Association For Medical Education Research Articles

Reflexivity in pharmacy practice qualitative research: systematic review of twelve peer-reviewed journals

Abstract Introduction Reflexivity is named as an important component for establishing trustworthiness and authenticity within qualitative research. Depending on the philosophical stance of the researcher, subjectivity is often intertwined with qualitative research, thus engagement in reflexivity accounts for how this subjectivity shapes the study and aids to increase its rigor. Walsh’s typology[1] proposed personal, interpersonal, methodological, and contextual dimensions of reflexivity, which are overlapping and interacting, and was endorsed by the International Association for Medical Education (AMEE).[2] As pharmacy professionals conducting research, we bring many aspects (personal and professional experiences, beliefs, values) that can help us develop deeper and richer insights into our work; if not considered through reflexivity, this may have unrealised impacts which can bring the findings under scrutiny. Aim This systematic review aimed to explore reflexivity reporting, type, and strategies in qualitative studies published in peer-reviewed pharmacy journals. Methods Two reviewers screened twelve pharmacy related peer-reviewed journals from inception to 1st August 2023 for qualitative studies; these were identified as the ‘top’ pharmacy practice journals in JANE (Journal/Author Name Estimator). Then, studies were independently reviewed against inclusion criteria. Any disagreements were discussed to reach a consensus. Qualitative studies discussing reflexivity, having dedicated reflexivity sections in the manuscript, or providing quality checklists with reflexivity were included. Quantitative, mixed methods, and educational research studies were excluded. Two reviewers completed data extraction: reflexivity methods, where discussed in the paper and to what extent, and type of reflexivity as per Walsh’s typology to determine the dimension of reflexivity.[1] Data were synthesised narratively. Quality appraisal of study conduct was not completed and all eligible papers were included. Results 452 qualitative studies were reviewed and 102 were included from seven journals. Thirty-four studies provided quality checklists and 18 had personal (n=10), interpersonal (n=2), methodological (n=1), or multi-type (n=5) reflexivity. In the remaining 68 articles, reflexivity was personal (n=20), interpersonal (n=3), methodological (n=16), multi-type (n=28), or unclear (n=1). Where reflexivity was presented, it was mostly reported in the manuscript’s methods section or within limitations sections of discussions; some had reflexivity named sections. However, reviewed studies lacked true reflexive comments, and often descriptions of research team backgrounds were provided without consideration of the impact on the study, or the focus was on minimising study bias. Twelve studies alluded to the use of reflexive diaries, journals, or note sheets but lacked detail in how they were implemented. Conclusion This is the first systematic review, to our best knowledge, focused on reflexivity reporting in pharmacy practice qualitative studies. It highlighted that reflexivity reporting was poor, often misunderstood, and use of the quality checklist did not increase appropriate reporting. Reflexivity was often described as something researchers ‘did’ to minimise bias, rather than something to embrace and explore as part of qualitative research process. We posit that this could be due to a lack of understanding of what true reflexivity is, unclear quality checklist instructions and limited potential to include it meaningfully in the final manuscript. The review was limited to twelve pharmacy practice journals and articles published in English.

Anatomy education during COVID-19 era: Evaluation of an anatomy blended course for medical students.

The COVID-19 pandemic has prompted a need to change traditional teaching methods. This study was conducted to evaluate the educational quality of a blended anatomy course and measure student satisfaction and knowledge after completing the course. Tyler's model was used to develop a new blended curriculum. The study guide for this curriculum was also developed using Association for Medical Education in Europe guide no. 16. A quasi-experimental study compared educational quality, students' satisfaction, and students' satisfaction using Students' Evaluations of Educational Quality (SEEQ), Borim Nejad's satisfaction survey, and multiple choice questions, respectively. Independent t-tests and Chi-square were used to compare the groups. A total of 122 students participated in this study, 62 and 60 in the intervention and control groups, respectively. The satisfaction score was significantly higher in the intervention group than in the control group (40.6 versus 38.6, P value = 0.03). The score of SEEQ was not significantly different (91.9 versus 91.08, P value = 0.52), but the subscales of learning (17.23 versus 16.32, P = 0.01), group interaction (16.87 versus 18.1, P = 0.01), and breadth (17.73 versus 16.65, P = 0.02) were significant. The knowledge score was also significantly higher in the intervention group than in the control group (18.13 versus 16.68, P value < 0.001). Using blended learning approaches for anatomy courses can increase students' satisfaction, improve the learning and breadth of educational quality subscales, but worsen group interaction. Although this study shows improvement in medical students' knowledge, further studies are needed because of the limitations of this study.

