Interlocutor. OET role play. Setting: Community Health Centre
You are 20 years old and you are concerned because an ear piercing which you had done a week ago has become quite sore. The nurse has just examined your ear. TASK: • When asked, say the pain started about a week ago, just after you had your ear pierced. Say it is about a five out of ten. You haven’t had anything like this before. • Ask how the nurse can be sure the lump isn’t something more serious. • Say if you’ve got an infection, you presume you can just use some antibiotic ointment you have at home. • Say you think you’ll go and see your doctor, just to be sure the lump isn’t something more serious. • Say you’ll wait and see if any more symptoms appear before seeing the doctor. When asked, say the place where you had your ear pierced seemed really clean, but now you’ve got this infection; you don’t know how you got it. • Say you hope it gets better soon; you’ll make an appointment with the doctor only if there’s no improvement in the next week.
Nurse. OET role play. Setting: Community Health Centre
You see a 20-year-old patient who has a recent ear piercing that has become quite sore. You have examined the area around the piercing and can see there is a granuloma (small lump) next to the piercing which, combined with the patient’s symptoms, indicates an infection. TASK: Find out details of ear problem (onset, level of pain, previous occurrences, etc.). Confirm presence of granuloma (small fluid-filled lump: formed of cells to fight infection, no cause for concern, etc.). Stress importance of not removing earring (e.g., hole closes, traps infection, etc.). Give reasons for your clinical opinion (e.g., appearance/how it feels, linked to infection, no other symptoms, etc.) Warn against over-the-counter antibiotic ointments (e.g., risk of skin irritation, slower healing, etc.). Make treatment recommendations (e.g., wash infected area 2-3 times daily with warm salty water, avoid perfumed toiletries; press water-soaked cotton pad against lump, etc). Find out any other patient concerns. Advise patient when to seek further medical attention (no improvement in symptoms, spread of infection, development of other symptoms, e.g., high temperature, increased pain, swelling, redness, pus, etc.) Give possible reasons for infection (e.g., unhygienic equipment, allergic reaction, sensitive skin, etc.)
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Your spouse is suffering from Chronic Obstructive Pulmonary Disease (COPD) and requires continuous oxygen. Mobility is now a problem. You have been caring for your spouse at home for two years but have recently returned to work. The nurse has just completed an assessment of his/her needs and is discussing full-time care options with you. TASK: When asked, say you have recently had to go back to work so are balancing being a carer and working full-time. You have put a fridge and microwave in the bedroom, and leave meals out every day, but you are worried it is not enough. Admit you knew that eventually your spouse would need more round-the-clock support, but you hoped it wouldn’t be so soon. You have no idea what you are going to do now. Say there is no way you can give up work and be a full-time carer as you need the money. Agree that a nursing home is a good option but there is no way your spouse will agree to it. Ask how you will know which nursing home to choose. Say that you will talk to your spouse about the option of a nursing home and let the nurse know what he/she says
Nurse. Role play. Setting: Patient’s Home
You are making a home visit to a patient who is suffering from Chronic Obstructive Pulmonary Disease (COPD) and requires continuous oxygen. Mobility is now a problem. The patient’s spouse has been caring for him/her at home for two years but has recently returned to work. You have just completed an assessment of the patient’s needs and are discussing full-time care options with his/her carer. Task: Find out how the spouse has been managing since your last visit. Reassure the spouse about his/her situation (doing all he/she can, very difficult to care and work full-time, etc.). Explain your assessment of the patient (e.g., needs constant monitoring, round-the-clock assistance, etc.). Outline options (full-time carer or a nursing home). Explore the option of the spouse giving up work again. Explain the benefits of a nursing home (high level of round-the-clock care, experienced staff, etc.). Advise on choosing a nursing home (make a list of requirements, visit different options, speak to staff/residents, etc.). Offer to suggest local nursing homes for consideration.
