Objective. To evaluate student perception of the flipped classroom redesign of a required pharmacotherapy course. Design. Key foundational content was packaged into interactive, text-based online modules for selfpaced learning prior to class. Class time was used for active and applied-but primarily case-basedlearning. Assessment. For students with a strong preference for traditional lecture learning, the perception of the learning experience was negatively affected by the flipped course design. Module length and time required to complete preclass preparation were the most frequently cited impediments to learning. Students desired instructor-directed reinforcement of independently acquired knowledge to connect foundational knowledge and its application. Conclusion. This study illustrates the challenges and highlights the importance of designing courses to effectively balance time requirements and connect preclass and in-class learning activities. It underscores the crucial role of the instructor in bridging the gap between material learned as independent study and its application.