The True Cost of Care: A Team-Based Learning Example.

Veterinary medicine is increasingly shaped by environmental change, social inequities, and economic pressures that influence animal health, access to care, and professional practice. Preparing graduates to respond to these challenges requires educational strategies that integrate sustainability into clinical reasoning rather than treating it as an isolated topic. The triple bottom line, originally developed within sustainability and business disciplines to evaluate organizational performance across environmental, social, and economic domains, offers a structured approach for examining the true cost of professional decisions. This Teaching Tip describes the development and implementation of a team-based learning module designed to operationalize the true cost framework within a pre-clinical veterinary curriculum. Through preparatory materials, readiness assurance testing, and applied team exercises spanning public health and small animal practice contexts, students engaged in systems-level analysis of trade-offs inherent in veterinary care. Performance on summative assessment and classroom discourse demonstrated integration of sustainability language and reasoning into clinical decision making. The true cost framework is presented as a flexible, longitudinal approach to teaching sustainability that can be embedded across species, practice types, and stages of training.