Clinical education remains one of the vital areas that facilitate the determination of the significance of a student’s performance in clinical settings-such as clinical wards, patients, staff and nursing instructors (Dadgaran et al., 2012).Nonetheless, the theory-practice gap has been an issue of concern among nursing students in clinical learning. In regards to the nursing student’s current clinical environment, the theory-gap problem has been compounded by an ever-changing healthcare landscape, proliferation of technology and changes in student and patient demographics (Dadgaran et al., 2012).
Ajani and Moez (2011) define the theory-practice gap as the difference between theoretical aspects taught in clinical learning and experiences during nursing practice. Noting that nurses form a significant portion of the healthcare system, the occurrence of a wide theory-practice gap has considerable impacts on healthcare outcomes. Illustratively, Jamshidi (2012) points out that nursing as a professional discipline seeks to utilize knowledge and skills to serve in various clinical settings. However, the presence of a theory-practice gap hinders the efficient utilization of clinical knowledge and skill to improve patient outcomes. In concurrence, Ajani and Moez (2011) point out that the theory-practice problem affects the development of clinical competence since clinical students face challenges in relating theory to nursing practice, making suitable clinical judgements and appreciating values and ethics in nursing practice. Similarly, Rafiee et al. (2014) point out that the theory-practice gap affects healthcare outcomes due to the student’s inability to become socialized into nursing practice and the inability to learn the required interpersonal and technical skills.
In regards theory-practice gap, its impacts can be categorized into impacts on the work environment and impacts on patient outcomes. According to Rafiee et al. (2014), the impacts of theory-practice gap on patient outcomes is closely associated with the nurses’ knowledge and skills in practice. More elaborately, research has shown that the theory-practice gap leads to discrepancies between knowledge attained in clinical education and what is required in nursing practice. As a consequence, the nurses fail to provide care that was envisioned in scholarly theories and therefore their clinical competence is adversely affected (Dadgaran et al., 2012).This leads to low quality patient care.
Further, the theory-practice-gap problem affects the nursing work environment in numerous ways. First, the previously mentioned problem hinders the development of competence during the student-professional transition period; since, the nursing students face challenges in systematically utilizing research findings and theories in their nursing care (Jamshidi, 2012).Similarly, Rafiee et al. (2014) points out that discrepancy between theory and practice affect nursing work-environments due to excessive feelings of anxiety among nursing students. To elaborate, Dadgaran et al. (2012) point out that lack of linkages between theory and practice raises anxiety in nursing-work-environments by creating doubt about knowledge and skills required to cater for various patients in clinical settings.
The study on problems associated with the theory-practice gap is significant to the nursing profession since it highlights the effects healthcare outcomes and nursing-work-environments. Noting that demands in the nursing profession require nurses to employ intervention approaches through the application of knowledge that is all-inclusive of nursing concerns(Jamshidi,2012),pin-pointing the effects of theory-practice-gap effects may provide insight on how to develop nursing courses that meet the current needs in nursing care.
Several approaches can be employed by nursing colleges to bridge the theory-practice gap. First, nursing colleges should employ service user involvement in health nurse education. Ajani and Moez (2011) highlight that involving service users and cares in the learning process will enable nursing students to understand the outcomes of different qualities of nursing care. Moreover, involving service users in nursing courses will enable nursing students to understand nursing care from a perspective that is different from the textbooks’. Second, nursing colleges should evaluate the compatibility of their courses with technological advances in nursing environment (Rafiee et al. 2014).This will play a vital role in enhancing the development of competence in the use of modern technology, thus improving the quality of nursing care.
Thirdly, nursing colleges should employ strategies that enhance communication between theory and practice teachers. Ajani and Moez (2011) points out that adequate linkage between theory and practice will produce quality nurses; since, they can relate theoretical views with practical approaches in nursing care. Fourthly, nursing colleges should ensure that instructor-student ratios enable nursing patients to interact with instructors, mentors and experienced nurses (Jamshidi,2012).More elaborately, suitable student ratios enable teachers to discuss and practice various theoretical concepts with small groups, thus reducing challenges associated with theory-practice discrepancies. Consequently, this will play a key role in enabling student nurses to develop clinical competence by relating theory to nursing practice, making suitable clinical judgements, and appreciating values and ethics in nursing practice (Rafiee et al.,2014). Lastly, healthcare facilities should introduce programs that allow mentoring of student nurses by experienced professionals. This will play a key role conveying information about new trends in nursing practice and their impacts on healthcare outcomes.
