The candidate card
Setting
Renal outpatient clinic
Candidate
You are a renal nurse in this original independent practice scenario involving Ms Orah Naylor, aged 67, whose healed left-arm fistula is used for haemodialysis. She wants advice before attending another clinic because she feels embarrassed about reminding staff which arm to avoid. For this fictional case, her renal team's documented plan is to use her right arm for routine blood pressure measurements, blood samples and cannulas, reserve fistula needling for the dialysis team, avoid tight clothing or direct pressure over the fistula, and check its usual vibration daily. You can demonstrate this check and provide written instructions and the renal unit's contact details; a complete ongoing clinical assessment may continue after this focused conversation.
Task (interlocutor: patient)
- Find out what Ms Naylor understands about protecting her fistula and briefly check whether she has noticed any current change in its vibration, appearance or comfort
- Explain that the fistula provides access for dialysis and discuss her renal team's protection plan
- Reassure her that reminding staff is appropriate and rehearse a question she feels comfortable using before a blood pressure check or needle procedure
- Advise her to contact the renal unit urgently if the vibration disappears, the area becomes painful, red or swollen, or her hand becomes cold or numb; explain that bleeding outside supervised dialysis care requires calling 999 immediately and applying firm direct pressure to the bleeding point with clean gauze while awaiting help
- Agree how she will identify her fistula arm, follow her renal team's instructions and obtain help; 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.
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 renal nurse in this original independent practice scenario involving Ms Orah Naylor, aged 67, whose healed left-arm fistula is used for haemodialysis. She wants advice before attending another clinic because she feels embarrassed about reminding staff which arm to avoid. For this fictional case, her renal team's documented plan is to use her right arm for routine blood pressure measurements, blood samples and cannulas, reserve fistula needling for the dialysis team, avoid tight clothing or direct pressure over the fistula, and check its usual vibration daily. You can demonstrate this check and provide written instructions and the renal unit's contact details; a complete ongoing clinical assessment may continue after this focused conversation.
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 separating her existing knowledge from what makes speaking up uncomfortable. Ask which part of reminding staff feels awkward, without assuming she distrusts them. Briefly establish whether any current change requires attention before continuing the planned education.
- Anchor the explanation to her own renal team's documented instructions, rather than presenting a universal rule for every patient. Connect each routine procedure to the right arm, and distinguish those procedures from fistula needling by the dialysis team.
- Treat the reminder as a shared check before care starts. Let her choose wording that feels natural, then rehearse it with a blood pressure cuff or needle procedure in mind. Avoid language that suggests she must police staff.
- Demonstrate the daily vibration check gently and invite her to show you back. Include avoiding tight clothing and everyday direct pressure, explaining that bleeding requires emergency pressure instead. Keep this practical; confidence during rehearsal does not establish complete understanding.
- Close by asking her to explain how she will identify the arm and obtain help, covering all listed escalation criteria together. Written instructions and renal contact details reinforce the conversation. If time is short, prioritise protection, speaking up and escalation.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- It can feel awkward to interrupt someone preparing a procedure.
- Could we check which arm you plan to use?
- Would you prefer a reminder that sounds more like a question?
- Let's practise until the words feel comfortable for you.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| fistula | The access in your arm used for dialysis. |
| haemodialysis | Treatment that filters your blood. |
| cannula | A small tube placed in 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). See the AI Speaking practice guide for what each criterion looks for.
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Next step for Australian nursing: if your pathway requires OBA after OET and NCLEX-RN, explore OSCE practice for Australian nurses at OSCE Australia, run by the same company as OETAce.
All sets: nurses, doctors, other professions. Your profession's guide: OET Nursing.
Questions about this role-play
How should I keep the emergency instructions complete?
Contact the renal unit urgently for absent vibration, pain, redness, swelling, or a cold or numb hand. For bleeding outside supervised dialysis, call 999 immediately (Australia: 000). Maintain firm direct pressure with clean gauze until help arrives, even if bleeding stops. Lie down; raise the arm. No tourniquet or bulky towel. [Bleeding guidance](https://www.ouh.nhs.uk/media/xhvgh0gd/108574bleeding.pdf); [Australian number](https://www.ambulance.nsw.gov.au/our-services/emergency-services).
What if another clinic proposes using the fistula arm?
Keep the discussion within the documented plan for routine care. Suggest that she tell staff about that plan and ask them to clarify any proposed departure with her renal team before proceeding. Avoid turning routine protection advice into an absolute claim about every possible emergency.
Can a reassuring account establish that the fistula is functioning normally?
No. This is a focused education conversation, and the card allows ongoing assessment afterwards. Record what she reports without presenting it as a complete clinical finding. Avoid promising that a healed appearance or her description of the vibration guarantees there is no problem.
Sources
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