AMEE Faculty Development Committee internship: A collage of social learning experiences

An internship with the Association for Medical Education in Europe (AMEE) Faculty Development (FacDev) Committee has proven to be a useful approach to engaging and supporting emerging faculty developers through social learning and communities of practice. An essential aspect of this internship process is to expand the membership of the faculty development team, fostering the individual and collective capabilities required to navigate the complexity of implementing AMEE faculty development goals.

Validation of the newly developed Advanced Practice Nurse Task Questionnaire: A national survey.

To describe psychometric validation of the newly developed Advanced Practice Nurse Task Questionnaire. Cross-sectional quantitative study. The development of the questionnaire followed an adapted version of the seven steps described in the guide by the Association for Medical Education in Europe. A nationwide online survey tested the construct and structural validity and internal consistency using an exploratory factor analysis, Cronbach's alpha coefficient and a Kruskal-Wallis test to compare the hypotheses. We received 222 questionnaires between January and September 2020. The factor analysis produced a seven-factor solution as suggested in Hamric's model. However, not all item loadings aligned with the framework's competencies. Cronbach's alpha of factors ranged between .795 and .879. The analysis confirmed the construct validity of the Advanced Practice Nurse Task Questionnaire. The tool was able to discriminate the competencies of guidance and coaching, direct clinical practice and leadership across the three advanced practice nurse roles clinical nurse specialist, nurse practitioner or blended role. A precise assessment of advanced practice nurse tasks is crucial in clinical practice and in research as it may be a basis for further refinement, implementation and evaluation of roles. The Advanced Practice Nurse Task Questionnaire is the first valid tool to assess tasks according to Hamric's model of competencies independently of the role or the setting. Additionally, it distinguishes the most common advanced practice nurse roles according to the degree of tasks in direct clinical practice and leadership. The tool may be applied in various countries, independent of the degree of implementation and understanding of advanced nursing practice. The STARD 2015 guideline was used to report the study. No patient or public contribution.

Integration of planetary health in undergraduate and postgraduate medical education: protocol for a scoping review

IntroductionDespite climate change being recognised as the greatest health threat of the 21st century, current medical education curricula do not reflect the urgency of the climate crisis. Preparing for climate-related...

Perception of Pharmacy Teachers About Their Roles and Current Practice at Governmental Universities in Sudan.

BackgroundPharmacy educator has a number of roles and responsibilities, an information provider, clinical trainer, role model on-the-job, formal teaching settings, course planner and resource material creator, student assessor, and curriculum evaluator.ObjectiveThis study aimed to assess the perception and commitment of pharmacy teachers in Sudanese governmental universities about their roles and educational responsibilities.Materials and MethodsDescriptive cross-sectional study was conducted at governmental pharmacy colleges in Sudan from November 2020 to July 2021. Data were collected using an online self-administered questionnaire adapted from the Association for Medical Education in Europe (AMEE) Guide No. 20. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 26 and Microsoft Excel version 16.ResultsOut of 125 participants, 61.6% were female and 65.6% were lecturers. Approximately half of them had less than five years’ experience. The most important role perceived and the highest committed one was a lecturer in the classroom setting. Only half of the participants had good perceptions and commitment regarding teachers’ roles. Age, designation, and continuous professional development were significantly associated with participants’ commitment. Also, a significant association was found between the perception and practice of the participants.ConclusionOnly half of pharmacy educators were found to have a good perception and good commitment regarding their role as teachers.

