The candidate card
Setting
Community pharmacy
Candidate
You are a pharmacist in a community pharmacy. Ms Diana Cowgill, aged 31, has come to the counter asking for a codeine-containing cough syrup for her 3-year-old son. A friend recommended it. Her son has had a cold with a dry cough, mainly at night, for four days.
Task (interlocutor: parent)
- Find out about her son's symptoms and general health (breathing, temperature, eating and drinking, what has been tried so far)
- Explain why codeine and other cough medicines are not suitable for her son (safety risks in young children)
- Advise on safe ways to ease his symptoms at home
- Respond to her concerns about her friend's advice and her son's cough
- Explain the warning signs that need medical attention and agree a 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.
How to approach this card
- Ask about his breathing first, then temperature, eating and drinking, and exactly what he has already been given, including anything from her friend. Keep questions open and free of blame, because your advice depends on what he has had.
- Acknowledge that the friend's tip was well meant before saying no. Then give one clear reason: codeine is not for children under 12 in Australia, and over-the-counter cough and cold medicines are not for children under 6, because of drowsiness and breathing risks.
- Offer home care she can start tonight: plenty of fluids, rest, saline nose drops or spray, honey in a warm drink (fine at his age) and a smoke-free home. If he is uncomfortable or feverish, follow the pack directions for his age and weight.
- Give the warning signs as one complete set. Call 000 for severe difficulty breathing, blue or grey lips, being very hard to wake or floppy, or choking. See a doctor promptly for fast or hard breathing, wheeze, drinking much less, fewer wet nappies, persistent fever or worsening.
- Typical error: lecturing about the friend's advice, or listing risks without a way to settle his cough at night. Say not to use leftover or adult cough products, and ask her to repeat the 000 signs back.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- I'm glad you asked me before giving anything.
- Nights with a coughing child are tiring, so let's find something safe that helps.
- Can you tell me in your own words what you would do if his breathing changed?
- First a few questions about him, then I'll explain what I'd suggest.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| codeine | an opioid medicine, related to strong painkillers, that can slow a young child's breathing |
| sedating | makes a child very sleepy and harder to wake |
| dry cough | a cough that doesn't bring up any phlegm |
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 Pharmacy role-play cards
- Stopping metformin because of stomach upset Community pharmacy
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- New medicines after hospital discharge Community pharmacy
All sets: nurses, doctors, other professions. Your profession's guide: OET Pharmacy.
Questions about this role-play
What if she says her friend's child was fine on it?
Don't argue with the friend's experience. Say that a child can seem fine and still be at risk, and that the advice is about safety for his age, not about anyone's parenting. Then move straight to what will help him tonight.
What if she asks for a different over-the-counter cough syrup?
Give the same explanation: these products are not recommended for a child his age, so you won't supply one. Show that you are not leaving her empty-handed by going through the home measures, and offer pharmacist follow-up if he doesn't improve.
What if she describes trouble breathing while I'm taking the history?
Stop the routine questions. Ask about colour, effort of breathing and how alert he is. If breathing is severe or he is blue or very drowsy, tell her to call 000 now; otherwise arrange same-day medical review rather than selling any product.
Sources
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