In recent years, language researchers and teachers have attempted to put meaningful communication at the centre of learners' classroom interactions. Yet the majority of existing computer-assisted language learning (CALL) applications have relied on largely non-communicative learner-computer interactions. The challenge facing CALL developers, therefore, is to explore new ways of providing learners with communicative practice. This article reviews existing uses of automatic speech recognition in second and foreign language teaching and describes the development of an innovative interactive automatic speech recognition system for developing second language speaking skills. This system uses video clips and the EduSpeak speech recognition system to simulate a nurse-patient interview. The system allows learners (for example, health care professionals whose first language is not English) to ask questions to an English-speaking patient and to receive both meaningful responses from the patient and feedback about their own pronunciation accuracy from the speech recognizer. (Contains 2 figures.)