The candidate card
Setting
Hospital ward (medical)
Candidate
You are a nurse on a medical ward. Mr Adebayo Abiodun's wife, aged 79, was admitted two days ago with a urinary tract infection and started on antibiotics. Overnight she became confused and agitated, tried to get out of bed and did not know where she was. The medical team has diagnosed delirium. Mr Abiodun, aged 80, has just arrived to visit and is very upset.
Task (interlocutor: relative)
- Find out how Mr Abiodun's wife usually manages at home (memory, daily activities, eyesight and hearing) and how she was before admission
- Explain what delirium is and what the ward is doing to manage it (treating the infection, checking fluids and other causes, keeping her safe)
- Reassure Mr Abiodun about his belief that his wife now has dementia and will not return home
- Explain how he and the family can help her recovery (familiar items, glasses and hearing aids, calm reassurance)
- Agree a plan for his visits and for keeping him informed
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.
How to approach this card
- Ask what she is normally like before explaining anything, including memory, daily tasks, eyesight and hearing. This gives you a baseline and shows him the change matters. Also invite him to say how he is feeling, since he is upset.
- Explain delirium in simple terms: a sudden change in thinking and behaviour, linked here to her illness. Describe what the ward is doing, including treating the infection, checking fluids and looking for other causes, and keeping her safe.
- Address the dementia fear directly but cautiously. Explain delirium is a different problem from dementia, and that it can improve as the cause is treated. Do not promise how quickly, or that she will definitely go home.
- Offer jobs he can do: bring familiar items, make sure glasses and hearing aids are in use, and speak calmly. Give him a role, because helplessness is likely part of his distress. Ask him to alert staff, not manage agitation alone.
- Agree visiting times that suit him and how you will keep him informed, including who he can ask and how updates reach him. Check he has understood by asking what he will tell the family.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- This must have been frightening to see. Let me explain what is happening.
- What is she usually like at home?
- It is too early to say how long this will last, but we will keep you updated.
- Your being here and her familiar things can really help her.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| delirium | A sudden state of confusion linked to illness, which can come and go. |
| agitated | Restless, upset and unable to settle. |
| urinary tract infection | An infection in the bladder or urine passages. |
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). Grade B usually means 5 on each language criterion and 2 on each clinical one. See the AI Speaking practice guide for what each criterion looks for.
More Nursing role-play cards
- Emergency: young woman who does not plan to carry her adrenaline autoinjector Emergency department
- Aged care: resident refusing to use his walking frame Aged care facility
- Post-operative pain management Surgical ward
All sets: nurses, doctors, other professions. Your profession's guide: OET Nursing.
Questions about this role-play
How do I answer if he asks whether she has dementia now?
Say that delirium is a different condition, caused here by her current illness, and the team is treating it. Avoid stating she definitely does or does not have dementia. Tell him her thinking will be reassessed as she recovers.
Can I promise she will go home?
No. Say that treating the cause is the focus and that you cannot yet predict how she will recover. Offer to arrange for the doctor to talk with him about the plan, which gives him a route to more information.
How do I involve him without overloading him?
Choose two or three simple actions, such as bringing glasses and hearing aids and familiar items, and speaking calmly. Ask which he can manage. Written visiting and contact details help because he is upset and may not take everything in.
Sources
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