The candidate card
Setting
Stroke rehabilitation ward
Candidate
You are a nurse in this original independent practice scenario, speaking with Mr Munyoki Wanjiku, aged 50, whose partner, aged 49, had a stroke three weeks ago and has aphasia. In an earlier supported discussion, she repeatedly selected sharing news with her daughter as her first communication goal, rather than practising work telephone calls, which Mr Wanjiku favours. Her speech and language therapist has established that she can communicate choices using photographs, short written keywords and pointing, with one idea presented at a time and time to respond; her proposed first step is to share one event from her day using her photograph booklet. She has agreed to this discussion with her partner while she rests, and the team's plan is to confirm the goal directly with her before recording it, provide her with an accessible copy and review progress at the next rehabilitation meeting.
Task (interlocutor: relative)
- Find out why Mr Wanjiku prioritises work telephone calls and what he understood about his partner's expressed preference.
- Explain how aphasia can affect communication without, by itself, showing that someone cannot make decisions; describe how his partner's preference was established.
- Acknowledge his concerns and explain how her chosen everyday activity can be a meaningful rehabilitation goal without promising a particular recovery outcome.
- Agree how to confirm the goal directly with his partner using her established communication supports, record her confirmed preference and support practice with her agreement; check his understanding.
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 in this original independent practice scenario, speaking with Mr Munyoki Wanjiku, aged 50, whose partner, aged 49, had a stroke three weeks ago and has aphasia. In an earlier supported discussion, she repeatedly selected sharing news with her daughter as her first communication goal, rather than practising work telephone calls, which Mr Wanjiku favours. Her speech and language therapist has established that she can communicate choices using photographs, short written keywords and pointing, with one idea presented at a time and time to respond; her proposed first step is to share one event from her day using her photograph booklet. She has agreed to this discussion with her partner while she rests, and the team's plan is to confirm the goal directly with her before recording it, provide her with an accessible copy and review progress at the next rehabilitation meeting.
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 curiosity about why work calls matter to him: ask what he hopes practising them would achieve. Then explore what he understood about her preference, so you can distinguish disagreement with her choice from uncertainty about how she communicated it.
- Before defending the proposed goal, address any uncertainty about her ability to choose. Explain that difficulty communicating does not itself establish inability to decide; describe her repeated selections as supported expressions of preference, without claiming they establish every aspect of decision-making ability.
- Connect the photograph-booklet activity to an everyday purpose she identified: sharing news with her daughter. Explain its relevance through what she wants to communicate, using concrete language rather than suggesting that a small first step is unambitious or that his concerns are irrelevant.
- Keep this conversation preparatory because she is resting. Agree how to ask her directly about the proposed goal using photographs, short written keywords and pointing, presenting one idea at a time and allowing a response; avoid making his agreement a substitute for hers.
- Close by distinguishing the proposed goal from the preference still to be confirmed. Prioritise direct confirmation if time is short, then explain recording, her accessible copy, practice with her agreement and review at the next rehabilitation meeting; invite him to explain his understanding.
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 Wanjiku, I'm one of the nurses on the ward. Thank you for making time while your partner is resting.”
- “I'd like to talk about her communication goals. How have you been finding things since her stroke?”
2. Key questions
- “What makes work telephone calls the goal you would like her to start with?”
- “What have you understood about the goal your partner has chosen, and how it was decided?”
- “What worries you most about starting with sharing news with her daughter?”
- “How do you usually help her when she's trying to tell you something?”
3. Handling the patient's concern
Likely concern: He may worry that her chosen goal matters less than work calls, or that it will not help her recovery.
- “I can see you want the best for her, and work calls clearly matter to you. This is a hard time for you both.”
- “I can't promise how her recovery will go. Sharing news with her daughter is an everyday activity she has chosen, and practising it can be a meaningful rehabilitation goal.”
4. Explaining
- “Aphasia can affect how she speaks and understands, but it doesn't by itself mean she can't make decisions. Her therapist found she can show choices with photographs, short written keywords and pointing.”
- “In an earlier supported discussion, using those supports, she repeatedly chose sharing news with her daughter as her first goal. The first step is sharing one event from her day using her photograph booklet. Does that make sense?”
5. Closing
- “Next we'll confirm the goal directly with her using her usual supports, then record it. She'll get an accessible copy, and progress will be reviewed at the next rehabilitation meeting.”
- “Practice will go ahead only with her agreement. What questions do you have, and how are you feeling about this plan?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- I can hear that her communication goals matter to you.
- Which part of this feels hardest to accept?
- We do not have to settle every future goal today.
- What would you like clarified before we speak with her?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| aphasia | Difficulty using or understanding language. |
| rehabilitation goal | Something she wants to work towards with practice and support. |
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
Should I describe her preference as choosing family over work?
No. The card identifies her first communication goal, not a permanent choice between family and employment. Avoid language such as giving up on work or rejecting telephone practice, because neither conclusion follows from the preference described.
How should I answer a question about whether she will manage work calls again?
Explain that this discussion cannot establish whether or when she will manage work calls. Do not attach a recovery timetable to the fact that her stroke occurred three weeks ago. Offer to bring his question to the rehabilitation team.
Should I suggest bringing her daughter into the discussion?
Sharing news with her daughter does not automatically mean she wants her daughter involved in planning. If involvement is suggested, first establish her wishes. Do not assume the daughter is available, willing to participate or already aware of the proposed activity.
What if he insists work calls must come first?
Acknowledge his reasons without arguing, then explain that the plan is to confirm her own preference directly with her. Offer to pass his concerns to the team. Avoid implying he is wrong or promising any particular recovery outcome.
Should I ask him to speak for her wishes?
No. His understanding is useful, but the goal must be confirmed with her directly using photographs, keywords and pointing, one idea at a time. Explain how she'll be asked so he sees her choice being respected rather than feeling overruled.
Sources
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