The candidate card
Setting
Orthopaedic rehabilitation ward
Candidate
You are a nurse in this original independent practice scenario; the patient details and individual treating-team plan are fictional case facts. Ms Songul Lochel, aged 55, had a left total hip replacement for osteoarthritis three days ago and is refusing mobilisation after reading about dislocation online. Her documented plan permits weight-bearing as comfortable, using her fitted walking frame with one staff member beside her for a short walk from the bed to the raised armchair; her individual precautions are to avoid crossing her legs, bending her hip beyond a right angle and sudden twisting, and to stop for ward assessment if pain increases or dizziness develops. She previously completed this route with the physiotherapist, reports unchanged mild soreness today, and has no discharge date agreed; the physiotherapist is available to review any uncertainties before practice.
Task (interlocutor: patient)
- Explore what Ms Lochel read, what she fears will happen and whether her hip symptoms have changed.
- Explain how supported walking helps recovery and clarify her documented walking plan and precautions.
- Acknowledge her fear and explain that dislocation is possible but uncommon, without promising that movement is risk-free.
- Agree a manageable next step with her consent, offering physiotherapy review if needed; check her understanding of the support and when to stop.
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 this original independent practice scenario; the patient details and individual treating-team plan are fictional case facts. Ms Songul Lochel, aged 55, had a left total hip replacement for osteoarthritis three days ago and is refusing mobilisation after reading about dislocation online. Her documented plan permits weight-bearing as comfortable, using her fitted walking frame with one staff member beside her for a short walk from the bed to the raised armchair; her individual precautions are to avoid crossing her legs, bending her hip beyond a right angle and sudden twisting, and to stop for ward assessment if pain increases or dizziness develops. She previously completed this route with the physiotherapist, reports unchanged mild soreness today, and has no discharge date agreed; the physiotherapist is available to review any uncertainties before practice.
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 the online information rather than an instruction to walk. Ask which detail frightened her and what she imagines happening. Her likely concern is injury; explore this without assuming it, and establish whether her hip symptoms have changed.
- Acknowledge the fear before explaining supported walking as part of recovering everyday movement. State that dislocation is possible but uncommon. Avoid using reassurance to rush her decision: uncommon does not mean impossible, and agreement should remain voluntary.
- Describe weight-bearing as comfortable, using her fitted frame with one staff member beside her for the short bed-to-raised-armchair walk. Keep all precautions together: avoid crossing legs, bending the hip beyond a right angle, and sudden twisting.
- Explain together that increased pain or dizziness means stopping for ward assessment. Her unchanged mild soreness is relevant context, but does not establish that movement is risk-free. Ask her to explain these stopping instructions back in her own words.
- Close by agreeing a manageable next step with her consent and checking her understanding of the support available. Offer physiotherapy review for uncertainties before practice. If time runs short, prioritise clear boundaries and her decision over further persuasion.
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 Lochel, I'm one of the nurses on the ward. I'd like to talk with you about getting up to walk today. How are you feeling?”
- “Could you tell me how your new hip is feeling today?”
2. Key questions
- “I understand you've been reading about your operation. What did you read?”
- “What are you most afraid might happen if you walk?”
- “Have you noticed any change in your pain, or any dizziness?”
- “What would help you feel safer about trying a short walk?”
3. Handling the patient's concern
Likely concern: Likely to fear that walking could dislocate her new hip.
- “That sounds frightening, and it's reasonable to want to be careful. Dislocation is possible but uncommon, and I can't promise any movement is completely risk-free.”
- “You wouldn't be doing this alone: I'd be right beside you with your frame, going at your pace. Would that feel more manageable?”
4. Explaining
- “Supported walking helps your recovery. Your plan is a short walk from the bed to the raised armchair, using your frame, with me beside you, putting weight on the leg as comfortable.”
- “Your precautions: don't cross your legs, don't bend your hip beyond a right angle, and avoid sudden twisting. Stop and tell me if pain increases or you feel dizzy. Have I made that clear?”
5. Closing
- “So, if you agree, we'll try the short walk to the chair with your frame and me beside you. If you'd like, I can ask the physiotherapist to talk it through first.”
- “Could you tell me which movements to avoid, and when you'd stop and let me know? Is there anything else you'd like to ask?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Reading about dislocation after your operation sounds frightening.
- Thank you for telling me what has been troubling you.
- Would you like a moment to think before answering?
- Which part of our discussion would you like explained differently?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| mobilisation | Getting up and moving around. |
| dislocation | The replacement hip joint coming out of position. |
| total hip replacement | Surgery to replace your hip joint. |
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 refer to her previous walk with the physiotherapist?
Use it as a shared reference: ask what she remembers about that walk and whether anything about it felt difficult. It establishes that she has completed this particular route before, but should not become an argument that she must repeat it or that another walk cannot cause problems.
What if she asks whether refusing this walk will delay discharge?
State that no discharge date has been agreed. The card provides no basis for predicting how this decision will affect discharge, so avoid promising an earlier departure or suggesting a penalty. Keep any discussion of discharge separate from obtaining consent for this walk.
What if she asks why online advice differs from her documented precautions?
You do not know what the website says or why its advice might differ. Ask her to identify the particular conflicting instruction. Avoid guessing about surgical techniques or dismissing the website; bring the specific discrepancy to the available physiotherapist for clarification before practice.
What if she still refuses after I explain?
Accept her decision for now without pressure. Ask what would need to change, offer a physiotherapy review of her uncertainties before practice, and document her choice. Offer to revisit the walk once she has spoken with the physiotherapist.
What if she reports increased pain or dizziness during the conversation?
Do not start the walk. Stay with her and arrange ward assessment, because her plan says to stop for assessment if pain increases or dizziness develops. Explain calmly what you are doing and why, and inform the team.
Sources
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