Strategies for bridging the theory-practice gap from the perspective of nursing experts

Nurses, midwives and students' reports of effective dedicated education units in five European countries: A qualitative study

AIM

To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment.

DESIGN

A multi-country, phenomenological, qualitative study.

METHODS

Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives.

RESULTS

Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment.

CONCLUSIONS

A close educational-service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment.

IMPLICATIONS FOR THE PROFESSION

It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population.

IMPACT

Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes.

PUBLIC CONTRIBUTION

Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement.

Positioning virtual reality as means of clinical experience in mental health nursing education: A quasi-experimental study

PURPOSE

Virtual reality technology has been used to establish a risk-free environment in which students can practice psychiatric nursing. A quasi-experimental study was conducted to examine the effects of a virtual reality (VR) based mental health nursing simulation on practice performance of undergraduate nursing students.

METHODS

A quasi-experimental, pre- and post-test design was used. A total of 68 students were randomly assigned to an experimental group (n = 32) and a control group (n = 36). The control group received conventional simulation using text scenario-based role play. The intervention group received VR software consisting of 360° video clips and related quiz questions.

RESULTS

The self-reported perceived competency in nursing performance showed no statistically significant improvement in the experimental group, whereas the control group showed a statistically significant improvement in symptom management (t = 2.84, p = 0.007) and nurse-patient interaction (t = 2.10, p = 0.043). Scores from the assessor showed better performance scores in the experimental group in symptom management (t = -2.62, p = 0.011), violence risk management (t = -3.42, p = 0.001), and nurse-patient interaction (t = -3.12, p = 0.003).

CONCLUSIONS

The findings of this study indicate the potential of using VR for optimized mental health nursing simulation. VR technology allowed realistic experiences which may ensure students have a more comprehensive understanding of mentally ill patients and in doing so, overcome barriers of traditional simulation, resulting in better learning outcomes.

Knowledge about the best practice guidelines in the nursing degree: A non-randomized post-test design

AIM

To compare knowledge of Nursing Degree students about Best Practice Guidelines when there are included as teaching content in a subject vs knowledge through having the usual internship experience without teaching specific guidelines contents.

DESIGN

Non-randomized post-test-only design with a comparison group.

METHODS

143 students of the nursing degree at the Autonomous University of Barcelona were recruited. The intervention group received a classroom training in three Best Practice Guidelines with Problem-Based Learning methodology. The comparison group only attended internship, without specific guidelines contents. Knowledge was evaluated with an ad hoc post intervention questionnaire. The information was collected between 2016 and 2018.

RESULTS

The average score of knowledge was low, 5.1 out of 10, and differs between guides. The best results were obtained by the students with internships and that had consulted the guides on some occasions. Synchronized effort and leadership in Academia and Healthcare are needed to favour evidence-based practice. The combination of the consultation of the Best Practice Guidelines in theoretical learning combined with the practice, increases the knowledge of the Best Practice Guidelines and will favour the implementation of evidence-based practice. Some students were involved in questionnaire design.

Nursing educational framework: A new nurse-driven, conceptually guided approach

PURPOSE

The aim of this article is to present the Nursing Educational Framework (NEF) as an opportunity to integrate core elements of a humanistic person/family-centered view and as guidance in structuring a relationship-based curriculum.

DATA SOURCES

Empirical and theoretical literature studies were reviewed to define the framework rationale and its components.

DATA SYNTHESIS

A deductive/inductive collaborative expert-informed approach was undertaken to develop this evidence-based codesigned framework. Its mission, along with unique components, implementation strategies, and outcomes, were successively integrated into the framework to guide nursing knowledge, learning, and curriculum development. A hermeneutic collaborative process of circular reflection was used in the development process.

CONCLUSIONS

The NEF contains central guiding principles and concepts that are intended to provide structural consistency across its included programs from a humanistic person/family-centered approach.

IMPLICATIONS FOR NURSING PRACTICE

This comprehensive theory-guided framework allows educators to suggest specific directions for nursing practice within the nursing discipline and articulate nursing's unique and specialized approach to promoting excellent patient care outcomes. It can assist students to develop critical lens from a person/family-centered relationship-based practice approach.

