The candidate card
Setting
Paediatric ENT discharge area, Australia
Candidate
This is original independent practice: you are a nurse preparing Ms Seanan Quinney, aged 42, to care for her eight-year-old daughter following a tonsillectomy yesterday. In this fictional case, her daughter has been cleared for discharge, is drinking, has manageable pain and has no bleeding; Ms Quinney says she cannot remember all the instructions. The fictional treating-team plan is to give the supplied prescribed pain medicines regularly according to their pharmacy labels, record each administration, avoid additional medicines or dose changes without professional advice, encourage frequent drinks and contact the ENT team for pain not controlled by the prescribed treatment; the pharmacist has already checked the labelled doses and schedule with her, and no numerical dosing recall is required here. The supplied escalation plan is to attend the nearest emergency department immediately for fresh blood from the mouth or nose, blood in vomit or new repeated swallowing suggesting bleeding, even if visible bleeding stops; call 000 for heavy bleeding, breathing difficulty or collapse, obtain urgent assessment if she cannot drink, and use the ENT discharge contact for other recovery concerns.
Task (interlocutor: relative)
- Find out which instructions Ms Quinney finds confusing, what she currently understands and whether she has practical support at home.
- Explain the supplied pain-management and drinking plan in small sections, then ask her to describe how she will manage medicines at home.
- Explain the supplied bleeding and emergency plan, then ask what she would do if her daughter spat out fresh blood that subsequently stopped.
- Reassure her that asking for repetition is appropriate, respond to any misunderstanding without blame and explain the relevant point again.
- Agree a manageable home-care plan, confirming access to the written instructions, discharge contact and emergency transport; check any remaining questions before discharge.
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.
This is original independent practice: you are a nurse preparing Ms Seanan Quinney, aged 42, to care for her eight-year-old daughter following a tonsillectomy yesterday. In this fictional case, her daughter has been cleared for discharge, is drinking, has manageable pain and has no bleeding; Ms Quinney says she cannot remember all the instructions. The fictional treating-team plan is to give the supplied prescribed pain medicines regularly according to their pharmacy labels, record each administration, avoid additional medicines or dose changes without professional advice, encourage frequent drinks and contact the ENT team for pain not controlled by the prescribed treatment; the pharmacist has already checked the labelled doses and schedule with her, and no numerical dosing recall is required here. The supplied escalation plan is to attend the nearest emergency department immediately for fresh blood from the mouth or nose, blood in vomit or new repeated swallowing suggesting bleeding, even if visible bleeding stops; call 000 for heavy bleeding, breathing difficulty or collapse, obtain urgent assessment if she cannot drink, and use the ENT discharge contact for other recovery concerns.
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 by exploring which instructions feel hardest to remember, rather than asking whether everything makes sense. She is likely worried about forgetting something important; establish her current understanding and available home support before deciding which explanation needs the most attention.
- Organise the medicine explanation around what she will actually do at home. Use the supplied pharmacy labels as the reference, then invite her to describe her routine; this checks practical understanding without turning the conversation into a numerical dosing test.
- Keep drinking advice separate from the medicine explanation so neither gets lost. Explain frequent drinks, regular prescribed pain treatment and contacting ENT for uncontrolled pain; make clear that additional medicines or dose changes require professional advice.
- Give the complete supplied escalation plan together before testing her response to the stopped-bleeding example. The usual trap is accepting general agreement without establishing what action she would take; if time runs short, prioritise this check over repeating routine explanations.
- Close by checking that the agreed routine is manageable with her available support. Confirm she can access the written instructions and discharge contact, and establish how she would reach emergency care; invite remaining questions without treating discharge clearance as proof of parental confidence.
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 Ms Quinney, I'm the nurse looking after your daughter's discharge. It's a lot to remember, so let's go through it together at your pace.”
- “Which of the instructions are you finding most confusing, and what do you remember so far?”
2. Key questions
- “What's your understanding of the instructions at the moment, and which parts feel unclear?”
- “Who will be at home to help you look after your daughter?”
- “Once you're home, how will you manage her pain medicines from day to day?”
- “If your daughter spat out fresh blood and then it stopped, what would you do?”
3. Handling the patient's concern
Likely concern: She may worry she will forget something important or give the medicines wrongly.
- “Asking me to repeat things is completely fine. The pharmacist has already checked the labelled doses with you, so you only need to follow the labels.”
- “If something I said wasn't clear, that's on me, not you. We'll go through it in small pieces, and the written instructions will help too.”
4. Explaining
- “Give the prescribed pain medicines regularly as the pharmacy labels say, write down each one, and don't add other medicines or change doses without advice. Encourage frequent drinks. If pain isn't controlled, call the ENT team. Does that make sense?”
- “Go straight to the nearest emergency department for fresh blood from mouth or nose, blood in vomit or new repeated swallowing, even if it stops. Call 000 for heavy bleeding, breathing difficulty or collapse. Urgent assessment if she can't drink.”
5. Closing
- “So: medicines by the labels and recorded, regular drinks, the ENT discharge contact for other concerns, and the emergency plan we just went through. Do you have the written instructions, the contact and a way to get to hospital?”
- “Is there anything still unclear, or any part you'd like me to go over once more before you take your daughter home?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- There is a lot to take in while you are caring for your daughter.
- You do not need to apologise for asking again.
- We can pause here for a moment.
- Which part would you like us to go over once more?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| tonsillectomy | an operation to remove the tonsils |
| administration | giving a medicine |
| ENT | the ear, nose and throat team |
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 exactly should the complete escalation explanation include?
Attend the nearest emergency department immediately for fresh mouth or nose blood, blood in vomit, or new repeated swallowing suggesting bleeding, even if visible bleeding stops. Call 000 for heavy bleeding, breathing difficulty or collapse. Obtain urgent assessment if she cannot drink. Use the ENT discharge contact for other recovery concerns.
How should I handle questions about exact doses or keeping track of medicines?
The pharmacist has already checked the labelled doses and schedule with her, and numerical recall is not required. Help her locate that information and explain that each administration should be recorded. If she remains uncertain about a label, arrange professional clarification rather than supplying a dose from memory.
How should I respond if her explanation reveals a misunderstanding?
Thank her for explaining her thinking, identify the specific point that needs correction and explain it again in simpler language. Avoid describing her answer as a failure or blaming her memory. Ask her to explain the corrected point in her own words before moving on.
What if she cannot repeat the plan back correctly?
Treat it as my explanation needing work, not her failing. Re-explain only the missed point in a shorter chunk, then ask her to say it back. Do not ask her for dose numbers; the pharmacist has already covered the labelled doses and schedule.
What if she says she would wait and see whether the blood stops?
Don't argue. Gently explain that fresh blood from the mouth or nose means going to the nearest emergency department immediately, even if it stops. Ask her to repeat that. If bleeding is heavy, or there is breathing difficulty or collapse, remind her to call 000.
Sources
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