What sparks a guide on the side? A qualitative study to explore motivations and approaches of mentors in health professions education

Introduction Despite abundant research emphasising the value of mentoring for healthcare professionals, little is known about what motivates mentors. This study aimed to explore what motivated a group of internationally renowned health professions educators to accept informal, international and mostly online mentoring roles, and their approaches to that mentoring. Methods Using a qualitative approach, we interviewed ten global educational leaders, who volunteered to serve as mentors in an initiative implemented by the Association for Medical Education in Europe in 2019, via Zoom. The hour-long interviews, conducted between May and October 2019, were audiotaped and transcribed on Zoom. De-identified transcripts were analysed for key themes. Results The key themes identified could be mapped to three categories, Motivations – Why; Approaches – How, and Global and virtual mentoring – What. Themes under motivations included: (1) Nurturing relationships focussed on mentees’ growth; (2) Pass on the benefit of one’s experience; (3) For one’s own continued growth. Themes under approaches included: (1) Provide a safe space; (2) Encourage mentees to take ownership of their professional development. Themes under global and virtual mentoring included: (1) Mentoring across geographical borders is still about relationships; (2) Virtual mentoring is not a barrier to relationship building. Discussion Though mentors also saw own growth and ongoing professional development as an important benefit of mentoring, altruism or the desire to benefit others, appeared to be a key motivating factor for them. Finding ways in which to identify mentors who are passionate about strengthening the field in this way – for example through reflective narratives and critical conversations – could be key when implementing mentoring initiatives.

On pandemics and pivots: a COVID-19 reflection on envisioning the future of medical education.

The required adjustments precipitated by the coronavirus disease 2019 crisis have been challenging, but also represent a critical opportunity for the evolution and potential disruptive and constructive change of medical education. Given that the format of medical education is not fixed, but malleable and in fact must be adaptable to societal needs through ongoing reflexivity, we find ourselves in a potentially transformative learning phase for the field. An Association for Medical Education in Europe ASPIRE Academy group of 18 medical educators from seven countries was formed to consider this opportunity, and identified critical questions for collective reflection on current medical education practices and assumptions, with the attendant challenge to envision the future of medical education. This was achieved through online discussion as well as asynchronous collective reflections by group members. Four major themes and related conclusions arose from this conversation: Why we teach: the humanitarian mission of medicine should be reinforced; what we teach: disaster management, social accountability and embracing an environment of complexity and uncertainty should be the core; how we teach: open pathways to lean medical education and learning by developing learners embedded in a community context; and whom we teach: those willing to take professional responsibility. These collective reflections provide neither fully matured digests of the challenges of our field, nor comprehensive solutions; rather they are offered as a starting point for medical schools to consider as we seek to harness the learning opportunities stimulated by the pandemic.

Performance assessment: Consensus statement and recommendations from the 2020 Ottawa Conference

Introduction In 2011 the Consensus Statement on Performance Assessment was published in Medical Teacher. That paper was commissioned by AMEE (Association for Medical Education in Europe) as part of the series of Consensus Statements following the 2010 Ottawa Conference. In 2019, it was recommended that a working group be reconvened to review and consider developments in performance assessment since the 2011 publication. Methods Following review of the original recommendations in the 2011 paper and shifts in the field across the past 10 years, the group identified areas of consensus and yet to be resolved issues for performance assessment. Results and discussion This paper addresses developments in performance assessment since 2011, reiterates relevant aspects of the 2011 paper, and summarises contemporary best practice recommendations for OSCEs and WBAs, fit-for-purpose methods for performance assessment in the health professions.

Twelve tips for facilitating and implementing clinical debriefing programmes

Contemporary clinical practice places a high demand on healthcare workforces due to complexity and rapid evolution of guidelines. We need embedded workplace practices such as clinical debriefing (CD) to support everyday learning and patient care. Debriefing, defined as a ‘guided reflective learning conversation’, is most often undertaken in small groups following simulation-based experiences. However, emerging evidence suggests that debriefing may also enhance learning in clinical environments where facilitators need to simultaneously balance psychological safety, learning goals and emotional well-being. This twelve tips article summarises international experience collated at the recent Association for Medical Education in Europe (AMEE) debriefing symposium. These tips encompass the benefits of CD, as well as suggested approach to facilitation. Successful CD programmes are frequently team focussed, interdisciplinary, implemented in stages and use a clear structure.