Causes and effects of theory-practice gap during clinical practice: the lived experiences of baccalaureate nursing students

PURPOSE

This study evaluated the baccalaureate nursing students' lived experiences of the causes and effects of TPG during clinical practice in a tertiary health institution in Enugu, Nigeria.

METHOD

A qualitative design using existential descriptive phenomenological approach was adopted to explore 20 baccalaureate nursing students at 500 level of study. The class level of the students was purposively sampled and the exact number of students sampled using snowball technique. Semi-structured interview guide was the instrument for data collection. Data were collected using audio-tape recorder, face to face in depth discussions, and analyzed using qualitative thematic analysis.

RESULT

Five broad themes and 12 subthemes emerged from this study namely: Resource constraints (limited resources, resource improvise); Unhealthy human attitudinal and behavioural factors (nurse clinicians, nurse educators, student nurses factors); Environmental system challenges (paradoxical academic design and structure, paradoxical clinical setting); Integration Inadequacy (team cooperation paucity, scarce surveillance, insufficient timing of clinical placement); Observing effects of TPG (observing adverse impacts, observing positive implications).

CONCLUSION

The causes of TPG during clinical practice emerge from nursing education and practice. TPG have adverse impacts on patients, nursing students, nursing education and practice, other health practitioners, while linkage to response is its positive implication.

The challenges of the Iranian nursing system in addressing community care needs

BACKGROUND

The nursing system is one of the major and important fields of health and medicine in every country, responsible for providing nursing care and addressing medical and health-related community care needs. The aim of this study was to explain the challenges of the Iranian nursing system in addressing community care needs.

MATERIALS AND METHODS

A conventional content analysis method was performed in this exploratory qualitative study, and 27 participants were selected through a purposive sampling method based on the inclusion criteria. In-depth semi-structured interviews were conducted with the subjects, and data saturation was achieved in the 27th interview. The main interviews with the participants were individual, in person, and face-to-face, conducted at different times (morning and evening) in a peaceful environment and at the convenience of the participants. The interviews were recorded by the researcher with the participants' consent. The duration of the interviews ranged from 50 to 70 minutes, given the participants' energy and time. Data analyses were done using Graneheim and Lundman approach.

RESULTS

After conducting the interviews and the simultaneous analysis, three themes were extracted, including the challenging structure in the internal environment, the operating environment, and the social environment, with seven main categories and 26 subcategories. An inadequate number of nurses given the real needs of society, the unbalanced proportion of employed clinical nurses to the real needs of society, poor presence of nurses in community-based nursing services, insufficient attention to the optimization of the work environment, the gap between education and clinical practice in the nursing system, poor mutual accountability of the community, and policies in the health system were seven main categories in this study.

CONCLUSION

In general, the results showed that the Iranian nursing system faces many micro, meso, and macroscale challenges. It is necessary to plan properly to enhance the accountability of the nursing system to the current community care needs by improving the situation.

Modelling the case-based learning preferences of undergraduate nursing students using a discrete choice experiment in China

PURPOSE

To investigate the preferences for case-based learning programmes among undergraduate nursing students.

METHOD

A questionnaire was designed based on a discrete choice experiment, and 227 undergraduate nursing students were investigated. In STATA 15.0 software, the data were statistically analysed using a mixed logit model.

RESULT

All attributes in our study were found to have a significant influence on undergraduate nursing students' preferences for case-based learning programmes. The students' preference for the CBL programme was influenced by the clinical internship experience and type of university. Furthermore, the most ideal scenario was found to be video case modality, unfolding delivery, provided by academic experts and clinical instructors, group size 9-11, adequate feedback, and fragmented case content.

CONCLUSION

The undergraduate nursing students' preferences for case-based learning programmes were affected by the provider, case modality, modality, group size, feedback, and case content. Our results can provide useful information for nursing educators to gain insight into student preferences and formulate case-based learning programs.

Implementation of a virtual student placement to improve the application of theory to practice

BACKGROUND

The primary aim of undergraduate, pre-registration nursing education is to prepare students to be nurses who can apply theory to practice, with clinical placements to support the practice element of the clinical programme. However, the theory-practice gap is a longstanding problem within nurse education, as nurses continue to practise with incomplete knowledge to support their actions.

