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It depends on the specific e books. I know that McGraw Hill and Pearson were time limited and not available once that expired, the nursing program I am in now uses Elsevier. The Elsevier rep said our access to the e-books is Lifetime access. However the text to speech is questionable as it mispronounces a lot of the technical vocabulary and abbreviations. It will phonetically say various acronyms. Also it reads all the charts, text boxes, in text citations and credits etc. you probably need to follow along with the book even if using the text to speech. In other words, they did not have someone record the reading. they use a computer voice to read everything.
I use text to speech all the time on my mac, particularly when I am tired and dont feel like reading. I find it to be pretty good. Might be tricky for medical term pronunciation though.
I have alot of ebooks and most on kindle. some are textbook version. Its pretty good. It will increase your ability to study by having your book at your fingertips all the time, since lugging the books around is a challenge.
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Who's using e-books for school? The availability has increased in recent years, but has usability? Are any Mac owners using the text to speech feature?