Florida International University Herbert Wertheim College of Medicine.

Florida International University Herbert Wertheim College of Medicine.

Test Items Validation in the Context of Education Export

It is necessary to develop special assessment tools for international students, which will comply with the principles of evidence-based education. This is especially important in the context of Russian higher education export. Multiple choice questions (MCQs) are an essential part of the assessment and are suited for assessing the knowledge level of international students. The “Organic chemistry” is a basic course for pharmaceutical students, which is necessary for the understanding of principal subjects. The study objective was to develop a normative-oriented model of the “Organic chemistry” MCQs based examination for international students (the specialty 33.05.01 “Pharmacy”) in accordance with the recommendations of the Association for Medical Education in Europe (AMEE). The previously developed interactive “Organic Chemistry Test Simulator”, created at the Sechenov University, was used as the basis for the examination MSQs bank. It was analyzed by five independent experts, who work as teachers of organic chemistry. The average timing and the cut score were determined by the Angoff method, 90 sec and 64%, respectively. Among analyzed MCQs the 3% were found irrelevant, 22% were recommended for revision and modernization. Valid MSCs (600 items) served as the basis for the creation of extended examination MSQs bank. An algorithm for modeling the “Organic chemistry” MCQs based examination was proposed. The standardized examination test has 30 MSQs of different types. The standardized normative-oriented model of the “Organic chemistry” MCQs based examination for international students (the specialty 33.05.01 “Pharmacy”) was validated in terms of relevance and representativeness, optimized in time and cut score.

Twelve tips for organising speed mentoring events for healthcare professionals at small or large-scale venues

Mentors play a critical role in the development of professionals, influencing their job satisfaction, career aspirations and evolving professional identity. A variety of mentoring models exist, each with distinct benefits and challenges. Speed mentoring, based on the concept of speed dating, provides mentees with opportunities to meet multiple mentors over a short time and pose focussed career development questions. At large-scale events such as the annual AMEE (Association for Medical Education in Europe) meeting, speed mentoring sessions can successfully connect aspiring, novice and mid-career educators with international educational leaders to facilitate transfer of valuable insights for professional growth. For some mentors and mentees, this might spur ongoing communications or even longitudinal relationships. In this paper, we aim to provide strategies for planning and implementing speed mentoring events, combining insights gained from the literature and our experience of organising speed mentoring at the 2019 AMEE meeting in Vienna. These tips will be useful to a variety of professionals planning to organise speed mentoring initiatives.

Developing future medical educators in an Australian medical program: supervisors’ reflections on the first four years of MD Professional Project implementation

ABSTRACT Background Increasingly, professional bodies expect doctors to not only provide patient care but also educate students, trainees and patients. Few medical students, however, receive formal tuition in terms of the theory and practice of medical education. A curriculum restructure from an MBBS to a Doctor of Medicine (MD) program provided an opportunity to develop three Masters streams: Clinical research, Capstones and educational Professional Projects. This submission describes how one Australian medical school is preparing some students for their future roles as medical educators through MD Professional Projects. Design Framed by the 12 roles of the medical ‘teacher’, most students undertaking these projects take on Resource Developer (including simulation) and Assessor roles. For those choosing resource development (excluding simulation) or assessment, the Association for Medical Education (AMEE) Student Essential Skills in Medical Education (ESME) Course is compulsory. For those choosing educational research, the ESME Course is optional. Outcomes By December 2020, four MD cohorts will have graduated with 69 students having undertaken educational MD Professional Projects, with fifty-one completing the ESME Course. MD students have created a range of resources for the curriculum, their colleagues and the local healthcare community. In addition to the expected learning we identified additional value-added outcomes for learners (e.g. skill development), the curriculum (e.g. areas of difficulty), academic supervisors’ roles (e.g. role-modelling) and for the health care community (e.g. as expert reviewers). Conclusions Engaging in scholarly activities such the ESME Course and developing learning resources not only provided MD students with a more in-depth theoretical knowledge in a range of clinical areas, but also developed skills that would prepare them for their future roles as medical educators. As supervisors, we identified the value these projects add to the broader health community as well as personal and professional benefits for ourselves.

