The candidate card
Setting
Postnatal ward
Candidate
In this original independent practice role-play, you are a nurse caring for Ms Else Faulkner, aged 32, who wants to stop breastfeeding immediately because she believes her milk is unsafe. She was readmitted eight days after giving birth, has been assessed by the doctor as clinically stable with left-sided mastitis, and has a healthy, term baby. Her documented individual feeding plan is to continue breastfeeding from either breast according to her baby's cues if she wishes; if feeding is too painful, help her hand express enough milk for her baby, without additional pumping to empty the breast. A breastfeeding specialist can assist with her next feed, the doctor will reassess her later today before discharge is considered, and she should alert ward staff immediately if she feels worse.
Task (interlocutor: patient)
- Find out what Ms Faulkner believes about her milk, how feeding is going and what she would like to do about breastfeeding.
- Explain her clinician's individual feeding advice, including the option of supported hand expression if feeding is too painful.
- Respond to her fear of harming her baby and explain why stopping suddenly is discouraged (milk can build up, increasing breast fullness and discomfort), while respecting her feeding choices and offering team support for a gradual change if she chooses to stop.
- Agree support for the next feed and today's review; check her understanding and explain when to call ward staff.
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.
In this original independent practice role-play, you are a nurse caring for Ms Else Faulkner, aged 32, who wants to stop breastfeeding immediately because she believes her milk is unsafe. She was readmitted eight days after giving birth, has been assessed by the doctor as clinically stable with left-sided mastitis, and has a healthy, term baby. Her documented individual feeding plan is to continue breastfeeding from either breast according to her baby's cues if she wishes; if feeding is too painful, help her hand express enough milk for her baby, without additional pumping to empty the breast. A breastfeeding specialist can assist with her next feed, the doctor will reassess her later today before discharge is considered, and she should alert ward staff immediately if she feels worse.
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 by exploring what unsafe means to her: ask what she thinks might happen to her baby. Her likely concern is harm, but establish her own explanation before offering reassurance so your response addresses her actual fear.
- Ask about feeding comfort and her preferred next step before discussing continuation. Separate what she wants from what she feels frightened into doing; the usual trap is treating her wish to stop as a belief to correct rather than a choice to understand.
- Explain her individual plan in manageable parts: either breast according to her baby's cues, if she wishes. If feeding is too painful, offer supported hand expression sufficient for her baby, without additional pumping to empty the breast.
- Use the doctor's assessment and her individual plan to frame reassurance, without promising that feeding carries no risk. Explain that stopping suddenly can allow milk to build up, increasing breast fullness and discomfort. Respect her choice and offer team support for a gradual change if she chooses to stop; pause to invite questions before seeking agreement.
- Close with a concrete next step: offer the breastfeeding specialist's help with the next feed and explain today's medical review. If time is short, prioritise her choice, understanding of the plan and alerting ward staff immediately if she feels worse.
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 Ms Faulkner, I'm your nurse today. I'm sorry you've had to come back into hospital.”
- “How are you feeling at the moment, and how has feeding been going for you?”
2. Key questions
- “What have you been thinking about your milk, and what has made you feel it might not be safe?”
- “How has feeding been on each side, and how painful is it?”
- “What would you like to do about breastfeeding right now?”
3. Handling the patient's concern
Likely concern: She is likely to fear her milk could harm her baby and want to stop breastfeeding straight away.
- “It makes sense that you want to protect your baby; that is clearly important to you. Thank you for telling me. Let's go through what the doctor has advised.”
- “Stopping suddenly isn't recommended, because milk can build up, making your breast fuller and more uncomfortable. But it's your choice, and if you decide to stop, we'll support a gradual change.”
4. Explaining
- “Your doctor has assessed you, and your plan is to keep breastfeeding from either breast, following your baby's cues, if you wish. Does that match what you were expecting?”
- “If feeding is too painful, we can help you hand express enough milk for your baby, without extra pumping to empty the breast. A breastfeeding specialist can help with your next feed. Does that sound manageable?”
5. Closing
- “So the breastfeeding specialist will help with your next feed, and the doctor will reassess you later today before discharge is considered. Have I understood what you'd like?”
- “Please tell ward staff straight away if you feel worse. What questions do you have, and what will you do if that happens?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- You do not have to agree to a feed to receive our support.
- Would it help to talk first, before deciding about the next feed?
- Which part still feels uncertain?
- Have I understood what matters most to you today?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| mastitis | Inflammation of the breast. |
| hand expression | Using your hand to gently release milk from your breast. |
| feeding cues | Your baby's signs that they want to feed. |
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 she asks whether the doctor has already approved discharge?
Distinguish her current assessment from a discharge decision. You could say: The doctor has assessed you as clinically stable, but will reassess you later today before discharge is considered. Avoid describing that review as a formality or promising that she will go home.
How much explanation can I give about why sudden stopping is discouraged?
The card supplies a simple reason: stopping suddenly can allow milk to build up, increasing breast fullness and discomfort. Explain this in plain language without predicting that complications will occur. Respect her choice about breastfeeding; if she chooses to stop, offer the team's help to plan a gradual change that also meets her baby's feeding needs. Do not prescribe a fixed schedule for reducing feeds.
What if she asks for a guarantee that her baby will not be harmed?
Acknowledge that she wants certainty, then distinguish the information available from a guarantee. The card describes a healthy, term baby and a clinician's individual feeding recommendation; it does not establish zero risk. Ask which specific harm she wants clarified so the appropriate clinician can address it.
What if she wants to stop before the specialist arrives?
Respect her choice and don't pressure her. Briefly explain again that stopping suddenly can lead to milk building up and more discomfort, and offer team support for a gradual change. Ask whether she would talk with the specialist first, and let the doctor know at today's review.
How do I avoid sounding as if I am dismissing her fear?
Name the fear first and ask what is behind it before giving any information. Avoid saying there is nothing to worry about. Instead, explain that the doctor has assessed her and set out her feeding plan, then use her own words when you describe it.
Sources
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