The candidate card
Setting
Physiotherapy clinic
Candidate
You are a physiotherapist. Mr Murali Easwaran, aged 42, is an office worker who has had low back pain for two weeks. His GP referred him to you after an assessment found no signs of a serious cause, and your own examination today agrees with this. He has told the receptionist that he expected to have an MRI scan first and that he has been resting at home until the pain goes.
Task (interlocutor: patient)
- Find out how the pain is affecting Mr Easwaran's daily life and what he has been doing to manage it
- Explain why a scan is not needed at this stage (no warning signs of a serious problem, scans often show changes that are not causing the pain)
- Persuade him that keeping active is better for recovery than resting in bed
- Explain a graded activity and exercise plan (walking, gentle exercises, breaking up periods of sitting)
- Agree a plan, including a gradual return to work, a review appointment, and warning signs that need emergency help (numbness around the buttocks or genitals, bladder or bowel problems, worsening leg weakness)
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 resting has actually looked like day to day and how the pain affects work, sleep and home life. Ask what he hoped the MRI would show. Listen before you explain, so your reasoning answers his expectation.
- Explain the scan decision in your own words: examination today found no warning signs of a serious problem, and scans often show changes that are not causing the pain. Avoid saying nothing is wrong or that the scan is pointless.
- Persuade with benefit rather than instruction. Credit that resting is an understandable response to pain, then explain that staying active supports recovery better than bed rest. Offer a first step that suits an office worker, such as short walks.
- Make the graded plan specific but short: walking, gentle exercises and regular breaks from sitting, built up gradually and linked to a stepwise return to work. Typical error: a long exercise sheet that overwhelms him.
- Give the emergency signs together and plainly: numbness around the buttocks or genitals, bladder or bowel problems, or worsening leg weakness. Tell him to seek emergency help at once. Agree the review date and ask him to repeat the signs back.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- It makes sense that you've rested, because it hurts. Let's look at what helps recovery.
- What were you hoping the scan would tell you?
- Let's start with one small step you can manage this week.
- Can you tell me which symptoms would mean you need emergency help?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| graded activity | slowly building up what you do, step by step, rather than all at once |
| numbness around the buttocks or genitals | loss of feeling in the area that would touch a bike seat |
| bladder or bowel problems | trouble passing urine or stool, or not being able to control them |
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 Physiotherapy role-play cards
- Physiotherapist: breathing exercises and getting out of bed after open bowel surgery Surgical ward
- Falls at home - keep Dad in a wheelchair? Home visit
- Walking the day after hip fracture surgery Hospital orthopaedic ward
All sets: nurses, doctors, other professions. Your profession's guide: OET Physiotherapy.
Questions about this role-play
What if he still insists on an MRI?
Acknowledge the wish without arguing. Restate that the GP's assessment and your examination found no warning signs, and explain that you will rethink if emergency signs appear or he is not progressing at review. Make clear the question stays open if things change.
How do I talk about rest versus activity without blaming him?
Credit resting as a natural instinct when something hurts, then explain that for this kind of back pain, gradual movement tends to help recovery more than staying in bed. A small, achievable first step makes activity feel doable.
How should I handle the return to work?
Ask what his job demands, then propose a gradual return rather than all-or-nothing, tied to the walking and sitting breaks in his plan. Tell him you will adjust it at the review appointment depending on how he is going.
Sources
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