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You’re 76 years old and were discharged from the hospital six weeks ago following your hip replacement. A community nurse visits to check on your progress, so you tell him/her about the fatigue and the headache you’ve been experiencing. TASK: When asked, say that you are feeling better and walking is easier now. Say you are feeling tired though, as you’ve been sleeping badly the last few nights. Say that you aren’t anxious or stressed, but your face feels a bit painful and you’ve had a headache for a few days. You had a cold last week and your nose is badly blocked, which is disturbing your sleep. Say that your headache is bad, about a seven out of ten, and feels worse when you lean forward. You don’t have a fever, but you’re eating less as chewing hurts and you’ve lost your sense of taste. Say you’ll do what the nurse has suggested, but you think you need to see a GP. Say you will try the nurse’s suggestions and see a GP if there’s no improvement.
Nurse. Role play. Setting: Home visit.
You visit a 76-year-old patient to check on his/her progress following hospital discharge six weeks ago after undergoing a right hip replacement. During your visit, the patient reports some symptoms suggestive of sinusitis (fatigue, headache). Tasks: Confirm reason for visit (check-up following right hip replacement). Find out how patient is feeling. Explore possible reasons for patient’s poor sleep (anxiety, stress, pain, etc.). Find out more about patient’s symptoms (severity of headache, if worse when moving, any fever, change in appetite, loss of sense of taste, etc.). Explain symptoms suggest acute sinusitis (inflammation of sinus linings at back of nose). Reassure patient (e.g., condition usually self-resolving, not serious, etc.). Recommend self-help treatments (e.g., high fluid intake to loosen secretions, gentle nose blowing, head elevation when lying down, etc.). Stress needs to see GP only if no improvement in one week (e.g., GP to prescribe appropriate treatment, rule out other conditions, etc.). Stress likely effectiveness of self-help treatments.
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You are 44 years old and in hospital following medical assessments for fainting (syncope). The assessments indicate postural hypotension as the cause. The nurse is explaining the discharge plan with you and reviewing the instructions for you to monitor your blood pressure when you return home. You express concern about being sent home. TASK: • When asked, say you are feeling anxious about going home; you think it might be too soon. • Say the doctor explained when and how to monitor your blood pressure, but you can’t really remember what he said. • Agree to follow the instructions and document the readings. Ask what you need to do if you get any abnormal readings. • Say you live with your spouse, who will be looking after you, and other family live close by. • Say that you will attend the review appointment in one week’s time and bring the readings with you.
Nurse. Role play. SETTING: Hospital
Your patient is 44 years old and preparing for discharge following medical assessments for syncope (fainting). Preliminary tests indicate postural hypotension as the cause. You are discussing the discharge plan and reviewing instructions for the patient to monitor his/her blood pressure (BP) at home. TASK: Explain reason for seeing patient (discharge discussion). Find out how patient is feeling about going home. Reassure the patient about the discharge decision, emphasizing that it was made by a multidisciplinary team and is dependent on a satisfactory assessment with no danger to their health. Explain how to take blood pressure readings (twice daily, at the same time, for one week, and document readings). Advise patient to contact doctor if he/she has any concerns about readings. Find out about support patient has at home (family, friends, neighbours, etc.). Reaffirm importance of support network (e.g., family, neighbours, GP, etc.). Advise need for review appointment in one week’s time (check BP, look at readings, discuss any issues/concerns, etc.).
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Patient. Role play. Setting: Community Health Centre Patient:
You are accompanying your father who is 74 years old and suffering from Alzheimer’s disease for 4 years. You have got a new job in the next state and you need to go as early as possible. There is no one to take care of your father in your absence. You need assistance from the Community Health Nurse to take care of him. Task: • Explain your father’s condition and your worries. • Ask if she could do anything for you.
