Sep 13, 2022 in Education

Gap in Nursing Education and Nursing Practice

This paper explains the value of both nursing education and nursing practice for a qualified and skillful future nursing specialist. However, its main task is to reveal the gap in nursing education and nursing practice that makes a clinical environment less effective and leads to the emergence of a large number of nursing specialists who are not prepared to work in real conditions. The given paper explains the main reasons for the gap and inconsistency between nursing education and theory that challenge both nurses and healthcare organizations and encourage to look for the most effective ways of development of new nursing specialists. Finally, it suggests the ways of overcoming the gap in nursing education and practice and making the two areas harmonic and interrelated.

Clinical learning is one of the most important aspects that define a nursing student’s performance and ability to demonstrate his/her success and efficacy not only in nursing education but nursing practice as well. At the same time, a clinical setting is also significant as it provides more opportunities than educational environment and allows applying the theoretical and practical knowledge in practice. Consequently, it increases students’ knowledge, develops their professional identities, and encourages them to practice their skills. Not surprisingly, a clinical learning environment is an essential part of the nursing program that is responsible for preparing students to real-life situations, providing them with unique learning opportunities, and developing necessary skills to become qualified specialists. However, currently, one can observe the gap between nursing education and nursing practice that leads to the fact that clinical environment becomes less effective. The mentioned gap is related to disharmony between the theoretical knowledge and clinical practice approaches, poor optimization and high standards of a clinical setting, and lack of collaboration between healthcare organizations and nursing schools. As this gap adversely influences clinical practice, it should be eliminated as fast as possible.

The Reasons of the Gap in Nursing Education and Nursing Practice

Both nursing education and nursing practice are significant when it comes to the development of a nursing specialist as a qualified and skillful employee who can contribute to the clinical setting. However, the main challenge is that nursing education and nursing practice fail to coincide and be harmonic and interrelated with each other that results in many gaps between them. There are a few reasons that can explain this situation. According to Salah, Aljerjawy and Salama (2018), students’ knowledge and skills acquired during theoretical lectures and their practical experience in the clinical setting can be different and, thus, create gaps and misunderstandings. It means that the main reasons for inconsistencies between nursing theory and practice are poor optimization of a clinical setting and the lack of harmony between the clinical practice approach and theoretical nursing approach. Therefore, there is a need to make a clinical environment more creative that will provide more opportunities for both students and clinical instructors. Moreover, it will assist in bringing the theoretical nursing approach into accordance with the clinical practice approach.

Additionally, the inconsistencies between nursing education and nursing practice are related to the fact that nursing education is lagging behind a constantly changing clinical setting. According to Blais and Hayes (2015), nursing education should prepare students for the changing healthcare system that operates in a culturally and spiritually diverse world and requires having knowledge and skills not only at nursing but also at law and ethics. Thus, the gap between nursing education and nursing practice exists because a professional nursing practice is developing constantly and becoming more complex and complicated; therefore, nursing students should also learn to be experts in law, ethics, theory, and nursing history (Blais & Hayes, 2015). Not without a reason, educators of nursing theory should constantly monitor clinical practice and change nursing programs to ensure that they provide students with all the necessary skills and knowledge.

Furthermore, some nursing colleges and universities collaborate with certain healthcare organizations and prepare future nursing specialists for them. Yet, such an approach also creates gaps and inconsistencies because if these nursing specialists change a clinical environment, they will have to deal with challenges and issues. According to Estrada, GuanHing and Maravilla (2015), nursing institutions are competent to teach to provide patient care and help students to enter the nursing practice, but they should work on the improvement of strategies they use due to ever-changing nursing standards and practices. Thus, the researchers see a gap between nursing education and practice in the lack of innovation and changes in the clinical learning environment that makes students less prepared for challenges of real situations (Estrada et al., 2015). It means that nursing education should enhance the quality of information regarding standards of nursing care and ensure they provide professional clinical competencies to deal with the existing gaps and inconsistencies with nursing practice. Overall, it is a must to make clinical learning as realistic as possible and make it resemble a clinical setting.

The lack of balance between nursing education and nursing practice is another reason for gaps and inconsistencies that are reinforced by the lack of opportunities for continuous education, absence of current clinical practice among nurse educators, and use of students as service providers but not nursing specialists. Moreover, there are no strategies and approaches that will allow merging theory and practice in the delivery of patient care and nursing education. According to Hussein and Osuji (2017), the gap in nursing education and practice exists because nurses and other healthcare specialists are skeptical about text-based sources and theoretical learning and recognize human sources of information as more valuable and practical. Not without a reason, it is recommended for nurse educators to re-experience the realities of practice, update their clinical experience, and spend more time in clinical practice. Additionally, the integration of nursing education and practice is possible when students, nursing teachers, and clinicians are interested in the common outcome. Thus, it is necessary to regard any gap or inconsistency as a driving force of transformation and improvement of learning and teaching strategies.

To continue, both the academic and clinical environments are criticized for gaps and inconsistencies between nursing education and practice that create further issues and challenges for healthcare organizations. In particular, academe is criticized for providing insufficient preparation of future nurses for participating in patient care. Practice setting is subject to criticism for setting unrealistic standards and expectations from new graduates. According to Huston et al. (2017), gaps exist between the academic nursing programs and practice setting standards that make students unable translate theory and knowledge into practice. In addition, the researchers have discovered that new nurses focus too much on technology and have concrete thinking; therefore, they are weak in situations when they have to notice subtle changes in patient’s state and, consequently, do not see the bigger picture (Huston et al., 2017). The mentioned above competence gap that is typical for newly employed nurses can be related to the issues with teamwork, critical thinking, physical assessment, communication, psychomotor or technical skills, clinical knowledge, professionalism, and time management. Yet, all these skills are crucial when it comes to the quality of care and patient safety. In addition, new graduates deal with such concerns like changes, and the need for speed, high standards, and expectations. The misbalance in nursing education and practice has negative consequences as it increases turnover rate among nurses, makes new nurses feel stressed and depressed as they are aware of their deficiencies and preparation gaps.

Recommendations

It is possible to overcome the gap in nursing education and practice, but it is necessary to unite the efforts of both academic and nursing settings. First, it is a must to establish the collaboration and interaction between clinical instructors, nursing lecturers, and nursing matrons as it is the way to choose the proper teaching and learning strategies that will correspond to the needs of a clinical setting. Second, it is recommended to improve and diversify education strategies to address the competency gap. In particular, one could increase the use of stimulating learning in nursing education, promote learner-centered and active approaches to studying, revise curriculum, and implement the competency-based education. Third, a clinical environment should also improve its strategies by using dedicated learning units, and establishing academic service partnerships. Thus, it is critical for healthcare organizations and nursing schools to work even more closely to prepare the qualified generation of nurses and ensure high-quality, effective, and safe nursing care.

In conclusion, obviously, there is the gap between nursing education and nursing practice that arises from poor optimization of a clinical setting in the clinical learning environment, lack of harmony between the theoretical nursing approach and clinical practice approach, inability of nursing schools to change and innovate, and high standards and expectations of healthcare organizations. In addition, the gap under consideration exists due to the lack of close collaboration and interaction between learning and clinical settings. This results in high turnover of nurses and makes nurses stressed and depressed because they are aware of their gaps in preparedness. Thus, it is recommended to change strategies for theory and practice learning and make them more oriented to the desired outcomes rather than prescribed standards. In addition, nursing schools and healthcare organizations should collaborate and interact and be interested in ensuring the qualitative nursing care.

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