The candidate card
Setting
Community pharmacy
Candidate
You are a community pharmacist. Mrs Rudo Tipene, aged 49, has brought in a discharge prescription for her father, aged 82, who went home from hospital yesterday after an admission for heart failure. The discharge summary shows that his perindopril was stopped and, after the required 36-hour gap, sacubitril with valsartan was started in hospital; bisoprolol, dapagliflozin and furosemide have also been started, ibuprofen is to be stopped and atorvastatin is unchanged. His discharge action plan says: weigh every morning and contact the GP or heart failure team within 24 hours if weight rises by more than 2 kg in two days or swelling or breathlessness worsens; if vomiting, having diarrhoea or unable to eat and drink normally, withhold dapagliflozin and seek advice promptly for an individual plan for his other heart medicines and restarting; stop dapagliflozin and get urgent medical help for possible ketoacidosis (abdominal pain, vomiting, unusual drowsiness, deep or fast breathing), even if blood glucose is not high; and call an ambulance (000) for severe breathlessness, chest pain, or swelling of the face, tongue or throat. Mrs Tipene is confused about the changes and needs to return to work shortly.
Task (interlocutor: relative)
- Find out how her father manages his medicines at home, which old tablets he still has, and whether he has taken any perindopril since leaving hospital
- Explain in simple terms which medicines he should stop and which new ones he should start (old blood pressure tablet replaced, no anti-inflammatory painkillers)
- Explain the key safety points for the new medicines (dizziness, daily weighing and action plan, sick days, warning signs needing urgent help)
- Reassure her about her worries and offer a dose administration aid
- Agree a plan that fits her time constraints (today's supply, removing old medicines, follow-up)
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
- Start by asking what she finds most confusing, then how her father manages tablets, who sets them up, and which old boxes remain at home. Ask directly whether he has taken any perindopril since leaving hospital.
- If he has taken perindopril since discharge, do not simply dispense: sacubitril with valsartan needed a 36-hour gap after it. Contact the hospital team or prescriber first. Then give stop, start, unchanged: perindopril and ibuprofen stop, four new medicines, atorvastatin continues.
- Give the action plan in writing: weigh every morning; contact the GP or heart failure team within 24 hours if weight rises by more than 2 kg in two days or swelling or breathlessness worsens. Mention dizziness and standing up slowly.
- Give the urgent triggers together. Sick days: if vomiting, diarrhoea or not eating and drinking normally, withhold dapagliflozin and seek advice promptly. Ketoacidosis signs, even if glucose is not high: stop dapagliflozin and get urgent help. Call 000 for severe breathlessness, chest pain, face, tongue or throat swelling.
- She has to return to work soon, so prioritise: safe supply today, removing perindopril, ibuprofen and old tablets, then offer a dose administration aid and a follow-up call. Ask her to repeat the 000 triggers back.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- I'll go through this step by step, and you can take it away in writing.
- Which of these changes is the most confusing for you?
- What would be most useful to sort out in the time you have today?
- Tell me which tablets you'd take out of the cupboard tonight.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| sacubitril with valsartan | a new heart tablet that replaces his old blood pressure tablet, perindopril |
| ketoacidosis | a build-up of acids in the blood that can make a person very unwell |
| dose administration aid | a pack with his tablets sorted by day and time, prepared by the pharmacy |
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
- Demanding antibiotics for a sore throat Community pharmacy
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- Stopping metformin because of stomach upset Community pharmacy
All sets: nurses, doctors, other professions. Your profession's guide: OET Pharmacy.
Questions about this role-play
How do I explain sick days without alarming her?
Give one rule: if he is vomiting, has diarrhoea or can't eat and drink normally, pause dapagliflozin and get advice promptly. Explain he needs an individual plan for his other heart medicines and for restarting, so she shouldn't decide those herself.
Why should she act on ketoacidosis signs if his glucose reading is not high?
The action plan says to stop dapagliflozin and get urgent medical help for those signs even when blood glucose is not high. So she should not wait for or rely on a glucose check before acting.
What do I say about painkillers, since ibuprofen is stopping?
Say he should not take anti-inflammatory painkillers, including ones bought without a prescription. Ask what he uses for pain, and ask her to check with you or his doctor before buying any painkiller for him.
Sources
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