The candidate card
Setting
Rheumatology day clinic
Candidate
You are a nurse in this original independent practice scenario. Mr Njeru Mahat, aged 66, takes prescribed once-weekly methotrexate for rheumatoid arthritis and has brought his written monitoring schedule because his work shifts prevent him attending the booked blood test. His individual written plan states: 'Blood test tomorrow morning; contact the rheumatology day clinic if unable to attend'; these appointment details are fictional patient-specific facts, not a general monitoring guideline. The duty rheumatology clinician is available to discuss the problem today before he leaves and can confirm alternative testing arrangements and any medication instructions; no replacement appointment or medication change has yet been authorised.
Task (interlocutor: patient)
- Find out what Mr Njeru Mahat understands about his written schedule, how his shifts affect attendance and whether he feels unwell today.
- Explain the purpose of methotrexate blood monitoring in plain language, distinguishing the blood-test appointment from his weekly medication schedule.
- Clarify the instruction to contact the clinic if unable to attend, explaining that alternative testing arrangements and any medication questions need confirmation from the treating team.
- Respond to his concerns about attending tests around work and reassure him that discussing the difficulty is appropriate.
- Agree to contact the duty clinician with him before he leaves, identify workable appointment options and check his understanding of what remains to be confirmed.
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. Mr Njeru Mahat, aged 66, takes prescribed once-weekly methotrexate for rheumatoid arthritis and has brought his written monitoring schedule because his work shifts prevent him attending the booked blood test. His individual written plan states: 'Blood test tomorrow morning; contact the rheumatology day clinic if unable to attend'; these appointment details are fictional patient-specific facts, not a general monitoring guideline. The duty rheumatology clinician is available to discuss the problem today before he leaves and can confirm alternative testing arrangements and any medication instructions; no replacement appointment or medication change has yet been authorised.
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
- Invite him to explain the written plan in his own words, then ask which part is unclear and what he most wants help with. Let him finish before asking focused questions, so your explanation addresses the uncertainty he identifies.
- Describe blood monitoring as tests that help the treating team check his treatment. Keep tomorrow's blood-test appointment separate from his prescribed once-weekly medicine; neither schedule should be presented as an instruction to change the other.
- Treat his shift pattern as a practical constraint, using neutral wording such as availability rather than non-compliance. Establish possible times he could attend before contacting the clinician; these are preferences to discuss, not appointments you can promise.
- Ask how he feels today before focusing on scheduling. Any reported illness belongs in the discussion with the available clinician; avoid diagnosing from a brief account or inventing medication instructions while trying to resolve the appointment problem.
- Close with the clinician discussion before he leaves, separating confirmed decisions from unanswered questions. If time is short, prioritise that discussion and checking his understanding; an agreeable conversation alone does not authorise another test date or medication changes.
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 Mr Mahat, I'm a nurse in the rheumatology day clinic. I can see you've brought your monitoring schedule with you.”
- “What is your understanding of what it says, and what has made it hard to follow?”
2. Key questions
- “How do your work shifts affect getting to the blood test?”
- “Are you feeling unwell in any way today?”
- “How do you understand the blood test and your weekly methotrexate fitting together?”
- “Which days or times could you realistically attend?”
3. Handling the patient's concern
Likely concern: He is likely to worry that missing the test because of work will cause problems.
- “It's reasonable to tell us when work shifts make a test hard to attend, and we'll look at it together.”
- “Let's find out what can be arranged. I can't promise a new time yet, so I'll speak to the duty clinician with you before you leave.”
4. Explaining
- “The blood test is a check on how your body is responding to methotrexate. It is separate from your weekly methotrexate dose, which is a different part of your schedule.”
- “Your plan says blood test tomorrow morning, and to contact the clinic if you can't attend. A different testing arrangement, and any advice about your tablets, must be confirmed by the treating team.”
5. Closing
- “So we'll speak to the duty rheumatology clinician before you leave and look at workable options. They will confirm any new test arrangement and medication instructions.”
- “No new appointment or medication change has been authorised yet. Can you tell me in your own words what is still to be confirmed?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Thank you for bringing your written schedule.
- Would it help if we looked at the wording together?
- This is a reasonable difficulty to raise with us.
- Please tell me if I have misunderstood anything.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| methotrexate | your prescribed once-weekly medicine for rheumatoid arthritis |
| blood monitoring | blood tests to help the team check your treatment |
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 tomorrow morning represent a general methotrexate monitoring interval?
No. Tomorrow morning is the appointment specified in this patient's individual written plan. Do not turn that fictional appointment detail into advice about how frequently everyone taking methotrexate needs testing. The card provides no general monitoring interval.
How should I respond if he asks what individual blood-test results would mean?
The card supplies neither results nor the specific tests ordered, so avoid inventing either. Ask which aspect he wants explained and make that a specific question for the clinician, rather than offering an interpretation of results you have not been given.
How can I keep several medication questions manageable?
Invite him to identify the question he most needs answered, then capture his remaining questions accurately for the clinician. Use his own words where possible, and avoid replacing a precise question with a vague statement that he is anxious about his medicine.
What if he asks whether he should take his weekly methotrexate?
Don't advise on it yourself. Explain that medication instructions need confirmation from the duty clinician, whom you will speak to with him before he leaves. Note his exact question so it can be put to the clinician clearly.
How do I explore workable options without promising a time?
Ask which days and times his shifts allow and write them down. Say you will ask what is possible, and avoid naming a slot until the clinician confirms it, so he does not leave expecting something that has not been arranged.
Sources
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