The candidate card
Setting
Emergency department
Candidate
You are a nurse in the emergency department. Ms Xiaoling Mak, aged 24, came in last night with anaphylaxis after eating a restaurant meal that contained peanut sauce. She was treated with intramuscular adrenaline. She has mild asthma, and as a teenager her lips sometimes tingled after eating peanuts. She has recovered fully after observation, and the doctor has discharged her with a prescription for an adult EpiPen adrenaline autoinjector, a written anaphylaxis action plan and a referral to an allergy specialist. The hospital pharmacy can dispense the EpiPen before she leaves, and you have an EpiPen trainer to teach her how to use it.
Task (interlocutor: patient)
- Find out what Ms Mak understands about last night's reaction and explore any concerns she raises
- Explain why she needs to carry the EpiPen at all times and why antihistamines are not enough (hidden peanuts, unpredictable reactions, asthma)
- Explain her action plan (warning signs, lie down or sit with legs out flat, give the EpiPen, call an ambulance, use a second EpiPen if available if there is no improvement after 5 minutes)
- Demonstrate the EpiPen with the trainer and ask her to practise (pull off the blue safety cap, place the orange end against the outer mid-thigh, push down hard until it clicks, hold for 3 seconds, remove)
- Reassure her and agree a plan before she leaves (collecting the EpiPen today, allergy specialist appointment, GP review)
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
- Start by asking what she understood about last night and what she thinks about carrying an EpiPen, before you teach. The card gives no reason she might not carry it, so ask openly and listen before any persuasion.
- Ask neutrally about her past experiences with peanuts, including the occasional tingling lips she had as a teenager. Treat it as history to explore, not as proof of an earlier warning, and do not make her feel at fault.
- Explain why the EpiPen must always be with her: reactions can be unpredictable, peanut can be hidden in food, and her asthma is part of why this matters. Antihistamines are not a substitute for adrenaline in anaphylaxis. Avoid fear-heavy language.
- Go through the written action plan in full, in the order she would use it, then demonstrate the trainer once and have her practise. Use teach-back rather than asking if she understands, and make clear the trainer is not the real device.
- Close by making sure she leaves with the EpiPen: collect it from the pharmacy first, and confirm the allergy specialist and GP follow-up. Reassure without promising it will not recur. If time is short, prioritise her concern, practising the device and collecting it.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Tell me how you felt about last night, and what you think about carrying the EpiPen.
- That must have been frightening. What worries you most about going home?
- Now you show me, and I will guide you if you get stuck.
- Let us go through the plan once more. What would you do first?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| anaphylaxis | A severe allergic reaction that can affect breathing and blood pressure and needs adrenaline urgently. |
| autoinjector | A pen-shaped device that injects a set dose of adrenaline into your thigh when pressed on. |
| intramuscular | Injected into a muscle rather than just under the skin or into a vein. |
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.
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All sets: nurses, doctors, other professions. Your profession's guide: OET Nursing.
Questions about this role-play
She says she will just take an antihistamine instead. How do I respond?
Do not dismiss it. Explain that reactions are unpredictable and antihistamines are not enough for a reaction like last night's, which needed adrenaline. Her asthma is one reason to keep adrenaline immediately to hand. Then ask what she would do in the first minutes.
What if she says carrying it is inconvenient or embarrassing?
Ask what would make carrying it workable, such as a regular place for it in her bag, and agree one. Do not tell her how she should feel. If she is still reluctant, restate the reasons once and make sure the action plan and follow-up still go ahead.
What if she cannot demonstrate the device correctly?
Stay calm and correct one step at a time, then let her repeat the whole sequence on the trainer. Stress that the real device has a needle and needs firm pressure, so technique matters. Do not end the practice on a mistake.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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