The theory-practice gap in nursing is the idea that there is a distinct divide between our current knowledge base and the utilization of that knowledge into the discipline of nursing practice.

The theory-practice gap in nursing is the idea that there is a distinct divide between our current knowledge base and the utilization of that knowledge into the discipline of nursing practice.  The struggle to close this nursing theory-practice gap stems from factors such as a lack or inability to use theory in practice due to a deficiency of belief, knowledge, understanding, or application of theoretical concepts to guide nursing practice (Butts & Rich, 2015).  Venes (2009) describes the term theory as “a statement that best explains all the available evidence on a given topic.  If evidence that contradicts the theory becomes available, the theory must be abandoned, modified, or changed to incorporate it” (p. 2300).  Complicating the learning of theory, theorists often use abstract meanings and multiple interpretations when defining rules and procedures that apply to the clinical setting (Saifan, AbuRuz, & Masa’deh, R., 2015).  Comprehending nursing theories is often an obscure venture when the consensus among modern nursing theorists varies.  Perhaps this disconcertion, coupled with a more demanding need for a basic set of clinical skills, is the reason why traditional nursing practice favors medical knowledge as a guide instead of a theory-first approach.  According to Saifan, AbuRuz, and Masa’deh (2015), “this view was originated from the ability of clinical education to provide students with real-life events that enable them to develop, apply and evaluate their own understanding of concepts being studied” (p. 20).  However, even the most modern clinical educations have contentions as they cannot fully prepare nurses for the inconstant variables and complexity of the real-world practice domain.

There is a delicate balance between learning theory and preparation for clinical practice in nursing education.  Too much early focus on theory may leave nurses lacking in essential clinical competencies; a trend that would undoubtedly be detrimental to patient health outcomes. But, failure to address theory in a nurse’s education may not allow the clinical nurse to conceptualize patterns and experiences into research and theory thereby hindering the advancement of nursing practices.

I believe that theory is vital to fully recognizing and understanding how and why we pursue the advancement of better nursing practices.  However, it cannot be understated that there is a primary necessity for the development of clinical competence in gaining critical thinking and decision-making skills to achieve the desired patient outcomes for practicing nurses.  These clinical nursing skills are what purposes most nurses with providing health care services.  This actuality cannot overshadow the importance of introducing theory as part of the nursing curriculum.  Planting the early seeds of theory and the associated concepts in nursing education helps to later bridge the theory-practice gap through the merging of experienced clinical knowledge to a growing theoretical understanding in the evolution of the expert nurse.

 

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