How to close theory-practice gap in nursing

This article covers How to close theory-practice gap in nursing.

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How to close theory-practice gap in nursing

The existing practice –theory gap in nursing has been subject to several research studies. In nursing, the challenge posed by the theory-practice discrepancy has been in existence for a considerable time and there appears to be no solution in sight. One of the major challenges for attributed to the existence of the theory-practice gap is that nursing knowledge is not yet well defined (Meleis, 2018). Addressing the theory –practice gap is crucial in nursing to facilitate translation of research into actual practice, thereby improving the quality of care delivered to patients.  This paper critically discusses various approaches that could be applied in closing the theory-practice gap in the nursing profession.

In nursing practice, theory-practice gap is characterized by the deviation between what learners gain in theoretical classroom training and the actual experience in a medical setting. According to Rolfe (1993), theory-practice gap in nursing mostly evident in student nurses, irrespective of their level of nurse education. The nursing students often find themselves in dilemma when in actual clinical situations when it comes to translating the theoretical knowledge acquired in classroom to a practical setting. This has raised a fundamental question on whether the current nurse training programs produce nurses who are highly proficient in paper qualifications but with poor clinical proficiency in the actual practice. This state of affairs points to the need of reexamining the nurse education program, as the first strategy of closing the theory-practice gap.

In nurse training programs, nurse educators have a major role enabling the nurse student integrate theoretical knowledge into actual practice; thereby close the existing theory-practice gap. The role of nurse educators in closing the theory-practice gap has been acknowledged in several research studies.  An empirical research study by Mohamed and Osuji (2017) found that nurses, including student nurses consider human sources of knowledge highly than the information acquired theoretically from textbooks. The findings are similarly to those reported in a study conducted by Levin (2010), which found that nurse colleagues, including educators are the most regarded and widely applied sources of knowledge to inform nursing practice. In this case, nurse educators can help in closing the theory practice gap in various ways.

The first way is by mentoring and being role models to nurse students in practice and in training.  Nurse educators spend considerable time with students and could use the opportunity to guide them on applying and translating theoretical knowledge into actual clinical practice. Mentorship in this case includes providing guidance to the learners during clinical rounds and fostering leadership development among the nurse students, especially on matters pertaining to application of evidence based practice in medical settings.  Additionally, the nurse educators can encourage nurse students to get involved in lifelong learning to enhance their competence, particularly in translating upcoming medical technologies and innovations into actual practice (Mohamed & Osuji, 2017).

The second strategy of closing theory practice gap is by transforming nurse training education programs, so that it can address the transforming healthcare system.  Some of the changes in the current healthcare system include increased application data through health information tools, including information technology and transformation of acute care to population based care. Additionally, the healthcare system is becoming globalized, courtesy of various technological and social economic developments (Sellman, 2010). In this case, it is crucial to transform the current nurse training programs, to make them more responsive to the current and future changes in healthcare system to close the existing theory-practice gap.

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How to close theory-practice gap in nursing
How to close theory-practice gap in nursing

Transforming the nurse education could entail redesigning the nurse curriculum and developing clinical models focusing on patient centered strategies across care continuum, management of care transitions and collaborative practice, to promote inter and intra disciplinary collaboration among nurses (Levin, 2010). This would create a favorable environment, through which the nurse students can learn and apply theoretical knowledge into practice from their clinical mentors. Additionally, there is need for nurse educators to develop practice models of partnership, which encourage future collaboration to ascertain that the nursing graduates are prepared and competent to practice in todays and future healthcare systems.

Various attempts are currently being implemented in the current healthcare system to address the theory-practice gap. Some of the approaches include integration of on evidence based practice in nursing curriculum to equip learner on how to integrate theory, with empirical evidence to promote delivery of care in diverse practice settings. Additionally, the Institute of Medicine has made various recommendations aimed at empowering nurses’ deal with the current and future changes in healthcare system.  One of the recommendations includes increasing the number of nurses with baccalaureate and doctorate degrees in addition to ensuring engagement in lifelong learning (Meleis, 2018).

Conclusion

One of the factors contributing to theory-practice gap in nursing is lack of well-defined nurse knowledge, to enhance the capacity of nurses translate theory into practice that is responsive to the transformations in healthcare.  To close the gap, it is important for stakeholders involved in nurse training to facilitate development of knowledge that is responsive to the current and future changes in healthcare. Nurse educators have a major role in this regard and in mentoring nurse students to apply and integrate theoretical knowledge into practice.

References

Levin, R.F.(2010). Integrating evidence-based practice with educational theory in clinical  practice for nurse practitioners: Bridging the theory practice gap. Research and Theory  for Nursing Practice: An International Journal, 24(4): 213-216.

Meleis, A. (2018). Theoretical nursing: Development and progress (6th ed.). Philadelphia, PA; Wolters Kluwer.

Mohamed, T.L., & Osuji, J.(2017). Bridging the theory-practice dichotomy in nursing: The role of nurse educators. Journal of Nursing Education and Practice, 7(3): 20-25.  

Rolfe, G.(1993). Closing the theory-practice gap: A model of nursing praxis. Journal of Clinical Nursing, 2: 173-177

Sellman, D.(2010). Mind the gap: Philosophy, theory, and practice. Nursing Philosophy11: 85–   87.

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