“Everything is sorted” can sound reassuring while leaving a patient unsure what to do at home. An asthma review needs a more useful ending: the patient understands the personal instructions, any remaining gap is addressed, and both people know who will act next. This OET nursing asthma action-plan role-play teaches you to close a conversation accurately without inventing a medicine schedule or a completed arrangement.
The lesson draws on S15, “Closing and agreeing next steps,” and the C03 asthma demonstration in Jobins Training’s OET Speaking Workbook, matched to OET Speaking for Nurses — Course 44. The workbook’s asthma example explores uncertainty about a device and a personal plan. The original cards and nurse model below develop that theme into a complete practice lesson. They are independent teaching material, not official examination cards or a device demonstration.
1. Your asthma review role-play cards
Nurse role card
Setting: A routine respiratory review in an English primary-care clinic.
Situation: Camila Torres, 33, has established asthma. Her inhaler device changed two weeks ago, and the clinician has reviewed her treatment today. She has brought her current inhaler and personalised action plan. She is comfortable and has no acute breathing difficulty now. Your task is to discuss understanding, technique support and the next steps. The card supplies no medicine name, device type, dose, peak-flow threshold or follow-up date. Use the actual prescribed plan and device instructions in clinical practice; do not create those details for the role-play.
Your five tasks:
- Invite Camila’s main concern, check how she is now and explore her experience with the changed device.
- Clarify what she understands about her own action plan, including routine care and what to do if symptoms worsen.
- Explain why the device and treatment plan need individual instructions; offer a respectful technique check without assuming a particular inhaler method.
- Address practical access to the current plan at home and work, and clarify urgent or emergency help using the personalised instructions.
- Close by naming the agreed actions, who will do them and what must be checked before she leaves; confirm understanding and invite remaining questions.
Patient role card
Setting: The same review. You are Camila.
Situation: You have used inhalers for years and feel embarrassed admitting uncertainty about the new device. You are not sure when to breathe in. You can identify the routine directions on your plan, but you have not understood its worsening-symptom section. A friend has suggested following their instructions because their inhaler looks similar. You want a clear plan for work as well as home. You are not having an asthma attack.
Your five tasks:
- Start by saying you probably know enough because you have used inhalers before. Reveal the uncertain breathing step if the nurse asks respectfully.
- Explain which part of your own plan you understand and which part remains unclear. Do not invent doses or device details.
- Mention the friend’s advice and initially suggest using their instructions if symptoms change. Accept a clear correction and explain the distinction afterwards.
- Ask how to keep the current plan accessible during work. You can read the printed version in this first attempt.
- Agree to have the device technique and unclear plan section reviewed before leaving. Ask who will help and what you should do if any detail remains unresolved.
Practice method: Prepare separately for three minutes and aim for an approximately five-minute conversation. One partner plays Camila; the other speaks as the nurse. Keep the patient’s private uncertainty hidden before the attempt. The aim is to practise the discussion around a real technique check, not to mime an unspecified device or prescribe through a fictional card.
2. Understand asthma and the personal action plan
What happens in asthma?
Asthma is a long-term condition affecting the airways, the tubes carrying air through the lungs. These airways can become inflamed and narrowed, making breathing harder. Symptoms can include wheeze, cough, chest tightness and breathlessness. Their pattern varies, so feeling comfortable during the appointment does not mean the condition has disappeared.
Triggers differ between people and can include smoke, allergens, infections, cold air or exercise. The nurse should ask about the patient’s own pattern instead of assigning every possible trigger to them. Camila’s card does not identify a trigger or say that the new device has worsened her asthma.
Why are treatment instructions individual?
Asthma treatment can use different medicines, devices and regimens. Some plans use separate preventer and reliever inhalers. Others use a suitable combination inhaler as an anti-inflammatory reliever, known as AIR, or as maintenance and reliever therapy, known as MART. AIR-only and MART instructions differ even when the type of medicine is similar.
