The candidate card
Setting
Hospital ward, stroke rehabilitation unit
Candidate
You are a speech pathologist. Mr Bongani Andreou, aged 78, had a stroke ten days ago. A videofluoroscopic swallow study (a swallowing X-ray) three days ago showed that thin fluids enter his airway without him coughing, so he has been prescribed mildly thick fluids. The nurses report that he has been asking visitors to bring him ordinary tea and has said he will drink what he likes.
Task (interlocutor: patient)
- Find out Mr Andreou's views on his thickened drinks and what he has been drinking (how he feels about them, how much he drinks, visitors bringing tea)
- Explain the results of his swallow X-ray in simple terms (thin drinks going into the airway, why no cough does not mean he is safe, what thickened drinks can and cannot do)
- Respond to his anger and reassure him that the thickened drinks are intended to be reviewed as his swallow recovers
- Discuss ways to make the thickened drinks more acceptable to him
- Agree a plan (drinking enough, drinks from visitors, mouth care, review of his swallowing)
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
- Begin by asking how the thickened drinks feel for him and what he has actually been drinking. The nurses' report is second-hand, so let him tell you without feeling accused of non-compliance.
- Explain the X-ray using what he can picture: thin drinks went toward his airway and he did not cough. Stress that no cough does not mean it was safe, and say thickened drinks help but cannot remove all risk.
- Respond to his anger before defending the plan. Name the loss of control and ordinary pleasures, find out what matters most to him, and tell him the thickness is intended to be reviewed as his swallow recovers.
- Move to what can be changed: flavour, temperature, the type of drink, and what visitors may bring. Offer choices so he regains some control, rather than giving only a list of rules.
- Agree one clear plan in one place: how he will drink enough, what visitors can bring, mouth care and when his swallow will be reviewed. Check he understands and is willing before leaving.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- It sounds frustrating to have your drinks changed. Tell me how it feels.
- The scan showed drinks heading toward your airway, even though you did not cough.
- We will keep reviewing your swallowing and change the drink thickness if it becomes safe to do so.
- Which drinks do you miss most? Let us see what we can do.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| Videofluoroscopic swallow study | A moving X-ray that shows how food and drink travel when you swallow. |
| Airway | The tube to your lungs, which drinks should not enter. |
| Thickened fluids | Drinks made thicker so they move more slowly and are easier to control when swallowing. |
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 Speech Pathology role-play cards
- Preschool stuttering: a father's worry about 'slowing down' Community health centre, paediatric speech pathology clinic
- Speech sound errors and a request to 'cut the tongue-tie' Private paediatric speech pathology clinic
- Parkinson's disease: intensive voice therapy and the time commitment Hospital outpatient speech pathology department
All sets: nurses, doctors, other professions. Your profession's guide: OET Speech Pathology.
Questions about this role-play
How do I explain no cough without frightening him?
Explain calmly that the X-ray showed thin drinks entering his airway without a cough. This can cause a chest infection, and no cough does not make it safe. Thickened drinks may help but cannot remove all risk. Give him this information without alarm or pressure so he can make an informed choice.
Can I allow ordinary tea from visitors?
Not on your own authority; the card says the thickened drinks are the prescription. Explain what visitors can bring and ask whether tea can be made in the thickened form. Do not promise changes before your review.
What if he still refuses?
Explore reasons, offer acceptable alternatives and check he understands the risk, then record the discussion and let the team know. Keep the relationship open and agree a time to revisit. Avoid threats or ultimatums.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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