Rethinking the Gap: Investigating the Theory-Practice Relationship in Nursing

Abstract

For nursing education, theory and practice are commonly construed as discrete entities separated by a metaphorical void; usually referred to as the 'gap between theory and practice'. This particular conceptualisation, although widespread, was considered incomplete and for a more comprehensive understanding a Grounded Theory approach was taken to the collection and analysis of data from two phases of data gathering. The first phase was a series of computer mediated group discussions, and the second a number of individual interviews. In both sets of interviews participants were asked to describe how they experienced and managed differences they perceived between theory and practice in nursing. The participants referred to different types of theory relevant and central to effective nursing practice. The first was private theory the second was formal theory and third was situational theory. More specifically, the student nurses who participated in the study recalled critical moments when the different types of theory conflicted with the strongly held key values which each participant used as the standards against which they evaluated each type of theory. For the students it was a conflict that produced uncomfortable emotions, distrust of others and personal self doubt. In an effort to reduce this discomfort the students sought an explanation for the differences between theory and practice, some of which challenged their key personal values. However, the most emotionally neutral explanation that also preserved the integrity of their key values was that there was a gap between the theory and the practice of nursing. The theory Negotiating Different Experiences has implications for the education of nurses in that personal knowledge and experiences must be incorporated in a programme of study and the feelings evoked by learning must be acknowledged as a catalyst to enhance learning. Further, the different forms of theory to which students will be exposed must be made explicit and nursing educators who must involve the individual student as an active partner in the mapping of a personalised programme, which includes the creation of individual assessment methods.