A MART plan includes regular maintenance use as well as use for symptoms; an AIR-only plan uses the prescribed combination inhaler as needed for symptoms. Not every combination inhaler is suitable for these approaches. The clinician must identify the actual medicine, device and prescribed instructions. Appearance or colour is not enough to reconstruct a plan.
For this exercise, do not decide which regimen Camila has. That information is deliberately absent. Your useful response is to check the current prescription and plan, then explain the directions that genuinely apply. This is a communication boundary, not a reason to abandon the patient’s question.
What is an asthma action plan for?
A personalised action plan records how to manage asthma, recognise deterioration and act during an attack. It should match the person’s current treatment. The nurse and patient need to go through it together so the instructions can be used outside the clinic. Simply handing over a document does not show that its meaning is clear.
Camila can identify the routine section but is unsure about the worsening-symptom instructions. That is a specific gap to address. Asking her to read the whole document later would leave the most important uncertainty unresolved at the point when help is available.
Why does inhaler technique matter?
The way an inhaler is prepared and used affects delivery of the medicine. Different devices require different steps and breathing techniques. A method learned for one device may not transfer correctly to another. A clinician or pharmacist can observe the person using the actual device, demonstrate the relevant method and check it again.
Respect existing experience. “You have used inhalers before; let us check this particular one together” recognises Camila’s knowledge while making room for an update. Do not claim you have watched or corrected her technique when the role-play supplies no device demonstration. Describe the next action and use the right resource when the real device is available.
What makes a plan usable at work?
The current plan needs to be easy to find and read. A printed copy, digital copy or clear photograph may help, depending on the person’s preference and access. Replace an older copy when the plan changes. Keeping a document on a phone is useful only if the person can open and read it when needed.
Ask about the work setting without assuming a smartphone is always available. The plan may be readable at home but inaccessible during a shift. The patient can decide whether to share relevant information with someone who could help; do not announce that you will contact their employer or colleagues.
When should symptoms prompt review or emergency action?
Symptoms that are worsening, waking someone at night, limiting usual activity or requiring more reliever use need prompt clinical review. Follow the personal action plan and seek advice from the care team. A routine future review should not be used to postpone help for deteriorating asthma.
An asthma attack can be life-threatening. In this England-based example, sit upright and use the prescribed reliever according to the relevant attack instructions. Call 999 if symptoms worsen at any time, do not improve after the maximum reliever dose specified for the plan, or an inhaler is unavailable during an attack. Do not drive yourself to A&E. The general NHS page linked below distinguishes different inhaler regimens.
No emergency dose is invented here because Camila’s medicine and regimen are not supplied. The clinician must make that part of her actual plan explicit. If someone has severe breathing difficulty or other signs of an emergency, seeking immediate help takes priority over completing this educational conversation.
What should a closing summary preserve?
A closing summary needs the real decision, the action and the person responsible. It should also preserve a relevant condition: for example, the unclear section still needs to be reviewed before departure. “You will follow your current plan, and we will check the unclear instructions together” is different from “You now understand everything.”
The review date, contact route and any pending arrangements must come from the actual clinical information. If one is missing, name the need to confirm it. A truthful incomplete arrangement is safer than a confident invented booking, and it can still lead to a useful next step.
3. Coach the five tasks towards a clear ending
Task 1: Let confidence and uncertainty coexist
Camila’s experience with inhalers is real within the case. Her uncertainty about the new device is also real. Avoid forcing a choice between “experienced” and “needs help.” Ask, “How has using this particular device been?” Then allow enough time for the answer.
Check her present condition before continuing. The supplied case is a routine discussion with no acute breathing difficulty. If the partner introduces a new symptom, clarify it and respond appropriately rather than treating the original plan as permission to ignore the change.
Task 2: Find the exact gap in the plan
Ask what Camila understands and which part she would like to go over. This is more informative than asking “Have you read it?” Reading and applying instructions are different skills. Invite her to describe what she would do if symptoms changed.
