Education provides a set of particular skills of learning, teaching, and applying theoretical knowledge to practice. The theory is formed by a number of common principles that account for certain facts and phenomena that are generally accepted and commonly used to make inferences and predictions. On the contrary, practice is connected with the actual process of performing a certain action. Thus, proper nursing education bridges the gap existing between knowledge and practice as it contributes to the achievement of the ultimate goal – that is, increasing the quality of health care (DiCenso, Guyatt, & Ciliska, 2014).
Nursing involves caring for a patient, teaching about health, preventing diseases, and promoting higher standards of health care provision (DiCenso et al., 2014). However, despite the fact that nurses are supposed to be proficient in both theoretical and practical aspects of their work, there is still a lot of evidence that student nurses who show excellent results in education are unable to prove their knowledge in practice. In contrast, those who possess strong practical skills often find it challenging to make theoretical generalizations (Potter, Perry, Stockert, & Hall, 2016).
Thus, the paper at hand is aimed to address the issue of the non-correspondence of nursing practice to the education received.
Student Nurses Perspective of the Problem
Most researchers who accept the importance of the problem agree that the gap existing between education and practice has the most deteriorating influence on student nurses. The point is that future specialists have to encounter the dilemma as they are constantly torn between the requirements of their teachers and supervising nurses. Even if they are diligent enough in systematizing and memorizing the theory, they still get lost being placed in a real clinical setting and having to deal with real patients whose life and health are at stake. The problem remains unresolved as nursing education is becoming increasingly divorced from practice, which continues to create concern among teachers, students, and nurse practitioners. It means that even practical principles (leaving alone the theory) that are included in the curriculum do not correspond to those applied in the workplace.
This detachment of education from real nursing often makes students and graduates leave their profession without attempting to adjust to the new demands.
Reasons for the Gap between Education and Practice
Several reasons can be identified for the growing gap between nursing education and operation in the clinical area. They include (Schmidt & Brown, 2014):
- Clinical instructor’s competence. Unfortunately, it is often the case that clinical instructors do not possess proper qualifications and experience for teaching students. Despite the fact that they are required to have at least a bachelor degree to be allowed to the position of the instructor (and a lot of them have master degrees and PhD), they often lack necessary communicative skills (Blegen, Goode, Park, Vaughn, & Spetz, 2013). Thus, students do not receive the support and attention that they need. Besides, a lot of instructors are more focused on theory and marks rather than on students’ penetration into the practice area.
- Lack of connection between the theory teacher and the practice instructor. High-quality nursing can be achieved only through ongoing communication and collaboration of theory and practice teachers. It also makes students feel secure as they know how the theory relates to practice. Unfortunately, in many cases, teachers do not cooperate and have no intention to facilitate their students’ learning process.
- Ignoring the differences between students. One of the biggest problems creating a discrepancy between education and practice is the neglect of students’ personal differences. A lot of teachers apply only one or two methods, which makes it difficult for students to grasp the information equally as their personal ways of learning are ignored. It should also be taken into consideration that the methods of teaching that are perfectly applicable in theoretical education may prove to be completely ineffective in practice.
- Redundant theoretical materials and neglect of practical skills development. The theory is essential for building the knowledge base and learning about the essence of the illnesses, their symptoms, consequences, and ways of treatment. However, actual nursing is more concerned with skills rather than knowledge. Thus, many students are not quick and skilful enough for performing even simple tasks as they are overloaded with knowledge which they cannot connect to practical performance. Moreover, in order to make the process of teaching easier, a lot of instructors simply provide a list of requirements, following which a student can receive the highest grade without resorting to critical thinking.
- Stress levels. Poor communication with the instructor, vague requirements, new experience, responsibility for the lives of real patients, and other factors may create a stressful situation that tells on students’ ability to transfer their knowledge to practice. Besides, it is often the case that instructors expect from students to know all the peculiarities of their new position from the very beginning and show judgmental attitude to those who fail to meet their expectations.
- Inadequate time management. The instructor-students ratio is one of the most significant factors predetermining time distribution. The gaps in education are unlikely to be eliminated when the number of students is too large for one instructor. The latter is unable to find an individual approach to each student, which tells on the quality of the performance.
Possible Solutions to the Problem
There are a lot of possibilities to eliminate the existing discrepancies between nursing education and practice. Some of them are (Hatlevik, 2012):
- spending more time in clinical settings doing research and observing the work of professional nurses;
- constantly updating theoretical knowledge and transferring it to practical skills;
- providing students with the required supervision and instructions that would allow them to learn instead of simply performing meaningless tasks that are developed for getting grades, not for acquiring knowledge;
- providing a constant exchange of information between teachers and clinicians;
- revising and reshaping the curriculum according to the current innovations in health care;
- drawing a clear borderline between student nurses and staff nurses as the former have tasks and objectives that are considerably different from those of the latter;
- making more emphasis on personal communication between students and their instructors, which fosters the individual approach.
It is clear that the gap between nursing education and nursing practice exists and has its unquestionable impact on the future competence of student nurses predetermining their knowledge and skills as well as their attitude to the profession. It cannot be denied that the problem is rather difficult to solve though it is still not irresolvable. There exist effective strategies that can assist in overcoming the issue. Most of them emphasize the importance of the curriculum revision, though the role of personal communication between teachers, clinical instructors, and students are not left unattended either.
Blegen, M. A., Goode, C. J., Park, S. H., Vaughn, T., & Spetz, J. (2013). Baccalaureate education in nursing and patient outcomes. Journal of Nursing Administration, 43(2), 89-94.
DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-based nursing: A guide to clinical practice. Amsterdam, the Netherlands: Elsevier Health Sciences.
Hatlevik, I. K. R. (2012). The theory‐practice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education. Journal of Advanced Nursing, 68(4), 868-877.
Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2016). Fundamentals of nursing. Amsterdam, the Netherlands: Elsevier Health Sciences.
Schmidt, N. A., & Brown, J. M. (2014). Evidence-based practice for nurses. Burlington, MA: Jones & Bartlett Publishers.