The candidate card
Setting
Children's ward, England
Candidate
You are a nurse in this original independent practice scenario, preparing Ms Risper Mutahi, aged 42, for her daughter's discharge following gastroenteritis. Her 10-month-old daughter was admitted yesterday; the treating clinician has reviewed her today and authorised discharge because she is alert, tolerating formula feeds and no longer clinically dehydrated. She has not vomited since yesterday evening but still has loose stools, and Ms Mutahi believes all milk should stop until these settle. The documented discharge plan is to continue her usual formula at its normal strength, offer smaller feeds more frequently while she is recovering, offer small sips of water between feeds, offer her usual age-appropriate foods when she wants them, and avoid fruit juice and fizzy drinks.
Task (interlocutor: relative)
- Find out what Ms Mutahi plans to offer at home, how her daughter is currently tolerating feeds and what her main feeding concern is; explore further according to her responses.
- Explain her daughter's documented fluid and feeding plan in plain language, clarifying that the team has advised continuing her usual formula at normal strength rather than stopping or diluting it.
- Respond to her feeding concerns without blame, acknowledging her observations and avoiding a guarantee that milk can never cause symptoms.
- Explain when to obtain help after discharge: call NHS 111 if she remains worried about her baby, who is under 12 months; contact the GP urgently or call NHS 111 if her daughter stops feeding, has fewer wet nappies or repeatedly vomits and cannot keep fluids down; call 999 immediately if she is not responding as usual, becomes unresponsive or has severe difficulty breathing.
- Agree how she will manage the next feed and feeds at home, check her understanding and offer treating-team clarification if concerns remain. If new deterioration is reported or observed during the discussion, pause discharge and arrange prompt clinical reassessment, activating the ward emergency response for emergency signs.
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, preparing Ms Risper Mutahi, aged 42, for her daughter's discharge following gastroenteritis. Her 10-month-old daughter was admitted yesterday; the treating clinician has reviewed her today and authorised discharge because she is alert, tolerating formula feeds and no longer clinically dehydrated. She has not vomited since yesterday evening but still has loose stools, and Ms Mutahi believes all milk should stop until these settle. The documented discharge plan is to continue her usual formula at its normal strength, offer smaller feeds more frequently while she is recovering, offer small sips of water between feeds, offer her usual age-appropriate foods when she wants them, and avoid fruit juice and fizzy drinks.
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 she intends to give at home, current feed tolerance and her main concern about milk. Ask focused safety questions about vomiting and wet nappies, then follow up according to her responses. Exploring the source of her belief or every hidden concern is optional; correcting her immediately risks sounding dismissive.
- Before discussing feeds, explain why discharge has been authorised: her daughter is alert, tolerating formula and no longer clinically dehydrated. Acknowledge the continuing loose stools so the mother does not hear discharge as a claim that every symptom has resolved.
- Present the plan in chunks: usual formula at normal strength, without stopping or diluting it; smaller, more frequent feeds; small sips of water between feeds; usual age-appropriate foods when wanted; and avoiding fruit juice and fizzy drinks. Pause for questions.
- Keep help-seeking instructions together: call NHS 111 if she remains worried about her baby, who is under 12 months; urgently contact her GP or NHS 111 for stopped feeding, fewer wet nappies or repeated vomiting with inability to keep fluids down; call 999 immediately if her daughter is not responding as usual, becomes unresponsive or has severe breathing difficulty. If new deterioration is reported or observed on the ward, pause discharge and arrange prompt clinical reassessment, activating the ward emergency response immediately for emergency signs.
- Close by checking how she will manage the next feed, feeds at home and obtaining help. Teach-back or another effective practical check is acceptable; no fixed wording is required. If time is short, prioritise this practical check and the help-seeking instructions; arrange treating-team clarification before departure if concerns remain.
- Author note only, not a candidate task or assessment requirement: this child's improvement and authorisation for discharge are invented case facts for original independent practice. They must not be presented as universal discharge criteria for children with gastroenteritis; discharge requires an individual clinical decision. Clinical advice checked on 2026-11-05 against NHS guidance, Diarrhoea and vomiting: https://www.nhs.uk/symptoms/diarrhoea-and-vomiting/.
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 Mutahi, I'm one of the nurses on the ward. I'd like to go through getting your daughter ready to go home today. Is that all right?”
- “To start, how are you feeling about taking her home, and what are you planning to offer her to drink and eat?”
2. Key questions
- “How has she managed her feeds today, from what you've seen?”
- “What have you noticed about her stools since yesterday?”
- “What is your main worry about feeding her at home?”
- “Has anything changed since the clinician reviewed her today, such as vomiting or seeming less alert?”
3. Handling the patient's concern
Likely concern: Likely to believe all milk should stop until the loose stools settle.
- “It makes sense to link milk with loose stools, and what you've noticed matters. I can't promise milk never affects her tummy, but the team advises continuing her usual formula.”
- “Would you like me to ask the treating team to go through this with you again? I'd like you to leave feeling confident, not unsure.”
4. Explaining
- “The clinician has reviewed her today: she's alert, managing her formula and no longer dehydrated. The advice is to keep her usual formula at normal strength, not stopping or watering it down, in smaller, more frequent feeds.”
- “Between feeds, offer small sips of water, and her usual age-appropriate foods when she wants them. Please avoid fruit juice and fizzy drinks. Does that fit with what you've seen, and can you say it back to me?”
5. Closing
- “Before you go: ring 111 if you're worried. Contact the GP urgently or ring 111 if she stops feeding, has fewer wet nappies, or keeps vomiting and can't keep fluids down.”
- “Ring 999 immediately if she isn't responding as usual, becomes unresponsive or has severe difficulty breathing. So next feed: usual formula, smaller and more often. Can you tell me your plan back?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- You have noticed the loose stools, and your observations matter.
- Thank you for raising your concern about milk before going home.
- Which part of the feeding advice feels hardest to put into practice?
- Does that explanation fit with what you have seen?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| gastroenteritis | The stomach and bowel illness she has been treated for. |
| clinically dehydrated | Showing signs that her body does not have enough fluid. |
| normal strength | Her usual formula concentration, without extra water added to dilute it. |
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
How should I answer if she asks whether milk caused the loose stools?
Separate her observation from an explanation: noticing loose stools does not establish that milk caused them. The card does not establish a cause for any milk-related symptoms. Avoid claiming milk can never cause symptoms, and keep your answer anchored to the treating team’s documented advice.
Should I suggest exact feed volumes or a different formula?
The card provides neither feed volumes nor an instruction to change formula. Adding either would create a new treatment recommendation. If she requests that level of individual advice, identify the specific question and seek clarification from the treating team before she leaves.
What if she agrees politely but still seems unconvinced?
Treat agreement as an opening rather than proof of confidence. Give her permission to disagree and ask whether any part of the explanation conflicts with her experience. Avoid describing her as non-compliant or assuming that cultural beliefs, previous advice or family pressure explain her response.
What if she vomits or seems worse while we are talking before she leaves?
Pause the discharge, stay with her and arrange prompt clinical reassessment. If she shows emergency signs, activate the ward emergency response rather than continuing the explanation. Tell Ms Mutahi calmly what you are doing and why.
What if she still wants to stop milk after my explanation?
Don't argue or guarantee anything. Restate the team's advice once, ask what worries her most about continuing, and offer to arrange clarification from the treating team before she leaves. Give her the safety-net advice either way.
Sources
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