If she mentions the friend’s instructions, explore the reason briefly and then correct the conclusion. Her friend may be experienced, but a different prescription cannot define Camila’s treatment. Use that answer to explain why the current personal plan is the reference.
Task 3: Offer a check without making it a test
Ask permission to review the device together and explain the purpose. A useful invitation is, “Would you be comfortable showing the clinician how you use it so the steps can be checked?” This makes the demonstration collaborative.
Do not begin an imagined inhaler tutorial with a universal instruction to shake, load, click or breathe in at a fixed speed. Those details depend on the device. You can still demonstrate good communication by arranging the correct check, asking what remains unclear and confirming the patient can repeat the relevant steps after teaching.
Task 4: Connect instructions with daily circumstances
Ask where the plan will be kept and whether it is usable at work. If Camila chooses a photograph, check readability and currency. If she prefers paper, discuss an accessible place. This turns the instruction “keep a copy” into a plan connected to her day.
Separate the route for a routine question from the response to worsening symptoms or an attack. Do not bury urgent action inside a long closing list. Check the emergency meaning before moving on to practical details.
Task 5: Close with who, what and what remains
Summarise selectively. Camila has agreed to a device check and clarification of her own plan; no medicine change has been decided in this conversation. The nurse’s immediate action is to obtain the relevant review and resolve the uncertainty, not to declare that the demonstration has already happened.
Then ask Camila to explain the next step and raise any remaining question. If a gap appears, return to it. An effective closing may briefly reopen the conversation. Finishing on time is useful, but it should not require pretending a misunderstanding has been resolved.
4. Extended nurse-viewpoint model answer
This expanded model is for study after your first attempt. It is longer than the timed conversation and contains listening pauses. It models how to discuss and arrange the appropriate check; it does not claim to perform a demonstration of an unspecified inhaler or supply a dose.
Hello Camila, I am the nurse going through the next steps after your asthma review. Before we finish today, what would be most useful to clarify about your inhaler or the plan you have brought?
Pause for her statement about experience. You have been using inhalers for some time, so you already bring a lot of experience. How has it been using the device that changed two weeks ago?
Before we go further, how is your breathing at the moment? Have you had any new difficulty since the clinician reviewed you today? I want to make sure this is the right time for a routine explanation.
Listen to the supplied comfortable, non-acute response. Thank you. With this particular device, is there any step that feels less familiar, even if the overall idea of using an inhaler is familiar?
Camila reveals uncertainty about when to breathe in. Thank you for mentioning that. A changed device can involve different steps. You do not need to feel that you should automatically know a method you have not had clearly demonstrated.
Would you be comfortable having the technique checked with your actual inhaler? The aim is to make the steps clear and help the medicine reach where it is needed, rather than to test you.
We need to use the instructions for this device. I would not want to give you a breathing method for a different one. We can arrange for the relevant steps to be demonstrated and then give you a chance to show them back.
Let us also look at your current action plan. Which part feels clear already, and which part would you most like us to go through together?
Listen for routine directions versus worsening symptoms. You can identify the usual instructions, but you are unsure what to do if your symptoms change. That is an important section to clarify before you leave.
Asthma can vary over time. The plan connects your treatment with what to do in different situations, including when symptoms worsen. We need to make sure those instructions are clear for your own medicines.
What had you thought you might do if symptoms became worse? I am asking so I can see whether the plan has explained that clearly enough, rather than expecting you to remember a particular sentence.
Listen for the friend’s advice. Your friend has experience with asthma and wants to help. Their inhaler may look similar, but their treatment instructions may be different. Use your own current plan rather than borrowing their doses or schedule.
Some people have separate inhalers and others use a suitable combination inhaler in different ways. We should check the name, device and prescribed directions together. Colour alone will not tell us everything we need to know.
Could you tell me whose instructions you would use if your symptoms changed? If any part of your own plan is unclear, we should resolve that with the care team rather than fill the gap with someone else’s plan.
Listen for the corrected distinction. Yes, your own plan is the reference. We still need to go through the actual worsening-symptom and attack instructions with you. I am not assuming that knowing which plan to use means every detail is already clear.
