The candidate card
Setting
Infusion day unit
Candidate
You are an infusion-unit nurse in this original independent practice scenario, speaking with Mr Jaidyn Morrison, aged 66, who has confirmed iron-deficiency anaemia and is declining his prescribed intravenous iron because he believes it is a blood transfusion; no cannula has been inserted and no treatment has started. His prescriber recommended intravenous iron after iron tablets caused persistent nausea and constipation, and investigations into the cause of his deficiency are already being arranged separately; the proposed infusion supplies iron medicine through a small tube into a vein, contains no donor blood, and helps replace the iron needed to make red blood cells. Staff monitor patients during and after infusion because reactions can occur, including rare serious allergic reactions, while leakage around the cannula can cause lasting skin staining; breathing difficulty, swelling or feeling faint require immediate staff attention, as does pain or burning at the cannula site, with treatment stopped and urgent clinical help obtained for a suspected serious reaction. He may decline or postpone without pressure, and the prescriber is available today to discuss alternatives, including whether a different oral-iron approach is suitable; this focused conversation does not replace the full pre-infusion assessment, product-specific consent discussion or ongoing clinical assessment.
Task (interlocutor: patient)
- Explore Mr Morrison's understanding of the proposed treatment and the reasons for his refusal
- Explain why intravenous iron was recommended in his case and how it differs from a blood transfusion
- Describe the procedure, key risks and monitoring in plain language, checking what further explanation he needs
- Acknowledge his concerns and clarify his right to decline or postpone without pressuring him to consent
- Agree his preferred next step, offering a discussion with the prescriber about alternatives and follow-up
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 an infusion-unit nurse in this original independent practice scenario, speaking with Mr Jaidyn Morrison, aged 66, who has confirmed iron-deficiency anaemia and is declining his prescribed intravenous iron because he believes it is a blood transfusion; no cannula has been inserted and no treatment has started. His prescriber recommended intravenous iron after iron tablets caused persistent nausea and constipation, and investigations into the cause of his deficiency are already being arranged separately; the proposed infusion supplies iron medicine through a small tube into a vein, contains no donor blood, and helps replace the iron needed to make red blood cells. Staff monitor patients during and after infusion because reactions can occur, including rare serious allergic reactions, while leakage around the cannula can cause lasting skin staining; breathing difficulty, swelling or feeling faint require immediate staff attention, as does pain or burning at the cannula site, with treatment stopped and urgent clinical help obtained for a suspected serious reaction. He may decline or postpone without pressure, and the prescriber is available today to discuss alternatives, including whether a different oral-iron approach is suitable; this focused conversation does not replace the full pre-infusion assessment, product-specific consent discussion or ongoing clinical assessment.
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
- First find out what he believes the infusion contains and what concerns him about receiving it. Nothing has started, so there is room to listen; explore the reason for refusal without assuming religious beliefs or treating disagreement as misunderstanding alone.
- After understanding his concern, distinguish iron medicine from donor blood and explain its role in making red blood cells. Connect the recommendation to his persistent nausea and constipation with tablets; describe delivery through a small tube into a vein.
- Explain monitoring during and after infusion, possible reactions including rare serious allergy, and lasting staining from leakage. Breathing difficulty, swelling, faintness, cannula-site pain or burning require immediate staff attention; suspected serious reactions require stopping treatment and urgent clinical help.
- Allow space after explaining risks and ask what remains unresolved. Make declining or postponing a real option, without suggesting he owes consent because treatment was prescribed; if time is short, preserve his opportunity to decide rather than adding technical detail.
- Close by agreeing his preferred next step and who will help arrange it. Offer today's prescriber discussion about alternatives, including whether another oral-iron approach is suitable, and clarify follow-up without implying that a different tablet regimen has already been approved.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- You do not have to justify asking questions.
- What would you most like clarified before making a decision?
- Would a pause help you consider what we have discussed?
- How would you like us to record your preference today?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| iron-deficiency anaemia | too little iron for making the red blood cells your body needs |
| intravenous iron | iron medicine given through a small tube into a vein |
| blood transfusion | receiving donated blood |
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
Does agreement after this explanation amount to full infusion consent?
Do not present agreement in this conversation as completing every requirement for treatment. The card explicitly preserves the full pre-infusion assessment, product-specific consent discussion and ongoing clinical assessment. Establish his preference, then ensure the remaining assessment and consent discussion occur before proceeding.
What if he asks why he became iron deficient?
Say that investigations into the cause are already being arranged separately. Do not guess at bleeding, diet or another cause, and do not imply that replacing iron answers that question. Ask what he would like clarified about those investigations and direct it to his prescriber.
How should I handle a request for numerical estimates of benefit or risk?
The card provides no figures or expected response times. Avoid inventing percentages, treatment duration or a timetable for feeling better. Identify which estimate matters to his decision and obtain the relevant explanation through the product-specific discussion or prescriber rather than substituting a confident guess.
Sources
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