PROBLEM

In April 2020, the COVID-19 pandemic caused a reduction in clinical placement capacity that affected student learning opportunities.

APPROACH

Based on Miller's pyramid of learning, a virtual placement was created using evidence-based learning theories and an array of multimedia technologies with the intention of replicating real-life experiences and promoting problem-based learning. Scenarios and case studies were collated from clinical experiences and mapped against student proficiencies to produce an authentic and immersive learning environment.

CONCLUSION

This innovative pedagogy provides an alternative to the placement experience while enhancing the application of theory to practice.

Nursing students' experiences and expectations of clinical learning: A qualitative study

BACKGROUND

Clinical learning is an important component of nursing education that can support the development of competence. Nursing students have expectations before clinical learning, however if these expectations are not matched with their experiences, then development can be hampered.

OBJECTIVE

To explore nursing students' expectations and experiences of their clinical learning experiences.

DESIGN

Qualitative descriptive design.

SETTINGS

The study was conducted at a large teaching hospital in Namibia.

PARTICIPANTS

Fifteen first to fourth year undergraduate nursing students who were allocated to a teaching hospital in Namibia.

METHODS

The participants were purposively sampled among the teaching hospital's undergraduate nursing students. Data were collected between June to November 2021 through in-depth, semi-structured interviews that lasted between 35 and 45 min each. Data were analyzed using thematic analysis.

RESULTS

The data analysis identified four themes: clinical outlook and role, supporting/role modelling, clinical teaching and learning, and linking theory and practice.

CONCLUSION

The expectations and experiences of nursing students regarding the clinical environment were mixed. The findings demonstrated the need to moderate students' expectations, as well as to reorganize the clinical learning environment to enhance students' learning. Further studies should look at the standardization of student expectations based on the context of their clinical learning environment, and how this can improve learning experiences.

A systematic review on clinical guidelines of home health care in heart failure patients

BACKGROUND

"Guidelines for the care of heart failure patients at home support safe and effective evidence-based practice. The aims of the present study were: [1] to identify guidelines addressing the care at home for adults with heart failure and [2] evaluate the quality of the guidelines and the extent to which they address eight components of home-based HF disease management."

METHODS

A systematic review was conducted of articles published between 1st of January 2000 to 17th of May 2021 using the databases of PubMed, Web of Science, Scopus, Embase, Cochrane, and nine specific websites for guideline development organisations. Clinical guidelines for HF patients with recommendations relevant to care provision at home were included. The results were reported according to the Preferred Reporting Items for Systematic Reviews (PRISMA-2020) criteria. The quality of included guidelines was evaluated using the Appraisal of Guidelines for Research and Evaluation-II (AGREE-II) by two authors independently. Guidelines were evaluated for their coverage of eight components of HF care at home, consisting of integration, multi-disciplinary care, continuity of care, optimized treatment, patient education, patient and partner participation, care plans with clear goals of care, self-care management and palliative care.

RESULTS

Ten HF guidelines, including two nursing-focused guidelines and eight general guidelines were extracted from 280 studies. After evaluation of quality by AGREE-II, two guidelines obtained the highest score: "NICE" and the "Adapting HF guideline for nursing care in home health care settings. Five guidelines addressed all eight components of care at home while the others had six or seven.

CONCLUSIONS

This systematic review identified ten guidelines addressing care at home for patients with HF. The highest quality guidelines most relevant to the care at home of patients with HF are the "NICE" and "Adapting HF guideline for nursing care in home health care settings" and would be most appropriate for use by home healthcare nurses.

Radiographers' experiences of image interpretation training in a low-resource setting

INTRODUCTION

Radiographers extend their roles through formal and on-the-job training to keep up with clinical practice changes. One area of role extension that is now incorporated into undergraduate programmes is image interpretation, although the training provided may vary between institutions. This study explored the experiences of graduates from one higher education institution in a low-resource context with regard to their image interpretation training.

