Journal of Education and Health Promotion

Exploring the reasons for theory‑practice gap in emergency nursing education: A qualitative research

Document Type : Original Article

Authors

. Shima Safazadeh
. Alireza Irajpour 1
. Nasrollah Alimohammadi 1
. Fariba Haghani 2

1 Department of Critical Care Nursing, Nursing and Midwifery Care Research Centre, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences

2 Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract
BACKGROUND: Nursing is a scientific profession, based on theory and art of care. However, the
theory‑practice gap has become the biggest challenge of this profession and decreases the quality
of service both in teaching and practice. Thus, it seems necessary to search for these reasons in
situations such as emergency department – which has an effective role in patients’ health.
OBJECTIVES: The objectives of this study were to find the perceived reasons for the theory‑practice
gap in the process of emergency nursing education from the perspective of professors, nurses, and
students, as well as doctors, since they cooperate with nurses and students in the training environment.
METHODS: A qualitative study was carried out; this included 18 deep, semi‑structured interviews in
7 months with the people involved in the process of emergency department apprenticeship alongside
with observing the activities of stakeholders. The data analysis was done in accordance with content
analysis method including three steps of preparation, organization, and reporting.
RESULTS: The perceived reasons for theory‑practice gap were classified into 13  secondary
categories. At the end of data analysis, five main categories of student, instructor, environment,
culture, and the organizational process, and finally, two themes of “input” and “process” emerged.
CONCLUSIONS: Nursing students in emergency department face a number of challenges in
implementing theory into practice which stems from the faculty as an academic environment and
the hospital as an educational environment. These underpinning reasons for the theory‑practice
gap influence the quality of nursing education and care delivery in emergency department. Hence,
decreasing the theory‑practice gap lies in the amendment of any of these factors.