Students’ engagement in the medical school in Nepal based on ASPIRE criteria

Background and Objectives: Students’ engagement in active learning and scholarly activities are essential for effective medical education. This is one of the dimensions of ASPIRE-to-Excellence-Initiative. Objective of this study was to know from students about their engagement in Universal College of Medical Sciences (UCMS) Bhairahawa, Nepal as per ASPIRE criteria for excellence.&#x0D; Material and methods: This is questionnaire-based survey done in UCMS, in October 2019. The Criteria regarding students’ engagement developed by International Association for Medical Education (AMEE)for ASPIRE-to-Excellence-Initiative was utilized in the questionnaire. The questionnaire comprised of four ASPIRE criteria and 21 sub-criteria. The response on each sub-criteria (statements) were three yes/to some- extent/no. They had to select one response as deemed appropriate. 3rd-year MBBS students participated in the survey. The data was entered into SPSS 21; frequency, and percentage were computed.&#x0D; Results: Out of 100 students; 80 participated in the survey. The response rate was 80%. Around 2/3 of the students reported that they didn’t engaged with management of the school, including matters of policy and mission and vision of the school. Overall students’ engagement is poor on criteria-1. More than 2/3 of the students mentioned that they have been engaged in the school’s education program (delivery of teaching and assessment). Overall students’ engagement is fair on criteria-2. More than 50% of students reported that they have been engaged in the academic community (school’s research program and participation in meetings). Overall students’ engagement is satisfactory on criteria-3. More than 70% of students mentioned that they have been engaged in the local community and service delivery. Overall students’ engagement is good oncriteria-4.&#x0D; Conclusion: Students’ engaged on 4 criteria varies from poor to good; poor on criteria 1 while good on criteria 4. More research is required involving all batches of students and other medical colleges in Nepal to know the details of students’ engagement in medical schools based on ASPIRE criteria.

Innovations in Curriculum Designs Do Not Guarantee Students’ Patient-Centered Attitudes Running Title: Curricula and Patient-Centered Attitudes

ABSTRACT Background Medical schools all around the world are engaged in curricular reforms aimed at fostering patient- and learner-centeredness, implementing curricular transformations in order to counterbalance the erosion of humanistic and professional values and the loss of idealism of recent graduate physicians. In Brazil, medical schools are facing the challenge of redesigning medical curricula towards more learner-centered and patient-centered approaches, stimulated by recent national medical education guidelines. However, desirable outcomes towards medical education have not been fully achieved. Aim To access medical students’ attitudes and determine predictors of medical students’ patient-centered attitudes among students from different curricular designs (traditional, innovative and advanced). Methods Medical students from 1st to 6th year from 21 Brazilian medical schools participating in the project for evaluating change and trends proposed by the Brazilian Association of Medical Education, with different stages of curricular designs (traditional, innovative and advanced), answered the Brazilian version of the Patient–Practitioner Orientation Scale (B-PPOS) and a questionnaire with curricular and sociodemographic variables. Results Brazilian medical students care more than they share information, power and responsibility (p &lt; 0.001; d = 0.599). They are more concerned with the psychosocial context than with patient’s perspective (p &lt; 0.001; d = 0.797) and share more power and responsibility than understanding (p &lt; 0.001, d = 0.455). Female gender (B = 0.180), students from public schools (B = 0.132), year of medical training (B = 0.021), preference for future medical practice in public services (B = 0.053) and extracurricular activities (B = 0.068) were predictors of patient-centered attitudes among medical students (p &lt; 0.05). Meanwhile, the father’s educational level and choice to study surgical specialties (p &lt; 0.05) were predictors of less patient-centered attitudes among students. Different curricular designs were not associated with students’ patient-centered attitudes (p &gt; 0.05). Conclusion tant predictors of patient-centered attitudes among medical students. Further research should investigate the direct influence of faculty professionalism development programs on students’ patient centered-attitudes.