NURSE. Role play. Setting: Community Health Centre Patient:
A man has brought his 74-year-old father who is an Alzheimer’s patient for 4 years. He wants you to take care of him or else find out a suitable person who can look after his father when he is away for his job in the other state. Task: • Explain the rules and regulations of the Community Health Centre. • Assure him to find someone who can do this for him as early as possible. • Enquire about the routines of his father. • Ask if there is any particular matter which needs to give extra attention about.
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You are a 25-year-old apprentice who has a pilonidal sinus (cyst) scheduled for excision next week. You have quite a bit of pain, but you are embarrassed. You have seen the doctor, and you are discussing your treatment and preoperative documents with the nurse. TASK: Tell the nurse you feel weak because of this ailment but need painkillers more often than you take them. Emphasise how embarrassed you are and ask if you can still find out what a pilonidal sinus is since you didn’t pay attention when the doctor explained it. Argue that you are very clean and due to your work, you shower in the morning and have a bath at night. Ask what you need to do after the procedure. • Reassure the nurse that you will follow the doctor/nursing staff’s advice when in the hospital and adhere to the medication regime, rather than suffer pain.
NURSE. Role play. SETTING: General Practice
You are preparing a 25-year-old apprentice for excision of a pilonidal sinus (cyst) next week. The patient is in pain but is embarrassed about the problem and thinks taking medication to alleviate pain is a sign of weakness. You are discussing treatment and preoperative documents, following the doctor’s appointment. TASK: Express concern that the patient has pain and views taking analgesics as a “weakness.” Assure the patient that you understand the embarrassment, but doctors and nurses are used to a huge range of medical issues. Explain that a pilonidal sinus is a small opening, a tract on the surface of the skin predominantly caused by an ingrown hair, exacerbated by sweat and prolonged sitting. Reassure the patient that you were not indicating that he/she is dirty, and salt baths post-operatively will help facilitate healing. Provide information on post-operative care (e.g., bleeding, signs of infection, importance of taking analgesia appropriately, use of antiseptic dressings, etc.).
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SETTING: Hospital Ward NURSE: ‘You see a 40-year-old patient who had a urinary catheter inserted following a hernia repair. He/she had the catheter removed six hours ago and you are monitoring his/her bladder function.
TASK: § Find out how the patient is feeling (any pain, whether passed urine, etc.). § Find out more details about the pain (onset, treatment tried, etc.). Explore the patient’s hydration (quantity, time of last drink, etc.). § Explain the purpose of the trial without catheter (e.g., ensure bladder function restored, etc.), and trial failure (no urine passed in six hours). Outline next steps (re-insert catheter, discharge with catheter bag, retrial within one week). § Warn the patient of possible risks of not re-inserting the catheter (e.g., urinary retention, infection, etc.). § Give details of catheter management (ease of emptying catheter bag, community nursing support available, etc.). Establish patient consent for catheter reinsertion. § Inform the patient of timescale for returning to hospital (within 1 week to remove the catheter, then repeat trial without catheter) and advise him/her to return sooner if he/she is worried (increasing pain, etc.).
Model answer
Nurse: Hi John, I am Matthew, one of the registered nurses, working in this hospital ward. How are you feeling?
Patient: I am okay nurse, thanks.
Nurse: I am glad to hear that. From your records, I understand that you underwent a hernia repair, and presently your bladder function is being monitored without the aid of a catheter. Is that correct?
Patient: Yes, that’s correct.
Nurse: Okay. Before we proceed any further, I would like to ask you a few questions for documentation purposes. Is that alright?
Patient: Yes, sure.
Nurse: Thanks. I would like to know how you are feeling overall.
Patient: I am okay.
Nurse: Do you experience any pain?
Patient: Yes, I have a little pain in my abdomen area, but it is manageable. I don’t worry about it.
Nurse: Have you passed urine after the catheter removal?
Patient: No, I haven’t.
Nurse: Okay, when exactly did the pain start?
Patient: I think it started after the catheter was removed.
Nurse: Have you taken any pain medication?
Patient: No, I haven’t.
Nurse: Okay. Now, I would like to know about your fluid intake. Have you been drinking enough water?
