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Objective. To evaluate the effectiveness of an opioid objective structured learning experience (OSLE) focused on identifying and communicating about at-risk opioid behaviors in a community practice setting. Methods. A literature search included a review of the AACP Opioid-Related Activities Database that identified and evaluated educational activities, such as the RESPOND program (Oregon State University), that focused on communication surrounding opioids. A lack of activities emphasizing how to convey concerns about at-risk behaviors and refuse to fill opioid prescriptions in the AACP database was noted. With permission, aspects of the RESPOND program were utilized to develop a new opioid activity that included a didactic lecture and OSLE. The OSLE included two cases where students refused to fill an opioid prescription and counseled a patient demonstrating at-risk opioid behaviors on an opioid prescription. Student communication was evaluated by rubrics that were created and adapted from other activities included in the AACP database. A voluntary and anonymous survey that utilized a Likert scale (strongly agree to strongly disagree) evaluated student confidence in their skills and satisfaction with the activity before and after the OSLE. Results. One hundred forty-four and one hundred nine students completed the pre- and post- surveys, respectively. After the OSLE, student confidence in their ability to assess at-risk opioid behaviors, counsel a patient demonstrating at-risk behaviors, refuse to fill an opioid prescription, and respond to a patient's nonverbal responses improved by 67%, 37%, 49%, 46%, respectively. A majority of students (81%) felt that practicing these skills in an OSLE was beneficial. Conclusion. Incorporating an opioid OSLE allowed students to practice engaging in difficult conversations with patients demonstrating at-risk opioid behaviors and improved student's self-reported confidence. A majority of students agreed the OSLE was beneficial.Objective. To evaluate the effectiveness of an opioid objective structured learning experience (OSLE) focused on identifying and communicating about at-risk opioid behaviors in a community practice setting. Methods. A literature search included a review of the AACP Opioid-Related Activities Database that identified and evaluated educational activities, such as the RESPOND program (Oregon State University), that focused on communication surrounding opioids. A lack of activities emphasizing how to convey concerns about at-risk behaviors and refuse to fill opioid prescriptions in the AACP database was noted. With permission, aspects of the RESPOND program were utilized to develop a new opioid activity that included a didactic lecture and OSLE. The OSLE included two cases where students refused to fill an opioid prescription and counseled a patient demonstrating at-risk opioid behaviors on an opioid prescription. Student communication was evaluated by rubrics that were created and adapted from other activities included in the AACP database. A voluntary and anonymous survey that utilized a Likert scale (strongly agree to strongly disagree) evaluated student confidence in their skills and satisfaction with the activity before and after the OSLE. Results. One hundred forty-four and one hundred nine students completed the pre- and post- surveys, respectively. After the OSLE, student confidence in their ability to assess at-risk opioid behaviors, counsel a patient demonstrating at-risk behaviors, refuse to fill an opioid prescription, and respond to a patient's nonverbal responses improved by 67%, 37%, 49%, 46%, respectively. A majority of students (81%) felt that practicing these skills in an OSLE was beneficial. Conclusion. Incorporating an opioid OSLE allowed students to practice engaging in difficult conversations with patients demonstrating at-risk opioid behaviors and improved student's self-reported confidence. A majority of students agreed the OSLE was beneficial.