Keywords

Emergency department
nursing education
qualitative research
1. Jasmine T. Art, science, or both? Keeping the care in nursing. Nurs
Clin North Am 2009;44:415‑21.
2. Cody W. Philosophical and Theoretical Perspectives for
Advanced Practice Nursing. Burlington, MA: Jones & Bartlett
Learning; 2013.
3. Ousey K, Gallagher P. The theory‑practice relationship in nursing:
A debate. Nurse Educ Pract 2007;7:199‑205.
4. Rush KL, Adamack M, Gordon J, Lilly M, Janke R. Best practices
of formal new graduate nurse transition programs: An integrative
review. Int J Nurs Stud 2013;50:345‑56.
5. Risjord M. Nursing Knowledge: Science, Practice, and
Philosophy. United Kingdom: John Wiley & Sons; 2011.
6. Flood LS, Robinia K. Bridging the gap: Strategies to integrate
classroom and clinical learning. Nurse Educ Pract 2014;14:329‑32.
7. Hatlevik IK. The theory‑practice relationship: Reflective skills
and theoretical knowledge as key factors in bridging the gap
between theory and practice in initial nursing education. J Adv
Nurs 2012;68:868‑77.
8. Ajani K, Moez S. Gap between knowledge and practice in nursing.
Procedia Soc Behav Sci 2011;15:3927‑31.
9. Van Zyl AE. Exploring the Potential Theory‑Practice Gap in the
Teaching Methods of Nurse Educators. Stellenbosch: Stellenbosch
University; 2014.
10. LimaKR, de BritoTA, NunesHM, Rodriguez GC, do Nascimento RA,
Henriques LM, et al. Nursing students experience in emergency
and intensive care in a reference hospital. Int Arch Med 2016;9:9.
11. Streveler MJ. Students’ Perception of a Theory‑Practice Gap in
Athletic Training Education. University of Minnesota; 2013.
12. Saifan A, AbuRuz ME, Masa’deh R. Theory practice gaps in
nursing education: A qualitative perspective. J Soc Sci Sosyal
Bilimler Derg 2015;11:1.
13. Cheraghi MA, Salsali M, Safari M. Ambiguity in knowledge
transfer: The role of theory‑practice gap. Iran J Nurs Midwifery
Res 2010;15:155‑66.
14. Dadgaran I, Parvizy S, Peyrovi H. A global issue in nursing
students’ clinical learning: The theory – Practice gap. Procedia
Soc Behav Sci 2012;47:1713‑8.
15. Cheraghi M, Salsali M. To understand the process of theory and
practice gap in nursing education in Iran. Iran J Public Health
2005;34Suppl:26‑7.
16. Tiwaken SU, Caranto LC, David JJ. The real World: Lived
experiences of student nurses during clinical practice. Int J Nurs
Sci 2015;5:66‑75.
17. Bagheri H, Bazghaleh M. Clinical education and its related factors
in nursing: A qualitative meta – Synthesis study. J Nurs Educ
2016;4:26‑39.
18. Leppink J. Revisiting the quantitative – Qualitative‑mixed
methods labels: Research questions, developments, and the need
for replication. J Taibah Univ Med Sci 2017;12:97‑101.
19. Holloway I, Galvin K. Qualitative Research in Nursing and
Healthcare. United Kingdom: John Wiley & Sons; 2016.
20. Elo S, Kyngäs H. The qualitative content analysis process. J Adv
Nurs 2008;62:107‑15.
21. Henderson A, Cooke M, Creedy DK, Walker R. Nursing students’
perceptions of learning in practice environments: A review. Nurse
Educ Today 2012;32:299‑302.
22. Joolaee S, Jafarian Amiri SR, Farahani MA, Varaei S. Iranian
nursing students’ preparedness for clinical training: A qualitative
study. Nurse Educ Today 2015;35:e13‑7.
23. Kube ML. The Relationship of Nursing Faculty Clinical Teaching
Behaviors to Student Learning A Dissertation Submitted. College
of Saint Mary; 2010.
24. Wang XF, Zhao L, Hu HJ, Ou GW, Liao L. Competence of clinical
teachers: A survey on perception of masters of nursing specialist
postgraduates, their clinical teachers, and head nurses. Int J Nurs
Sci 2017;4:158‑63.
25. Baraz S, Memarian R, Vanaki Z. Learning challenges of nursing
students in clinical environments: A qualitative study in Iran.
J Educ Health Promot 2015;4:52.
26. Bahreini M, Moattari M, Kaveh M, Ahmadi F. Self assessment
of the clinical competence of nurses in a major educational hospital of Shiraz University of Medical Sciences. Pars J Med Sci
(Jahrom Med J) 2010;8:28-36.
27. Neal AR. Nurses’ Experiences of the Traditional Clinical Learning
Environment for Nursing Students. Capella University; 2016.
28. Flott EA, Linden L. The clinical learning environment in nursing
education: A concept analysis. J Adv Nurs 2016;72:501‑13.
29. Yousefy A, Yazdannik Ar, Mohammadi S. Exploring the
environment of clinical baccalaureate nursing students’ education
in Iran; A qualitative descriptive study. Nurse Educ Today
2015;35:1295‑300.
30. Mansutti I, Saiani L, Grassetti L, Palese A. Instruments evaluating
the quality of the clinical learning environment in nursing
education: A systematic review of psychometric properties. Int J
Nurs Stud 2017;68:60‑72.
31. Salehi S, Taleghani F, Afghari P, Moghadasi MH. Investigating
the efficiency of nursing education program from the perspective
of graduate students of nursing and midwifery. Iran J Nurs
Midwifery Res 2012;17:284‑9.
32. Nepal B, Taketomi K, Ito YM, Kohanawa M, Kawabata H,
Tanaka M, et al. Nepalese undergraduate nursing students’
perceptions of the clinical learning environment, supervision
and nurse teachers: A questionnaire survey. Nurse Educ Today
2016;39:181‑8.
33. Glynn P, Silva S. Meeting the needs of new graduates in the
emergency department: A qualitative study evaluating a new
graduate internship program. J Emerg Nurs 2013;39:173‑8.
34. Hickey MT. Baccalaureate nursing graduates’ perceptions of their
clinical instructional experiences and preparation for practice.
J Prof Nurs 2010;26:35‑41.
35. Farsi Z, Dehghan‑Nayeri N, Negarandeh R, Broomand S. Nursing
profession in Iran: An overview of opportunities and challenges.
Jpn J Nurs Sci 2010;7:9‑18.
36. Al Awaisi H, Cooke H, Pryjmachuk S. The experiences of newly
graduated nurses during their first year of practice in the Sultanate
of Oman – A case study. Int J Nurs Stud 2015;52:1723‑34.
37. Klimkewicz P. Nursing Students and Faculty Perceptions of
Effective Clinical Teaching Behaviors. Walden University; 2012.
38. Yaghobyan M, Salmeh F, Yaghobi T. Effect of mentorship program
on the stressors in the nursing students during their clinical
practice. J Mazandaran Univ Med Sci 2008;18:42‑50.
39. Alavi M, Irajpour A. Optimum characteristics of nursing students’
clinical evaluation: Clinical nursing teachers’ viewpoints
in Isfahan University of medical sciences. Iran J Med Educ
2014;13:796‑808.
Journal of Education and Health Promotion
Volume 8, Issue 10
October 2018
Pages 1-8

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