The candidate card
Setting
Surgical ward
Candidate
You are a physiotherapist. Mr Oluwaseun Ekwueme, aged 63, had open surgery yesterday to remove part of his large bowel. He is an ex-smoker, and on your assessment he is taking shallow breaths with reduced air entry at the bases of both lungs. He has refused to do his deep breathing exercises or sit out of bed because his wound hurts.
Task (interlocutor: patient)
- Find out about Mr Ekwueme's pain, how he is using his pain relief and what is stopping him from moving and breathing deeply
- Explain why deep breathing, coughing and getting out of bed early are important after his operation (risk of chest infection, ex-smoker)
- Demonstrate and explain how to support his wound when coughing and moving (pillow or folded towel)
- Reassure him about his concerns and persuade him to try the exercises
- Agree a plan, including asking the nursing staff to review how he is feeling and to time his pain relief before he gets out of bed again
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 with pain, not breathing: where it hurts, how severe it is, what pain relief he has had and when, and what happens when he tries to move or breathe deeply. Let him describe it fully before you explain anything.
- Link the exercises to his own situation: his breathing is shallow with reduced air entry at the bases of both lungs, and as an ex-smoker his chest infection risk is higher. Describe it as a risk you want to reduce, not something he has.
- Demonstrate wound support early, with a pillow or folded towel held against the abdomen for coughing and moving, then have him copy you. Showing it before asking for exercises answers the pain barrier he has given you.
- Acknowledge that the pain is real and do not promise it will not hurt. Offer a small trial, a few supported deep breaths and a short sit-up with help, and agree he can tell you to stop if it is too much.
- Close with who does what: you will ask the nursing staff to review how he feels and to time his pain relief before he next gets out of bed. Typical error: stressing risks without treating pain as the barrier.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Tell me what happens when you try to take a deep breath.
- I won't ask you to do anything that I haven't shown you first.
- We'll start small, and you can tell me to stop.
- I'll ask the nurses to look at your pain relief before we try again.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| reduced air entry | air isn't reaching the bottom of your lungs as well as it should |
| splinting the wound | holding a pillow firmly over your wound to support it when you cough or move |
| mobilise | get moving, such as sitting out of bed and walking |
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
- Falls at home - keep Dad in a wheelchair? Home visit
- Walking the day after hip fracture surgery Hospital orthopaedic ward
- Knee pain in a young footballer Physiotherapy clinic
All sets: nurses, doctors, other professions. Your profession's guide: OET Physiotherapy.
Questions about this role-play
What if he still refuses after my explanation?
Don't push through his pain. Agree a smaller step, such as practising supported coughing in bed first, and revisit after nursing staff have reviewed his pain relief. Record what he declined and what you explained, and tell the nursing team.
How much should I say about chest infection?
Keep it to a sentence or two: his breathing is shallow with reduced air entry at the lung bases, and deep breathing, coughing and moving reduce the chance of a chest infection. He needs the reason, not a frightening list of complications.
Should I advise him about his pain medication?
Ask what he has had and how he uses it, but leave changes to the nursing and medical team. Tell him you will pass on the request to review his comfort and time pain relief before getting up, then follow through.
Sources
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