part would you like me to explain differently?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| chronic kidney disease | A long-term condition affecting your kidneys. |
| fluid restriction | A prescribed limit on how much fluid you have. |
| dehydration | Not having enough fluid in your body. |
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 cannot remember everything he drank?
Treat a gap as missing information, not non-compliance. Ask him to mark what he cannot remember rather than inventing an amount. Help him choose a convenient way to make future entries, and bring the available record to today's review.
Can I reassure him that thirst means he is dehydrated?
No. The card reports thirst and worry, but does not establish dehydration. Acknowledge the discomfort without labelling its cause. His clinician can review the concern today; avoid suggesting that either drinking freely or cutting back is the answer before that review.
What complete escalation advice belongs in this discussion?
New breathlessness, markedly reduced urine or dizziness needs prompt clinical assessment; contact the renal clinician or seek urgent medical assessment. Severe breathing difficulty requires immediate emergency help: call the local emergency services for an ambulance. Do not wait for a completed intake record or the planned review before seeking the appropriate help. [Australian emergency guidance](https://www.healthdirect.gov.au/symptoms/shortness-of-breath).
Sources
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