Using cost-analyses to inform health professions education – The economic cost of pre-clinical failure

Abstract

Background: Student failure creates additional economic costs. Knowing the cost of failure helps to frame its economic burden relative to other educational issues, providing an evidence-base to guide priority setting and allocation of resources. The Ingredients Method is a cost-analysis approach which has been previously applied to health professions education research. In this study, the Ingredients Method is introduced, and applied to a case study, investigating the cost of pre-clinical student failure.

Methods: The four step Ingredients Method was introduced and applied: (1) identify and specify resource items, (2) measure volume of resources in natural units, (3) assign monetary prices to resource items, and (4) analyze and report costs. Calculations were based on a physiotherapy program at an Australian university.

Results: The cost of failure was £5991 per failing student, distributed across students (70%), the government (21%), and the university (8%). If the cost of failure and attrition is distributed among the remaining continuing cohort, the cost per continuing student educated increases from £9923 to £11,391 per semester.

Conclusions: The economics of health professions education is complex. Researchers should consider both accuracy and feasibility in their costing approach, toward the goal of better informing cost-conscious decision-making.

Acknowledgements

The authorship team would like to acknowledge the valuable contribution from the students, educators, and administrators who participated. We would also like to thank our reference group members for their time and assistance with project development and data interpretation. No financial compensation was received by those acknowledged.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Mr. Jonathan Foo, B.Physiother, is a PhD candidate of the School of Primary and Allied Health Care within in the Faculty of Medicine, Nursing and Health Sciences at Monash University, Australia.

Dr. Dragan Ilic, BSc, Grad Dip Rep Sci, MSc, PhD, GCHPE, is an Associate Professor and Head of the Medical Education Research and Quality Unit within the School of Public Health and Preventive Medicine at Monash University, Australia.

Dr. George Rivers, B.Econ (hons), M.Econ, PhD, is an Associate Dean with the Monash Business School and Senior Lecturer in the Department of Economics at Monash University, Australia.

Professor Darrell J.R. Evans, BSc (hons), PhD, is the Deputy Vice-Chancellor (Academic) at the University of Newcastle, Australia. Professor Evans was previously the Vice-Provost of Learning and Teaching at Monash University, Australia.

Dr. Kieran Walsh, MB, FRCPI, is the Clinical Director of Clinical Improvement for BMJ based in the United Kingdom. Dr. Walsh is a Fellow of the Higher Education Academy, Fellow of the Academy of Medical Educators and Fellow of the Royal College of Physicians Ireland.

Professor Terry P. Haines, B.Physiother (hons), G. Cert Health Economics, PhD, is the Head of School for the School of Primary and Allied Health Care at Monash University, Australia. He is also the Director of the Allied Health Research Unit at Monash Health, Australia.

Miss Sophie Paynter, BSc, B.Physiother (hons), GCHPE, is a Senior Lecturer in the Department of Physiotherapy within the Faculty of Medicine, Nursing and Health Sciences at Monash University, Australia.

Dr. Prue Morgan, BAppSc (physiother), MAppSc, PhD, is an Associate Professor and Head of the Department of Physiotherapy within the Faculty of Medicine, Nursing and Health Sciences at Monash University, Australia.

Dr. Stephen Maloney, B.Physiother, MPH, MBA (exec), PhD, is an Associate Professor and Director of Education for the School of Primary and Allied Health Care within the Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia. Dr. Maloney is also Chair of the Society for Cost and Value for Health Professions Education.

Additional information

Funding

This project is with thanks to the generous funding from the Monash University Office of Learning and Teaching. The research team maintained full intellectual and creative control over the study, independent of the funding organization. The funding organization approved the final manuscript.