If your symptoms start worsening, wake you at night, affect ordinary activities or mean you need your reliever more often, follow the plan and seek prompt advice. Do not wait for a routine future appointment if your asthma is deteriorating.
In an attack, sit upright and use the reliever according to your prescribed attack instructions. If you worsen, do not improve after the plan’s maximum reliever dose, or have no inhaler available during an attack, call 999. The exact medicine instructions must be clear in your plan.
We will make sure you know the difference between contacting the practice for a question and getting emergency help during an attack. Which part of those two routes would you like us to explain more clearly?
Pause and respond to the question raised. You also mentioned wanting the plan at work. What would be the easiest way for you to keep a readable, current copy with you during a shift?
Listen for her preferred format. A clear photograph or digital copy can be useful if you can access it when you need it. We should check that every part is readable and that it is the current version, not an older set of instructions.
Where would you keep the printed copy at home? And is there anyone you would choose to share the relevant information with so they know how to help? That is something we can discuss according to your preferences.
Let me summarise what we have agreed so far. You would like the technique for the changed device checked, and you want the worsening-symptom section of your own plan explained before you leave. Have I captured the two main priorities?
Listen and adjust the summary. My next action is to make sure the appropriate clinician reviews those points with you and that the instructions match the prescribed treatment. Your part is to bring the uncertainty into that review and show which steps remain difficult.
We also need to confirm the follow-up details and the contact route from the actual clinical plan. I do not want to invent a date or tell you that something has been booked when it has not. If anything is pending, we will identify who is checking it and how you will hear back.
Could you talk me through what happens next today, and what you will use as your guide once you are at home or work? That will help me check whether my summary has made the plan clearer.
Listen for the review before departure and use of the personal plan. Thank you. We will not treat an unresolved instruction as something you simply have to work out later. Let us get that clarification and check your understanding after the explanation.
What question have we not yet covered? In particular, is there anything about using the device, finding the plan or getting help that would still be difficult in your usual day?
5. Speaking tips for an accurate closing
Signal the summary without shutting down questions
“Let me check the next steps” gives the patient a clear transition. It also leaves room to correct you. “That is all sorted” can discourage a remaining question. Use a closing phrase that invites verification rather than announcing success.
Keep the summary shorter than the explanation. Select the two or three actions that matter now. Repeating the entire consultation can make the patient lose the immediate priority, especially when they are trying to remember a practical task.
Use verbs that match the status of the action
“Ask,” “request,” “check,” “arrange” and “confirm” do different jobs. Requesting a demonstration is not the same as completing one. Asking for a review slot is not the same as having a confirmed appointment. Choose the verb that matches the information available.
In this case, “We will check the unclear section before you leave” names an intended next action. “You have mastered the plan” claims an outcome that has not been shown. A confident tone should not turn an intention into a completed fact.
Let a check of understanding change the ending
If Camila still plans to use her friend’s advice, the conversation is not ready to close. Correct the specific misunderstanding and ask again in a different way. Do not repeat the same long paragraph and assume that more words will produce a different understanding.
The patient’s answer is useful evidence. “I will use my current plan and get this section clarified now” shows a meaningful distinction. “Yes, yes, I understand” may be polite agreement; ask for an application when the instruction matters.
Practise three honest endings
Try the same conversation with three outcomes: the patient agrees to the check, asks for more information, or declines it for now. Your summary must match the outcome. If the patient declines, explore the reason and explain the relevant concern within your role, but do not announce consent that was never given.
For partner feedback, ask: “Did my closing match what you decided?” and “Did you know what would happen next?” These questions test clarity more directly than asking whether the nurse sounded professional.
