The candidate card
Setting
Preoperative clinic
Candidate
You are a nurse in a preoperative clinic in this original independent practice case. Mrs Evelina Vuk, aged 45, is preparing for an elective hernia repair next week; she has obstructive sleep apnoea treated with CPAP and believes hospital oxygen means she can leave her machine at home. In this fictional case, her documented preoperative instructions are to continue her usual prescribed CPAP at home and bring her machine, mask, tubing and power cable to hospital, together with her sleep-service treatment information if available. Her individual anaesthetic, postoperative CPAP and monitoring arrangements have not yet been confirmed; the anaesthetist is available for discussion today, and you must not change her settings or promise a particular recovery arrangement.
Task (interlocutor: patient)
- Find out what Mrs Vuk understands about CPAP and hospital oxygen, how she currently uses her machine and what might prevent her bringing it.
- Explain the difference between CPAP and supplemental oxygen in simple terms, clarifying why oxygen does not replace the pressure that keeps her airway open.
- Explain her documented equipment instructions and why the anaesthetic team needs to know about her sleep apnoea and usual treatment.
- Explore and respond to her concerns about bringing the machine and involving the anaesthetist, without promising that surgery will proceed unchanged.
- Agree an equipment checklist and a discussion with the anaesthetist today to confirm her individual plan; check her understanding and leave her prescribed settings unchanged.
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 a preoperative clinic in this original independent practice case. Mrs Evelina Vuk, aged 45, is preparing for an elective hernia repair next week; she has obstructive sleep apnoea treated with CPAP and believes hospital oxygen means she can leave her machine at home. In this fictional case, her documented preoperative instructions are to continue her usual prescribed CPAP at home and bring her machine, mask, tubing and power cable to hospital, together with her sleep-service treatment information if available. Her individual anaesthetic, postoperative CPAP and monitoring arrangements have not yet been confirmed; the anaesthetist is available for discussion today, and you must not change her settings or promise a particular recovery arrangement.
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 inviting Mrs Vuk to explain what she expects hospital oxygen to do. Her likely concern may involve convenience or uncertainty about hospital care, but ask what matters to her before deciding why she wants to leave the machine.
- Address the proposed substitution before discussing packing, so the equipment instructions have a clear purpose. Keep the explanation brief and concrete; avoid a technical account of breathing physiology. Correct the misunderstanding respectfully, without making her feel foolish for asking.
- Explore her reaction to involving the anaesthetist before presenting the discussion as an agreed next step. Ask what concerns her about that conversation. Acknowledge the concern she actually expresses rather than assuming she fears cancellation or objects to specialist involvement.
- Ask her to describe her usual CPAP routine in her own words, using neutral questions rather than testing whether she is a good patient. Reinforce her documented instruction to continue usual prescribed treatment at home, and leave her settings unchanged.
- Close with an equipment checklist and agreement to speak with the available anaesthetist today. Ask her to explain the preparation back in her own words. If time runs short, prioritise correcting the substitution misunderstanding and securing these practical next steps.
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 Mrs Vuk, I'm the nurse in the preoperative clinic. I'm glad you've raised your sleep apnoea before your operation next week.”
- “What's your understanding of how your CPAP and the oxygen given in hospital fit together?”
2. Key questions
- “How do you use your CPAP machine at the moment, and is it every night?”
- “What do you understand hospital oxygen would do for your breathing at night?”
- “Is there anything that might make it hard to bring your machine, mask, tubing and power cable?”
- “How do you feel about the anaesthetist knowing about your sleep apnoea and your usual treatment?”
3. Handling the patient's concern
Likely concern: She may think bringing the machine is unnecessary or worry it will affect her surgery.
- “That's a sensible thing to ask. I can't promise your recovery arrangements yet, but the anaesthetist is available today and is the right person to confirm your plan.”
- “I can't promise surgery will go ahead unchanged, but telling the team now helps them plan around your sleep apnoea.”
4. Explaining
- “CPAP gives a steady air pressure that keeps your airway open while you sleep. Oxygen adds oxygen to the air you breathe, but it doesn't replace that pressure. Does that make sense?”
- “Please keep using your CPAP at home, and bring the machine, mask, tubing, power cable and any sleep-service treatment information you have. The anaesthetic team needs to know about your sleep apnoea and usual treatment. Clear so far?”
5. Closing
- “Let's go through your checklist: machine, mask, tubing, power cable and sleep-service information if you have it. I'll arrange for you to talk with the anaesthetist today. Your prescribed settings stay as they are.”
- “Could you tell me in your own words why the machine is coming with you and what oxygen can't replace? Any other questions?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Thank you for mentioning this before your operation.
- We can take your questions one at a time.
- Which part would you like me to explain differently?
- Does that address the concern you had?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| obstructive sleep apnoea | A condition where your airway repeatedly closes during sleep. |
| CPAP | A machine that supplies air under pressure through a mask to help keep your airway open. |
| supplemental oxygen | Extra oxygen supplied to help you get more oxygen when you breathe. |
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 can I explain precisely why hospital oxygen does not replace CPAP?
Explain the different functions: CPAP supplies pressure that helps keep her airway open, while supplemental oxygen provides extra oxygen. Oxygen does not replace that pressure. Avoid describing them as interchangeable treatments or suggesting that having oxygen available settles her CPAP arrangements.
What exactly belongs on her equipment checklist?
Include her machine, mask, tubing and power cable, together with her sleep-service treatment information if available. Name each item separately so that bringing the machine does not sound sufficient by itself. Preserve the distinction between the listed equipment and information requested only if available.
What can I say if she asks where she will recover or whether surgery will go ahead?
Say that her individual anaesthetic, postoperative CPAP and monitoring arrangements have not yet been confirmed. Explain that the team needs to know about both her sleep apnoea and usual treatment when confirming those arrangements. Do not guarantee a particular recovery location or that surgery will proceed unchanged.
What if she asks what recovery arrangements she will have after surgery?
Be honest that her individual anaesthetic, postoperative CPAP and monitoring arrangements haven't been confirmed, so you can't promise any particular arrangement. Explain that the anaesthetist is available today to discuss her plan, and offer to arrange that. Don't speculate.
What if she asks me to adjust her machine settings?
Explain that her prescribed settings stay unchanged and that you won't alter them. If she has comfort concerns, acknowledge them and say she can raise them with the anaesthetist today. Reinforce that she should keep using her CPAP as prescribed at home.
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