We would like to thank Dr. Spangler for his thoughtful comments regarding the resources associated with the flipped classroom. By providing Supplemental Digital Table 1 (a comparison of instructor and teaching assistant [TA] hourly time commitment for the traditional and flipped courses) in our article,1 we intended to illustrate the importance of careful planning and commitment to successfully implement and sustain this model. While we agree that there are costs, Dr. Spangler’s “crude cost estimate” for maintaining our course generated a number that represents less than 1% of the total semester tuition generated by enrolled students. This amounts to a relatively small investment in light of added benefits to students.
We acknowledged within our article that some may not have access to a TA and subsequently proposed two alternatives: senior medical students and/or PhD students.1 As others operationalize the flipped-classroom model, it is likely that additional approaches to effective teaching practices will be identified. Further, it is proposed that we, as well as others, will become more efficient with the flipped classroom over time. Faculty will have a growing body of resources to aid in the design and implementation of the model, which could also help reduce costs.
The flipped classroom does require an investment on the part of faculty and others, but this cost is not without benefits. Research clearly demonstrates the shortcomings of passive learning, and a financial analysis that excludes the benefits of the flipped classroom misrepresents the value of the model. If the flipped classroom improves learning, as demonstrated by our study and others, shouldn’t that contribute to the financial analysis as well? Schools are being challenged to design curricula that enhance student outcomes and better prepare students for the evolving needs of health care. As noted by Prober and Heath,2 “Since the hours available in the day have not increased to accommodate the expanded medical canon, we have only one realistic alternative: make better use of our students’ time.”
Amid these ongoing challenges to health professions education, we propose alternative cost considerations: namely, what is the cost of a failed student? And perhaps more important: What is the cost of a less competent professional?
Jacqueline E. McLaughlin, PhD, MS
Assistant professor and director, Office of Strategic Planning and Assessment, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina; firstname.lastname@example.org.
Mary T. Roth, PharmD, MPH
Associate professor and executive director, The Academy, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina.
Russell J. Mumper, PhD
Vice provost for academic affairs, University of Georgia, Athens, Georgia.
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
2. Prober CG, Heath C. Lecture halls without lectures—a proposal for medical education. N Engl J Med. 2012;366:1657–1659