Patient: Yes.
Nurse: When did you last drink water?
Patient: I’ve been drinking every hour.
Nurse: How much water have you been drinking?
Patient: Two glasses each time.
Nurse: That’s good.
Patient: I was hoping to be discharged as the catheter was removed.
Nurse: I understand John. Let me explain to you what’s going on. We’ve been checking your bladder function without the help of a catheter to see if your bladder function is fully restored. Unfortunately, the trial is a failure as you’ve not passed urine in the past six hours.
Patient: Okay.
Nurse: John, I know that it might sound frustrating; however, we need to make sure that your bladder function is fully restored; therefore, we need to re-insert the catheter.
Patient: I really don’t want the catheter to be reinserted. I hate it. There must be another way.
Nurse: I totally understand it John. However, please try to understand the situation. Let me explain to you the next steps. We will re-insert the catheter and discharge you with a catheter bag. You take rest at home, and in a week’s time, we will redo the trial. We hope that by that time, everything will be functioning fully. What do you think, can we proceed with that?
Patient: Actually, I hate the idea of wearing a catheter bag. Moreover, I don’t even know how to empty the bag.
Nurse: I understand. This indeed is not a pleasant situation. However, we must consider the risks that are involved if we don’t re-insert the catheter. For example, if we do not re-insert the catheter now, in worst-case scenarios, it could lead to urinary retention, urinal infection, and so on. Therefore, I would recommend you comply with the procedure for now as to avoid further complications.
Patient: Fine, I will do it; let me just go home after you re-insert the catheter. By the way, when exactly do I have to be back to the hospital?
Nurse: Thanks, John, for your agreement in this matter. Like I mentioned earlier, within one week, let’s say in 5-6 days, you can come back to the hospital for the retrial. However, please note that you can return to the hospital sooner in case if you feel any sort of abnormal or increased pain. How does that sound?
Patient: Sounds okay to me. I will be careful and monitor my pain. I really hope to get the catheter removed as soon as possible.
Nurse: We desire the same for you, John. Do you have any other questions or doubts that you would like to ask me?
Patient: No.
Nurse: To summarize our conversation, you’re currently under a catheter trial after undergoing a hernia repair. As you were not able to pass urine even after six hours of removal of the catheter, we will discharge you after re-insertion of the catheter and redo the trial within a week. Please remember to return immediately to the hospital if you feel any sort of elevated pain. I also recommend you stay hydrated at home as it would help your bladder function. Please drink plenty of water every hour. Do you understand everything I have explained, John?
Patient: Yes, nurse.
Nurse: Wonderful. Do I have your permission to re-insert the catheter?
Patient: Yes, you may.
Nurse: Thank you, John.
We hope that this model role play has aided your OET speaking skill. We’ve incorporated all 9 speaking criteria in this model role play. If you have doubts, please write in the comments section. For training, kindly get in touch with us. Thank you!
You are a 52-year-old working long hours in customer service. You are tired and have been experiencing aching feet. Sometimes you have numbness and tingling, which is worse at night. You are worried because your uncle has Multiple Sclerosis and your aunt has Parkinson’s disease. TASK: •Tell the nurse that you are very tired, you suffer from symptoms in the feet, your memory is not too good, and when you are stressed, your hands shake. •Explain that your work is stressful, moves at a frantic pace, and you have dozens of things to remember but don’t write them down. What can be done? •Accept that perhaps stress is causing your symptoms. •Agree to a referral to a podiatrist and seek advice from a doctor. •Reluctantly express the ‘real’ reason you are here – you are extremely ‘paranoid’ about the chance that you may have a neurological disease because of your family history.
