This large (22,000 participants) report (35 page PDF) makes the impact of textbook costs clear: "The findings suggest that the cost of textbooks is negatively impacting student access to required materials (66.6% did not purchase the required textbook) and learning (37.6% earn a poor grade; 19.8% fail a course)." There's no end to the efforts to improve course quality in order to improve outcomes, yet so little effort to address really obvious problems like this.
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