The candidate card
Setting
Community pharmacy
Candidate
You are a pharmacist. Mr Mitchell Quarrell, aged 68, has come to the counter asking to buy ibuprofen for lower back pain that started after gardening. Your pharmacy records show he takes warfarin for atrial fibrillation, prescribed by his GP. He says paracetamol 'does nothing' for him.
Task (interlocutor: patient)
- Find out about his back pain and how he has been using paracetamol (and anything else he has taken)
- Explain why ibuprofen is not recommended with warfarin (increased risk of bleeding)
- Respond to his annoyance and encourage safer ways to manage the pain (heat, staying gently active; paracetamol only with care while on warfarin)
- Agree a plan, including when he should contact his GP and which symptoms need emergency or same-day attention
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 the pain before saying no: how it began after gardening, how it limits him. Starting with his problem shows you are trying to help, which matters because he is likely to feel brushed off.
- Ask exactly how he has used paracetamol and what else he has taken, including anything bought without a prescription. Does nothing may mean something else, so check the amount and timing instead of assuming.
- Give the refusal in one short, firm statement linking ibuprofen and warfarin to bleeding risk. Do not imply he made a mistake; he may simply not know that the two do not go together.
- Acknowledge his annoyance directly, then move to what is possible: heat, staying gently active, and paracetamol used carefully while on warfarin. Do not overpromise relief, or he may return to ibuprofen.
- Check warning signs now: new bladder or bowel control problems, numbness around the genitals, worsening leg weakness, black stools or vomiting blood need emergency assessment. Call 000 for sudden severe back or abdominal pain, collapse, heavy bleeding or severe breathlessness. Fever, worsening pain, blood in urine or expanding bruises need same-day medical advice. Arrange GP review if pain persists and ask him to check before any new painkiller.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- I can hear how frustrating this is when you're in pain and the usual tablet isn't helping.
- I'd like to protect you, because your warfarin changes which painkillers are safe.
- Let's go through exactly how you've been taking the paracetamol.
- Would you come back to me before buying any other painkiller?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| warfarin | a blood-thinning tablet that helps prevent clots |
| atrial fibrillation | an irregular heart rhythm |
| ibuprofen | an anti-inflammatory painkiller that can make bleeding more likely when taken with warfarin |
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
- New medicines after hospital discharge Community pharmacy
- Demanding antibiotics for a sore throat Community pharmacy
- Codeine cough syrup request for a toddler Community pharmacy
All sets: nurses, doctors, other professions. Your profession's guide: OET Pharmacy.
Questions about this role-play
What if he says he has taken ibuprofen before without trouble?
Acknowledge that, but explain that taking it with warfarin raises the chance of bleeding, even if nothing happened before. Ask whether he has taken any recently. Keep the message about his safety, not about his past choices.
How do I advise on paracetamol without adding doses?
Check his dose, timing and other products. Use the lowest effective paracetamol dose for the shortest time within the label directions, and avoid doubling up with combination products. Regular use can increase warfarin's effect and bleeding risk. If he needs it for more than a few days, contact his GP or anticoagulation service about pain review and extra INR checks.
What if time runs short?
Prioritise the clear refusal with its reason, one workable alternative, and the warning signs with who to contact. Heat and gentle activity can be covered in a sentence each. Never skip the safety-netting.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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