NURSE. Role play. Setting: Private Clinic
You are attending to a 52-year-old who works long hours in customer service. The patient complains of being tired and has been experiencing aching feet. Sometimes he/she has numbness and tingling, which is worse at night. The patient admits to being ‘paranoid as his/her uncle has Multiple Sclerosis and his/her aunt has Parkinson’s disease. TASK: •Explain that working long hours and stress may produce symptoms such as tiredness and poor memory. •Suggest initial steps to improve sore feet issues (e.g., comfortable shoes, orthopaedic shoes; compression stockings, etc.). •Emphasise that you think the patient may be putting too much stress on him/herself. •Recommend a visit to a podiatrist. •Advise the patient to arrange a medical appointment. •Highlight the importance of not self-diagnosing and thinking the worst.
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You are 60 years old and are going to have an operation on your knee this week. You have been told you need to have MRSA (methicillin-resistant Staphylococcus aureus) screening. You attend an appointment for a preoperative assessment and ask for more information about the screening. TASK: •When asked, say you have been told that you need to get tested for MRSA, but you don’t really understand why it is necessary. •Say the reason for the MRSA screening is clear now but you’d like to know more about what the screening involves. •Ask what will happen if the test confirms that you have the bacteria. •Say even if your test is negative now, you are worried you might pick up the bacteria in hospital, and then won’t be able to have the operation. •Say everything is a lot clearer now; you are okay to have the screening.
NURSE. Role play. Setting: Pre-Surgery Clinic
You see a 60-year-old patient who is going to have an operation on his/her knee this week. He/she attends the clinic for a preoperative assessment and wants more information about the MRSA (methicillin-resistant Staphylococcus aureus) screening. TASK: •Confirm reason for patient’s appointment (preoperative assessment before knee operation). Find out if patient has any questions. •Give information about MRSA (e.g., common skin/nasal bacteria, resistant to antibiotics, harmless to healthy people, causes complications for surgery/recovery, etc.). Describe purpose of MRSA screening (e.g., infection control in hospitals, etc.). •Outline procedure for MRSA screening (e.g., swabs from nose/groin, sent to laboratory for testing, results within a few days, etc.). Find out any other concerns. •Explain next steps if result is positive (e.g., prescription for antiseptic body wash, extra hygiene measures, ointment for nostrils: five days, retest, etc.). •Reassure patient about precautionary measures to prevent spread of bacteria (strict cleaning regime, e.g.,antibacterial hand-wash, sterilisation of equipment, monitoring of facilities, etc.). Establish patient’s consent to have screening.
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You are the parent of a 4-year-old girl who has a suspected bladder infection, which she gets frequently. The doctor has requested a urine sample, and you see the nurse to get a sample bottle and to check the procedure for getting the urine sample. TASK: •When asked, say you need to get a urine sample for your daughter, who’s only four. Say you want to check that you just need to get her to pee into a container and then collect the sample from that. •Say you’ll follow the nurse’s instructions. Ask how quickly you need to bring the urine sample to the clinic. •Say your daughter keeps getting bladder infections, and you don’t think this problem will be resolved soon. •Say the doctor gave you lots of advice, for example, about hygiene, which you have been following. Admit it’s really difficult to get your daughter to drink anything, and she doesn’t like using the toilet at nursery. •Say that you are glad it is just a phase, and you’ll get the sample done as quickly as you can.
NURSE. Role play. SETTING: City Clinic
You see the parent of a 4-year-old girl who has a suspected urinary tract infection (UTI), which she gets frequently. You give the parent a sample bottle and advice on the procedure for collecting a urine sample, which the doctor has requested. TASK Find out the reason for the parent’s request to see you. Outline the urine collection process (e.g., get girl to drink water to fill bladder, collect mid-stream, use sterile sample bottle, etc.). Stress importance of not contaminating the sample (e.g., unreliable test results, cause of bladder infections not identified, etc.). Outline the next steps after sample collection (taken to the clinic within 12 hours, initial dipstick test, full lab analysis if needed, etc.) Give information about bladder infections in children (e.g., common, caused by reluctance to pee/lack of hydration, etc.). Establish what advice the doctor gave the parent (hygiene, cotton underwear, unscented/unperfumed products, etc.). Reassure the parent about child not using the toilet at nursery (e.g., common phase, will grow out of it as she gets used to the teachers, etc.). Give advice on hydration (e.g., fruit, ice blocks, etc.)
