The candidate card
Setting
Patient's home (community nursing visit)
Candidate
You are a community nurse. Mrs Beryl Hutchins, aged 79, has a venous leg ulcer above her left ankle that has been present for four months. Her ankle–brachial pressure index is normal, so she is suitable for compression therapy. Two-layer compression bandages were applied at your last visit three days ago, but today you find she has taken them off. The ulcer is not healing and the leg is swollen.
Task (interlocutor: patient)
- Find out why Mrs Hutchins removed the bandages, in a non-judgemental way
- Explain how compression helps the ulcer to heal and what may happen without it
- Discuss options to make compression more comfortable (different system, footwear, timing of visits)
- Advise on other self-care measures (raising the leg, walking, ankle exercises, skin care)
- Agree a plan with her and check her 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.
How to approach this card
- Begin with the ulcer and how the leg has felt since the bandages went on, before asking directly about removal. A curious tone makes honest answers more likely. Likely reasons include discomfort, heat, fit with shoes or bathing, but let her tell you.
- Explain compression as help for blood to return from the leg, which reduces swelling and supports healing. Say what may happen without it: the ulcer may stay open and the leg stay swollen. State this factually, not as a warning off.
- Offer the card's options as choices she controls: a different system, footwear that fits, or timing of visits. Match each option to the problem she described, so she sees you listened rather than repeating a standard list.
- Give the other self-care advice after the bandage discussion, in small pieces: raising the leg, walking, ankle exercises and skin care. Avoid blame words such as non-compliant. If time is short, prioritise the reason, the options and the plan.
- Agree one concrete next step, such as what is tried at the next visit, and ask her to repeat it in her own words. Mention that her circulation test result is normal so compression is suitable for her.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Some people find bandages hard to live with. What has it been like for you?
- I am not here to tell you off. I want to find something that works.
- Would a different type of bandage or different shoes make this easier?
- Can you tell me what we have agreed so I know I explained it clearly?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| venous leg ulcer | a long-lasting sore on the leg linked to poor blood flow back up from the legs |
| compression therapy | firm bandages that gently squeeze the leg to help blood flow back up |
| ankle–brachial pressure index | a test comparing blood pressure at your ankle and arm to check blood supply to your legs |
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.
More Nursing role-play cards
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All sets: nurses, doctors, other professions. Your profession's guide: OET Nursing.
Questions about this role-play
How do I avoid sounding judgemental about her removing the bandages?
Ask what happened rather than why she did it, and normalise it by saying other people find them difficult too. Avoid words like refused or failed. Thank her for being honest, because that gives you what you need to adjust the treatment.
How much should I say about what happens without compression?
Keep to what the card supports: the ulcer is not healing and the leg is swollen, so without compression it may not heal. Do not add predictions about complications or timeframes. Link the message to her own goal, such as getting the leg healed.
What if she says she will not wear any bandages?
Do not push. Explore what is behind it and revisit the options, since a different system, footwear or visit timing may change her view. Keep the door open, agree what she is willing to do now, and arrange a review.
Sources
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