Theory-Practice Gap Theory

allnurses Guide · Mar 6, 2011

I'm thinking the difference is not the theories of nursing researchers (Watson, etc.), as much as what we want nurses to do (theoretical best practice under ideal conditions), and the gap to reality of what nurses can actually do under real life conditions (administrative demands, paperwork, equipment failures, high nurse/pt ratios, difficult and demanding pts/families).

For instance, we know skin breakdown can begin after only 20 minutes of pressure on a hip or bony prominence, but actual practice is to turn and position every 2 hours. Or that you should spend as much time as needed to teach a new diabetic how to do blood sugar testing and insulin injections, but you only have 20 minutes in reality (and that gets interrupted by other demands). Or answering call bells within 2 minutes, but your aide is tied up in an isolation room, and 3 patients rang all at once.

llg, PhD, RN · Mar 6, 2011

I teach theory -- but I am confused by the use of the word "theory" when you state, "theory-practice gap theory." I have heard of the "theory-practice gap" for years, but never the "theory-practice gap theory." Is there a particular theory of the theory-practice gap that you are talking about ... or are you talking about the theory-practice gap in general. If there IS a particular theory about the theory-practice gap that you are talking about, who is the author of that theory?

If you are looking for a nursing theory that would provide a framework for discussing the theory-practice gap, you might want to look at the work of a Patricia Benner. Some of her more philosophical work discusses how nurses learn from experience and go back and forth between what they learn from books and classes (theory) and what they learn through practical experience. She talks about the fact that knowing how to do something is different from knowing that it needs to be done.

There is also literature at the graduate level of scholarship that discusses the relationships between practice, theory, and research. They relate directly to the theory-practice gap, but they can be very complex and a bit difficult to understand sometimes. I don't know what level you are at in school: so, I don't know whether or not those discussions would be something you would want to explore.

Fatmah Jabr · Mar 7, 2011

thank you jbudd and llg,

iig,

do suggest something from benner work?

the thing i know about benner work is that she talked about the "novice-expert theory", and i dont thing this can suit my study since this theory aim to follow nurses experience from the novice level to the expert level to guide thier practice.

however, my study is aim to explore the nurses perception about the gap from thier undergradaute nursing education, therfore here i need a theory that can talk about the gap in learning and practice.

that what made me confused about the meaning of the " theory-practice gap" and i am not sure if it is really theory or not becaue i usually find this term in a consequence of other theories and also there is a work don to this theory which is " bridging the theory-practice gap".

i would love from you to guide me to some work.

thanks in advance

regards

fatmah

llg, PhD, RN · Mar 7, 2011

I don't think there is a theory that specifically addresses the theory-practice gap. To use Benner, you would have to read her other, more philosophical works and relate how nurses learn (e.g. from novice to expert) in the practice environment in ways that emphasize the "doing" of things rather than the "knowing" of things.

Perhaps you should talk with your professors and get their help.

kevinadurr · Mar 8, 2011

Benner is a great theory but limited in applicability when trying to focus on the nursing student spectrum.

Try instead looking into some learning/teaching theory especially related to nurse teaching theory. Lots of research is out there regarding the importance of students being in the same clinical course as content being taught within the classroom. Unfortunately, this standard is still not universal, especially with the accelerated programs.

Part of the problem too is that typically classroom and clinical begin relatively close in time. Therefore, students are on the floor before grasping content learning in the classroom. Additionally, there is debate on whether to systematically progress through each system or to focus on the most relevant diseases and diagnoses present in the community. For example, for a pediatric course in the winter season, if an educator approaches with the stages of development or another system, it might be a few weeks until the most prevalent diagnoses of RSV, RhinoVirus, and others are discussed. Clinical educators should be at the planning table to discuss the popular diseases that would be most helpful for students to learn and know to help the for clinical. The second half of semester/quarters could be spent filling the gaps or quick systematic reviews.

--- Kevin