Nurse: Hi, I am John, one of the registered nurses working here in this clinic. How can I help you today?
Patient: Hi John. I am Sheena. Um, I’m actually here for my daughter, and she is suspected of suffering from a urinary tract infection.
Nurse: I’m so sorry to hear that.
Patient: It’s okay. Actually, the doctor has requested us to get a urine sample, so I’m here to collect a sample bottle in order to collect her urine sample. Would you help me with that?
Nurse: Certainly. But before we proceed any further, I’d like to collect some information for documentation purposes. Is that all right?
Patient: Sure.
Nurse: How old is your daughter?
Patient: She is four.
Nurse: And do you know how to collect this urine sample?
Patient: Yeah, I guess so. Is there anything that I should do extra? I thought I just had to get my daughter to pee, collect the sample, and bring it to the lab. Am I thinking correctly?
Nurse: Yes, you are right. However, let me explain to you the proper procedure so that you can do it accurately. May I?
Patient: Sure.
Nurse: Please make sure that your daughter drinks plenty of water first.
Patient: Okay.
Nurse: When she pees, do not collect the sample immediately, but wait for a few seconds and collect the midstream urine so that you get a proper sample. Do you understand?
Patient: Oh, okay. That makes sense.
Nurse: And please make sure that the sample does not get contaminated by any means. If it gets contaminated, it would result in unreliable test results, and the doctors may not be able to identify the exact reason for the infection or pinpoint the proper cause. Do you understand?
Patient: Yeah, I’ll make sure that the sample is not contaminated. You know, I get frustrated at times; my daughter keeps getting this infection. I don’t know why, and I don’t know how long I have to keep bringing her to the hospital and so on.
Nurse: I certainly understand your concern, but don’t worry. This is just a phase in her life. It is quite common with children, particularly children of your daughter’s age.
Patient: Uh-huh, okay.
Nurse: So, has the doctor given you any advice regarding how to manage this condition?
Patient: Actually, the doctor has told me a lot of things. I recollect him talking about the importance of following hygiene and so on.
Nurse: Yes, hygiene plays a vital role here, particularly in this condition. Please also make sure that your daughter wears cotton underwear. Moreover, she should avoid scented and perfumed products. Do you understand?
Patient: Yes, I do understand. Thanks for that. One more thing, I really can’t get her to drink water. She doesn’t like drinking water, and she does not like using the toilets at nursery. I don’t know what to do.
Nurse: I totally understand your concern, but do not worry. This is just a common phase and is quite common among children of this age. Your daughter will just grow out of it. Do you understand?
Patient: Oh, okay. That’s a good thing, and I’m relieved to hear that it’s just a phase.
Nurse: Yes, definitely. I can give you a few tips to improve her hydration. If she does not like drinking water, you can introduce fruits and even ice blocks to her. In that way, somehow, she’ll get water into her system. How does that sound?
Patient: That sounds brilliant! I can definitely do that.
Nurse: Okay. Is there anything else that you would like to ask me?
Patient: No, I’ll just get the bottle, collect the sample, and bring it back to you as soon as possible. Thank you so much for listening to my concern and explaining all these things. I appreciate it.
Nurse: You’re welcome. I’ll provide you with a sample bottle, and you can bring it within 12 hours. Please remember not to collect the urine immediately but to collect the midstream urine. We will start with a dipstick test and may also go for a full lab analysis. Please remember, this is just a phase in your daughter’s life, and she will grow out of it. Make sure that she follows proper hygienic practices and wears cotton underwear, avoiding scented and perfumed products. Okay?
Patient: All right, thank you.
Nurse: So, I’ll see you next time.
Patient: Thank you.
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