The candidate card
Setting
Palliative care ward
Candidate
In this original independent practice scenario, you are a nurse speaking with Ms Soraia Puig, aged 45, about her mother. Fictional case facts: her mother has advanced cancer, the treating team believes she is entering her last days, and she is increasingly sleepy, taking occasional sips and declining most food; when awake, she can express her wishes and has agreed to her daughter's involvement. The team's individual plan is to offer food and small drinks when she wants them and is awake enough to swallow comfortably, provide frequent gentle cleaning and moistening of her mouth and lips, and review discomfort or swallowing changes; you can demonstrate mouth care and request a doctor review today. General clinical background: appetite commonly decreases near death, food should not be forced, and coughing or distress during intake requires stopping the attempt and calling the nurse immediately; hydration decisions remain individual and require review.
Task (interlocutor: relative)
- Find out what Ms Puig understands about her mother's reduced intake and what she hopes feeding will achieve
- Explain why appetite can decrease near death and how care will continue while respecting her mother's wishes
- Explain the team's mouth-care and comfort-feeding plan, including what to do if swallowing causes coughing or distress
- Respond to her belief that not forcing food means neglect and invite her reaction to the explanation
- Agree how she would like to help, offer the doctor review today and check her understanding of the immediate plan
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 nurse speaking with Ms Soraia Puig, aged 45, about her mother. Fictional case facts: her mother has advanced cancer, the treating team believes she is entering her last days, and she is increasingly sleepy, taking occasional sips and declining most food; when awake, she can express her wishes and has agreed to her daughter's involvement. The team's individual plan is to offer food and small drinks when she wants them and is awake enough to swallow comfortably, provide frequent gentle cleaning and moistening of her mouth and lips, and review discomfort or swallowing changes; you can demonstrate mouth care and request a doctor review today. General clinical background: appetite commonly decreases near death, food should not be forced, and coughing or distress during intake requires stopping the attempt and calling the nurse immediately; hydration decisions remain individual and require review.
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 exploring what feeding represents to Ms Puig: ask what she hopes it will achieve and what worries her about reduced intake. A likely concern is neglect, but let her explain its meaning before offering reassurance.
- Establish her understanding before discussing the team's view that her mother may be entering her last days. Explain that appetite commonly decreases near death without presenting the timing as certain or suggesting that reduced intake makes continued care unnecessary.
- Make ongoing care visible: describe frequent gentle cleaning and moistening of the mouth and lips, then food and small drinks only when wanted and sufficiently awake for comfortable swallowing. Demonstration makes this explanation more concrete than reassurance alone.
- Explore her belief about neglect without agreeing that food should be forced. Keep her mother's expressed wishes central, and invite Ms Puig's reaction after explaining the plan; a longer lecture may miss the concern behind her objection.
- Close by agreeing what help she would feel comfortable offering, checking her understanding of the immediate plan and offering today's doctor review. If time is short, prioritise her mother's wishes, practical care and escalation over general information about dying.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- This is a difficult change to watch.
- We can pause if you need a moment.
- Which part feels hardest to accept?
- Would you prefer to watch the demonstration first?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| Palliative care | Care focused on comfort and support during serious illness. |
| Comfort feeding | Offering food or small drinks when she wants them and is awake enough to swallow comfortably. |
| Hydration | Providing fluid. |
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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Next step for Australian nursing: if your pathway requires OBA after OET and NCLEX-RN, explore OSCE practice for Australian nurses at OSCE Australia, run by the same company as OETAce.
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Questions about this role-play
How should I answer a question about a drip?
Explain that decisions about providing fluids need individual review; the card does not establish whether a drip would be appropriate for her mother. Avoid promising benefit or declaring that fluids are never used. Bring this specific question into the doctor review rather than making a treatment decision yourself.
What exactly should her daughter do if intake causes coughing or distress?
Stop the food or drink attempt immediately and call the nurse. Do not force further food or fluids or continue trying while her mother is distressed. The team should review the swallowing change before further attempts; do not interpret the episode as proof of a particular complication.
Can I promise that her mother is not hungry or thirsty?
No. The card describes reduced intake, not an assessment proving the absence of hunger or thirst. Ask about what her mother expresses when awake and distinguish those wishes from her daughter's interpretation. Avoid absolute reassurance about sensations that have not been established.
Sources
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