Background: Simulated Patient (SP) is defined as a layperson that simulates to portray the role of a patient with health-related conditions. International Medical University (IMU) has been utilizing SP for more than 10 years, however, the SP's experience toward the SP-based simulation session yet to be explored, the aim of the study was to explore the SP's experience toward the SP-based simulation session. Methods: Total of 6 participants recruited for a focused group interview, with the inclusive criteria of participated at least an SP-based simulation session. The interviewer used a list of guide question to explore both the positive and negative experience of the SP-based simulation session. A combination of manual and computer software Program was used for data management and analysis. Manual transcribing and coding technique was used for data analysis, while Qualitative Data Analysis (QDA) was used for data management and additional analysis. Results: Three main themes and eleven sub-themes have emerged. The first theme was Effective learning session, with the sub-themes of Student learning attitude, Treated as real patient, Standardization among lecturer, Appropriate respond to student and Focused learning outcome; second theme was Motivation, with the sub-themes of Respect, Feedback, and Caring; the third theme was Preparation prior to class, with the sub-themes of Clear instruction, Role-play, and Script. Conclusions: SPs perceived that lecturers should pay attention to the students’ learning outcome and fully utilize SPs for teaching. Besides that, SPs wished to be treated as a real patient due to the lecturer who treated the SPs as they are real patient gave students a mind-set that the learners were actually dealing with a patient with real conditions. SPs supposed that another role of the lecturer was well-prepared the SPs prior to the actual sessions. SPs expressed that students who took the session seriously, well-preparation before the classes, active participation during the sessions and proactive attitude encouraged realistic portrayal of the character. While SP role was memorizing a series of information needed for the scenario, prepare mentally for portrayal certain emotional as well as physical symptoms. Lecturer, SP as well as student influence a successful SP-based simulation session.

BACKGROUND Simulated patient (SP) is defined as a trained individual who portrays the role of a patient with various health associated conditions. The term SP also refers to a healthy individual trained to portray a patient. Another definition has described SP as a layperson who simulates as a real patient based on differing levels of training (1-3). Combining these descriptions, SP can be defined as a layperson who simulates to portray the role of a patient with healthrelated conditions based on varying levels of training. SP can be interchangeably used with role player, trained patient, patient instructor, and actor-patient. SP can also play a variety of roles along the educational path for To cite this article: Goh L-K, Yee B-L. Experience towards simulated patient-based simulation session: an integrative literature review.

Introduction: Many universities have been utilizing simulated patient (SP) programme for more than a decade for teaching sessions and simulation activities as well as Objective Structured Clinical Examination (OSCE), however the pre-clinical year medical student's experience toward the SP encounter yet to be explored. The aim of the study was to explore the pre-clinical year medical student's experience towards the SP-based simulation session. Methods: Total of 6 participants were recruited for a focused group interview, with the inclusive criteria of minimum enrolled into the medical program for more than a year. The interviewer used a list of guide question to explore both the positive and negative SP encounter experience during teaching and learning session as well as OSCE. A combination of manual and computer software Program was used for data management and analysis. Results: Three main themes and eight sub-themes have emerged. The first theme was Simulated patient as an effective learning tool, with the sub-themes of SP attitude and realism; second theme was Fairness, with the sub-themes of Appropriateness respond to student, Calibration of SP performance and Consistency; the third theme was Feedback from Simulated patient, with the sub-themes of Feedback on student's skill, Feedback on student social intelligence and Poor feedback skill. Conclusion: Student perceived that SP was proved as an effective learning tool only if the SP was able to portray a real patient role as well as able to demonstrate effective feedback skill. Moreover, standardization of the SP role portrayal and SP feedback influenced the fairness along the students' journey, especially during OSCE. Training SP for both realistic portrayals of the character and feedback is essential to optimize an SPbased simulation session.