The candidate card
Setting
Surgical outpatient clinic, telephone consultation
Candidate
In this original independent practice scenario, you are a surgical outpatient nurse telephoning Mr Friedemann Ortmann, aged 42, after a missed wound-review appointment. Fictional case facts: he had hernia surgery eight days ago, missed yesterday's appointment when his arranged transport failed, and has reported increasing wound soreness, redness and yellow discharge without an examination yet. The duty surgical team has offered reassessment in the clinic today; you can confirm attendance with them and ask the clinic coordinator to investigate suitable transport, but transport is not guaranteed, so any access failure must be discussed with the duty team to secure an alternative same-day assessment. General clinical background: these wound changes may indicate infection and need prompt review; new confusion, severe breathing difficulty or rapid serious deterioration require an ambulance via 999 rather than waiting for transport.
Task (interlocutor: patient)
- Find out how the wound has changed and how he feels now, checking for fever or shivering and emergency warning signs
- Explore what prevented attendance and what practical barriers could prevent assessment today, without blame
- Explain why examination today is needed while making clear that infection has not yet been confirmed
- Respond to his concerns about another failed journey and explain what access support you can investigate
- Agree a workable same-day assessment plan, including the duty-team fallback if transport fails and when to call 999
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.
In this original independent practice scenario, you are a surgical outpatient nurse telephoning Mr Friedemann Ortmann, aged 42, after a missed wound-review appointment. Fictional case facts: he had hernia surgery eight days ago, missed yesterday's appointment when his arranged transport failed, and has reported increasing wound soreness, redness and yellow discharge without an examination yet. The duty surgical team has offered reassessment in the clinic today; you can confirm attendance with them and ask the clinic coordinator to investigate suitable transport, but transport is not guaranteed, so any access failure must be discussed with the duty team to secure an alternative same-day assessment. General clinical background: these wound changes may indicate infection and need prompt review; new confusion, severe breathing difficulty or rapid serious deterioration require an ambulance via 999 rather than waiting for transport.
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
- Check his current condition before discussing the missed appointment, because telephone contact cannot establish how unwell he is by appearance. Explore wound changes, fever or shivering and all listed emergency criteria before moving into travel arrangements.
- Acknowledge the failed transport without framing attendance as a matter of compliance. Ask what would make another journey difficult today; his likely concern is another unsuccessful trip, but explore his own priorities rather than assuming reluctance.
- Connect the reported soreness, redness and yellow discharge to the need for examination today. Say these changes may indicate infection; avoid diagnosing it over the telephone or predicting treatment before the surgical team has assessed him.
- Separate what is available from what remains uncertain: the team has offered today's reassessment, while the coordinator can investigate transport. Confirm arrangements rather than promising collection, and establish how he will tell the clinic if access breaks down.
- Close with a plan that identifies who will confirm attendance and who will involve the duty team if transport fails. If time is short, prioritise securing same-day assessment and checking his understanding of escalation over reviewing why yesterday's appointment was missed.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- It sounds frustrating to arrange a journey that falls through.
- I appreciate you telling me about the discharge.
- Let me separate what is confirmed from what still needs arranging.
- Have I understood the travel difficulty correctly?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| Wound discharge | Fluid coming from the operation wound. |
| Reassessment | Another examination to check what is happening now. |
| Hernia surgery | An operation to repair a hernia. |
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
What if he asks for antibiotics instead of another journey?
Explain that the reported changes need examination and that infection has not yet been confirmed. Do not promise antibiotics or suggest that telephone advice can replace assessment. Explore whether the request reflects a practical access concern, then address that barrier alongside the duty surgical team.
What if the coordinator cannot find transport?
Contact the duty surgical team to secure an alternative same-day assessment rather than leaving him with an unfulfilled referral. Do not invent a home visit or another service's availability. Confirm the alternative arrangement with him and establish whether any remaining practical barrier would still prevent access.
Which emergency warnings must be covered in this role-play?
The candidate card lists three emergency warnings: new confusion, severe breathing difficulty or rapid serious deterioration. Explain that any one of these requires an ambulance via 999 rather than waiting for transport. Broader sepsis warnings can be discussed as supplementary patient education. [NHS sepsis advice](https://www.nhs.uk/conditions/sepsis/).
Sources
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