Perceptions Of Medical Students Regarding Excellence In Student Engagement: A Multi-Center Saudi Arabian Perspective.

BackgroundStudents and faculty members should work together as partners in the present era of modern medical education. Many medical schools across the globe are seeking excellence in medical education, including excellence in student engagement.ObjectiveThe current study aimed to explore Saudi medical students’ perceptions regarding the Association for Medical Education in Europe’s (AMEE) ASPIRE criteria for excellence in student engagement.DesignA cross-sectional study targeting Saudi medical students from the five main universities in Saudi Arabia. A questionnaire was designed based on the AMEE’s ASPIRE criteria for recognition of excellence in student engagement. Data were collected via SurveyMonkesy and analyzed using SPSS (Version 20). Twenty-three randomly selected medical students from Imam University were interviewed as well.ResultsSeventy-six percent (n=759) of students completed the survey. In general, Saudi medical students supported the ASPIRE criteria for student engagement. Students with the highest GPA (4.5–5) constituted 44% of students supporting excellence in student engagement. Students in medical schools using problem-based learning (PBL) agreed more than did those who did not follow a PBL curriculum. Most of the students at Imam Mohammad Ibn Saud University (87.8%) agreed that students should be formally and informally involved in peer-assisted teaching. The highest percentage of students who agreed was from Imam University as compared to the other four universities (P = 0.0001).ConclusionSaudi medical students support student engagement criteria as stated in the ASPIRE Awards criteria for excellence in student engagement. A significant proportional relationship was observed between increments in GPA and support of student engagement activities. The current study may encourage all colleagues around the world to implement the concept of “student engagement” in their universities. Additional studies should be conducted worldwide to seek international medical students’ perceptions regarding student engagement.

Association for Medical Education in Europe, AMEE 2008 参加報告

Association for Medical Education in Europe, AMEE 2008 参加報告

Development of an Instructional Design Evaluation Survey for Postgraduate Medical E-Learning: Content Validation Study

BackgroundE-Learning has taken a firm place in postgraduate medical education. Whereas 10 years ago it was promising, it now has a definite niche and is clearly here to stay. However, evaluating the effect of postgraduate medical e-learning (PGMeL) and improving upon it can be complicated. While the learning aims of e-learning are evaluated, there are no instruments to evaluate the instructional design of PGMeL. Such an evaluation instrument may be developed by following the Association for Medical Education in Europe (AMEE) 7-step process. The first 5 steps of this process were previously performed by literature reviews, focus group discussion, and an international Delphi study.ObjectiveThis study will continue with steps 6 and 7 and answer the research question: Is a content-validated PGMeL evaluation survey useful, understandable, and of added value for creators of e-learning?MethodsThere are five phases in this study: creating a survey from 37 items (phase A); testing readability and question interpretation (phase B); adjusting, rewriting, and translating surveys (phase C); gathering completed surveys from three PGMeL modules (phase D); and holding focus group discussions with the e-learning authors (phase E). Phase E was carried out by presenting the results of the evaluations from phase D, followed by a group discussion. There are four groups of participants in this study. Groups A and B are experienced end users of PGMeL and participated in phase B. Group C are users who undertook e-learning and were asked to complete the survey in phase D. Group D are the authors of the e-learning modules described above.ResultsFrom a list of 36 items, we developed a postgraduate Medical E-Learning Evaluation Survey (MEES). Seven residents participated in the phase B group discussion: 4 items were interpreted differently, 3 were not readable, and 2 items were double. The items from phase B were rewritten and, after adjustment, understood correctly. The MEES was translated into Dutch and again pilot-tested. All items were clear and were understood correctly. The MEES version used for the evaluation contained 3 positive domains (motivation, learning enhancers, and real-world translation) and 2 negative domains (barriers and learning discouragers), with 36 items in those domains, 5 Likert scale questions of 1 to 10, and 5 open questions asking participants to give their own comments in each domain. Three e-learning modules were evaluated from July to November 2018. There were a total of 158 responses from a Dutch module, a European OB/GYN (obstetrics and gynecology) module, and a surgical module offered worldwide. Finally, 3 focus group discussions took place with a total of 10 participants. Usefulness was much appreciated, understandability was good, and added value was high. Four items needed additional explanation by the authors, and a Creators’ Manual was written at their request.ConclusionsThe MEES is the first survey to evaluate the instructional design of PGMeL and was constructed following all 7 steps of the AMEE. This study completes the design of the survey and shows its usefulness and added value to the authors. It finishes with a final, publicly available survey that includes a Creators’ Manual. We briefly discuss the number of responses needed and conclude that more is better; in the end, however, one has to work with what is available. The next steps would be to see whether improvement can be measured by using the MEES and continue to work on the end understandability in different languages and cultural groups.

