The candidate card
Setting
Neurology community clinic
Candidate
You are a community neurology nurse seeing Mrs Everlyne Esinyen, aged 65, in this original independent practice scenario. She has multiple sclerosis and works in office administration; her treating team reviewed her longstanding fatigue last week, with no new symptoms reported. Her employer has requested a letter containing her diagnosis and medical history, but she currently authorises disclosure of functional limitations only. The clinic's process is to clarify her requested adjustments and consent, then contact the specialist MS nurse to coordinate occupational therapy advice and an appropriately authorised support letter; she can review the proposed wording before deciding whether it may be released.
Task (interlocutor: patient)
- Find out how fatigue affects her work, what adjustments she wants and what worries her about the employer's request.
- Explain how practical changes to work patterns may help manage fatigue, relating possible adjustments to her priorities without promising their effectiveness or the employer's agreement.
- Clarify exactly what information she permits in the letter, who may receive it and whether she wants to review it before release.
- Reassure her that the employer's request does not itself authorise disclosure of her diagnosis or medical history, while acknowledging that limited information may lead to further questions.
- Agree what you may discuss with the specialist MS nurse, document the external disclosure boundary and arrange a follow-up discussion about the proposed letter; summarise her wishes and invite correction.
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 community neurology nurse seeing Mrs Everlyne Esinyen, aged 65, in this original independent practice scenario. She has multiple sclerosis and works in office administration; her treating team reviewed her longstanding fatigue last week, with no new symptoms reported. Her employer has requested a letter containing her diagnosis and medical history, but she currently authorises disclosure of functional limitations only. The clinic's process is to clarify her requested adjustments and consent, then contact the specialist MS nurse to coordinate occupational therapy advice and an appropriately authorised support letter; she can review the proposed wording before deciding whether it may be released.
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
- Start with her experience rather than the employer's paperwork. Ask which parts of her working day fatigue affects and what concerns her about the request. Privacy or being misunderstood may be likely worries, but let her identify what matters.
- Establish her priorities before discussing possible changes to work patterns, so suggestions address her actual difficulties. Present adjustments as options to consider, with uncertain benefit and employer agreement, rather than prescribing a solution before understanding her working day.
- Separate the employer's request from her permission: requesting medical details does not authorise their release. Make the content and recipient explicit, avoiding a broad label such as relevant information that could conceal disclosure beyond functional limitations.
- Treat discussion with the specialist MS nurse and disclosure to the employer as separate decisions. Explain the coordination step involving occupational therapy advice, then establish what she permits internally; consent to preparing support must not become assumed consent to external release.
- Close by reading back the agreed boundaries and inviting corrections before arranging follow-up. Establish her preference about reviewing the proposed wording. If time is short, prioritise clear consent and the next contact; limited disclosure may still prompt further employer questions.
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
- “Good morning, Mrs Esinyen. I'm the community neurology nurse. Thank you for coming in today.”
- “Could you tell me how your fatigue has been affecting you at work?”
2. Key questions
- “What changes at work would make the biggest difference for you?”
- “What worries you about your employer's request for a letter?”
- “Exactly what information are you happy for the letter to include, and who may receive it?”
- “Would you like to read the proposed wording before anything is released?”
3. Handling the patient's concern
Likely concern: She is likely to be worried about her diagnosis or medical history being shared with her employer.
- “That's a fair concern. Your employer's request doesn't itself give permission to share your diagnosis or medical history. Only what you authorise will be used.”
- “Sharing functional limitations only may lead your employer to ask further questions. We can talk about how you'd like to handle that, and you can review the wording first.”
4. Explaining
- “Practical changes to work patterns can help some people manage fatigue. We can look at which changes fit your priorities, though I can't promise they will work or that your employer will agree.”
- “I'd like to speak with the specialist MS nurse to coordinate occupational therapy advice and a letter you have authorised. You'd see the proposed wording first and decide whether it can be released. Is that clear?”
5. Closing
- “So you have authorised sharing functional limitations only, and I may discuss with the specialist MS nurse what you've agreed. I'll document that boundary and arrange a follow-up about the letter.”
- “Have I understood your wishes correctly? Please correct anything I've missed or got wrong.”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Which part of the working day would you most like to change?
- You can tell me if any question feels too personal.
- Would a brief explanation help, or would you prefer more detail?
- Have I understood what matters most to you?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| fatigue | Tiredness. |
| functional limitations | The ways your condition limits what you can do. |
| occupational therapy advice | Advice about adapting everyday activities, including work, to your needs. |
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 use the information about last week's review?
Use it to keep the conversation anchored to longstanding fatigue and the workplace request. Do not describe her fatigue as worsening or claim the review established that nothing else could be wrong. No new symptoms were reported; that is the extent of the information provided.
Can I describe her as unable to work?
The card does not establish that she is unable to work or unable to perform particular duties. Avoid turning fatigue into a blanket statement of incapacity. Any description of work difficulties should reflect what she actually reports, without adding a fitness-for-work conclusion.
Should her age lead me to raise retirement?
Being aged 65 does not establish that she wants to retire, reduce her role or leave employment. Introducing those possibilities without a cue could redirect the conversation away from her request. Use neutral language about her work and avoid assumptions about her career plans.
What if she later asks me to include her diagnosis?
Don't assume. At the moment she authorises functional limitations only. If she changes her mind, clarify exactly what may be included and who may receive it, offer her the chance to review the wording, and document the new consent before anything is shared.
What if she is unsure what functional limitations means?
Explain in plain words that it describes what she finds difficult at work because of her fatigue, rather than the name of her condition or her history. Offer to draft wording together, and remind her she can review it before anything is released.
Sources
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