6. Useful sentences for next steps
| Purpose | Possible wording |
|---|---|
| Respect experience | “You know inhalers well; let us check what is different about this one.” |
| Locate uncertainty | “Which part would be hardest to use outside the clinic?” |
| Correct a comparison | “Their treatment may differ, so we need your own instructions.” |
| Name a pending action | “That still needs checking before we can confirm it.” |
| Assign responsibility | “I will check the arrangement; you will have the current plan available.” |
| Check the summary | “What will happen next, in your own words?” |
| Invite the last concern | “What would still make this difficult in your normal day?” |
Stress the action and the responsible person: “I will check…” and “You will…” should be easy to hear. Use future tense for an intended action and past tense only for something completed. Small tense errors can change the status of an arrangement.
7. Common mistakes and repairs
Giving one technique for every inhaler. The device is unspecified. Arrange the relevant demonstration and observation using the real device. General communication advice cannot replace its instructions.
Assuming a colour tells you the regimen. Check the medicine name and personal directions. Avoid turning familiarity with one inhaler into a rule for every patient.
Explaining only routine use. Camila’s uncertainty concerns deterioration. Address that section explicitly instead of spending all the time on the part she already understands.
Making the patient solve the gap later. “Read it when you get home” can leave an important instruction unclear. Identify the needed explanation and get it checked before ending the visit.
Claiming the review is complete. A discussion about a demonstration does not mean it has happened. Keep completed and pending actions distinct in your final summary.
Assuming a phone copy is accessible. Ask about readability, access and the work setting. If a format does not work, explore another way to provide the same verified information.
Ending with a promise about outcomes. “You will never have another attack” is not a realistic assurance. Explain how the plan supports management and what action to take if the situation changes.
8. Second attempt: the print is the problem
Change one private concern. Camila is now confident with the device, and the appropriate clinician has checked her technique in the supplied variation. Her difficulty is that the printed action plan is too small to read, and workplace rules mean she cannot access her phone during a shift. She says, “I know how to use the inhaler. I cannot use that sheet at work.” No alternative format has yet been supplied.
Your task: Respond for 60–90 seconds. Clarify the access problem, ask what format would help and agree how to obtain a readable current plan. Close with an accurate statement of what is still pending. Do not repeat a technique lesson when the technique is no longer the barrier.
Open a suggested response and explanation
Possible nurse response: “Thank you for separating those points. The device technique is clear; the problem is reading and accessing the plan at work. Would a larger-print paper copy help, or is there another format that would be easier for you to use?”
“We need the same verified instructions in a format you can read. I will check how we can provide that and go through it with you, especially the worsening-symptom and emergency sections. A phone photograph would not solve the problem if you cannot use your phone during the shift.”
“Let me check the next step: we still need to obtain and review the accessible copy. You can tell us where you would keep it at work so it is available when needed. We should confirm the arrangement before you leave rather than say the problem is already resolved. Does that address the difficulty you meant?”
Why this works: The response recognises the changed concern, checks a preference and preserves the accuracy of the clinical instructions. It does not assume that a new format has already been produced. The closing names the outstanding action and the person responsible for checking it.
Partner review: Did the nurse distinguish technique from access? Did they ask which format would work? Did the summary say what remained to be done? Identify one sentence that made the next step clearer and one that could be shortened.
For a final variation, the current plan is readable but an old photograph contains different instructions. Practise explaining which version must be confirmed with the care team and how the outdated copy will be replaced. Do not ask the learner to choose a dose by comparing two unexplained documents.
Continue with OET Speaking for Nurses — Course 44 for the matching workbook outline. Practise closing with a real decision, a named action and a truthful account of anything still awaiting confirmation.
Clinical reading for this teaching example
Clinical boundaries were checked against NHS asthma guidance, NHLBI’s explanation of asthma, and Asthma + Lung UK’s guidance on personal action plans, device-specific inhaler technique, AIR, MART and completing an action plan. Follow the individual prescription, device instructions and current clinical advice.
Your next step
OET Speaking for Nurses — Course 44
Explore the complete course outline and related practice topics.
Source: OET Speaking Workbook.pdf, Jobins Training. Examples labelled original or illustrative were written for this article. Independent exam preparation; no affiliation with or endorsement by the examining body. Practice does not predict an official score.