Letters to the Editor
To the Editor:
I read with interest the superb study by McLaughlin et al1 describing their successful implementation of a flipped classroom for a pharmacy course at the University of North Carolina (UNC) Eshelman School of Pharmacy. The increased time allowed for faculty and staff to implement the course appears to have been particularly helpful for its success, requiring the commitment of a full-time teaching assistant (TA). Unfortunately, course directors at many medical schools do not have the luxury of a TA, nor can they demand equivalent time of personnel from their office of medical education.
Using very basic assumptions, I calculated a crude cost estimate for implementing the authors’ course. These calculations are for “ballpark” estimates only and are not meant to be definitive. I assumed that the median national salary for an assistant professor of pharmacy was $75,9452 and that the 2012–2013 UNC stipend for a PhD graduate student TA in pharmacy was $25,500.3 I also assumed that each individual works 2,000 hours per year to get an “hourly wage” estimate. Next, I used the findings on the extra hours listed in the authors’ supplemental data4 for the course start-up and continuation.
With these approximations, I found that the baseline cost for the course in 2011 was $5,965.00. Costs above baseline were $8,763.00 in 2012 for one-time course implementation and $2,657.00 annually for course continuation (2013 and beyond).
Admittedly, 2,000 work hours per year is an underestimate, and not all expenses are included in these calculations (e.g., faculty fringe and benefits, computer costs). Nonetheless, these approximated costs show a relatively high investment—both one-time and ongoing—that might not be attainable at many academic health centers, particularly if multiple courses are “flipped” for a school’s curriculum.
It would be interesting to know the best estimate of additional costs McLaughlin et al incurred with their actual experience at UNC, and how they would propose other schools pay for these expenses. Furthermore, who would substitute for the TA?
John Spangler, MD, MPH
Professor of family and community medicine and professor of psychiatry and behavioral medicine, Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina; firstname.lastname@example.org.
1. McLaughlin JE, Roth MT, Glatt DM, et al. The flipped classroom: A course redesign to foster learning and engagement in a health professions school. Acad Med. 2014;89:236–243