Prescription Opioid Quality Measures Applied Among Pennsylvania Medicaid Enrollees.

The Pharmacy Quality Alliance (PQA) recently developed 3 quality measures for prescribing opioids: high dosages, multiple providers and pharmacies, and concurrent use of opioids and benzodiazepines. To examine the prevalence of the PQA measures and identify the patient demographic and health characteristics associated with the measures. We conducted a cross-sectional analysis using Pennsylvania Medicaid data (2013-2015). We limited our analyses to noncancer patients who were aged 18-64 years and not dual-eligible for Medicare/Medicaid. Per PQA specifications, patients were required to possess ≥ 2 opioid prescriptions for ≥ 15 days annual supply each year. Outcome measures included (a) high dosages, defined as > 120 morphine milligram equivalents for ≥ 90 consecutive days; (b) multiple providers/pharmacies, defined as receiving opioid prescriptions from ≥ 4 providers and ≥ 4 pharmacies; and (c) concurrent use of opioids and benzodiazepines, defined as ≥ 30 cumulative days of overlapping opioids and benzodiazepines among individuals having ≥ 2 opioid and ≥ 2 benzodiazepine fills. Patient characteristics assessed included demographics; other medication use; and physical, mental, and behavioral health comorbidities. We present descriptive and multivariable statistical analyses of the data to describe trends in quality measure prevalence and associations with enrollee health characteristics. Numbers of enrollees meeting inclusion criteria ranged from 73,082 in 2013 to 85,710 in 2015. From 2013 to 2015, high dosage prevalence increased from 5.1% to 5.5%; the use of multiple providers/pharmacies decreased from 7.1% to 5.0%; and concurrent use of opioids and benzodiazepines decreased from 29.1% to 28.4% (all P < 0.05). A substantial portion of patients with > 1 PQA measure from 2013 to 2015 was eligible for Medicaid because of disability (41.8%-81.9%). Enrollees with opioid use disorder were more likely to have high dosages (adjusted odds ratio [AOR] = 2.01, 95% CI = 1.83-2.21). Enrollees with anxiety and mood disorders were more likely to have multiple providers/pharmacies (anxiety: AOR = 1.54, 95% CI = 1.43-1.65; mood: AOR = 1.15, 95% CI = 1.06-1.25) and concurrent use of opioids and benzodiazepines (anxiety: AOR = 3.50, 95% CI = 3.38-3.63; mood: AOR = 1.42, 95% CI = 1.36-1.48). Given high levels of eligibility based on disability and the prevalence of mood, anxiety, and opioid use disorders among those identified by the quality measures, providers may require additional support to care for this patient population. This project was supported by a grant from the Centers for Disease Control and Prevention and was also supported by an intergovernmental agreement between the Pennsylvania Department of Human Services and the University of Pittsburgh. Lo-Ciganic was supported by the University of Arizona Health Sciences Career Development Award. The other authors have nothing to disclose. The conclusions, findings, and opinions expressed by authors contributing to this article do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the Commonwealth of Pennsylvania. A portion of these results was presented at the Association for Medical Education and Research in Substance Abuse 41st National Conference; November 2-4, 2017; Washington, DC.