METHODS

A qualitative phenomenological research design was employed to investigate the experiences of ten radiography graduates who were purposively selected from one higher education institution. Individual semi-structured interviews were conducted with each participant after obtaining their informed consent. The interview recordings were transcribed and analysed using Atlas.ti Windows (Version 9.0) software, following Colaizzi's seven-steps of data analysis.

RESULTS

From the ten interviews conducted, teaching approach, clinical education, and assessment strategy emerged as areas of experience within the teaching and learning theme, while practitioner role modelling, skill utilisation, and industry impact were sub-themes under the paradoxical reality theme. The participants' experiences indicated a theory-practice gap in image interpretation among radiographers.

CONCLUSION

The participants' experiences reflected a misalignment in the educational process due to inadequacies in the teaching approach, clinical education, and assessment strategies. Participants encountered significant differences between their expectations and clinical realities during and after training. Image interpretation by radiographers was recognised as a relevant area for role extension in this low-resource setting.

IMPLICATIONS FOR PRACTICE

While these findings are specific to the experiences of the participants, conducting similar research in comparable contexts and implementing competency-based image interpretation assessments could help identify gaps and guide interventions to address shortcomings.

Clinical learning for pre-registration nursing students: a viva voce approach during COVID-19

The COVID-19 pandemic restricted face-to-face contact between students and educators, limiting continual assessment of student's clinical skill development. This led to rapid transformational online adaptations to nursing education. This article will present and discuss the introduction of a clinical 'viva voce' approach, which has been used at one university to formatively assess students' clinical learning and reasoning skills using virtual methods. The Virtual Clinical Competency Conversation (V3C) was developed using the 'Think aloud approach' and involved facilitated one-to-one discussion based on two questions from a bank of 17 predefined clinically focused questions. A total of 81 pre-registration students completed the formative assessment process. Overall, feedback from students and academic facilitators was positive and facilitated both learning and consolidation in a safe and nurturing way. Further local evaluation is continuing to measure the impact of the V3C approach on student learning now that some aspects of face-to-face education have resumed.

Exploration of nursing students' views on the theory-practice gap in surgical nursing education and its relationship with attitudes towards the profession and evidence-based practice

AIM

The aim of this study was to explore nursing students' views on the theory-practice gap in surgical nursing education and determine its relationship with attitudes towards the profession and evidence-based practice.

BACKGROUND

In nursing education, the discrepancy between the theoretical knowledge and clinical practices is known as the "theory-practice gap". Although this problem was defined many years ago, scientific information on the subject is very limited in terms of surgical nursing.

METHOD

This descriptive-analytical and cross-sectional study was carried out in three different universities in the Black Sea Region of Türkiye. The sample consisted of 389 nursing students. The data collection was carried out in May-July 2022 through the use of the following tools: The Attitude Scale for the Nursing Profession (ASNP), the Knowledge, Attitudes and Behaviors Questionnaire for Evidence-Based Practice (KABQ-EBP) and the researchers made form to determine students' views on the theory-practice gap. The data were analysed with Student's t-test, multiple linear regression analysis.

RESULTS

72.8% of the students stated that they thought there was a discrepancy between their theoretical surgical nursing courses and clinical practice. While the total ASNP score of students who thought that there was a discrepancy between theoretical education and clinical practice was lower than that of the other students (p = 0.002), no difference was found among the students in terms of the total KABQ-EBP score (p > 0.05). In the multiple linear regression analysis, it was determined that thinking about gap (β = -0.125, p = 0.009), gender (β = -0.134, p = 0.006), willingness to choose the profession (β = 0.150, p = 0.002) and KABQ-EBP score (β = 0.247, p < 0.001) had significant effects on nursing students' attitudes towards the profession. In the model, %12 of the total variance was explained by the variables.

CONCLUSION

The study shows that the gap between theory and practice for the surgical nursing course is a problem perceived by most students. Also, students who thought that there was a theory-practice gap for the surgical nursing course had a more negative attitude towards the profession, while their attitudes towards evidence-based nursing were not different from others. The results of this study encourage further research to gain a better understanding of the impact of the gap between theory and practice on nursing students.

Identifying important conceptual areas in a nursing education programme to meet future demands, using group concept mapping

A nursing programme in southern Sweden was revised to meet future demands. The aim of this study was to explore important conceptual areas to be included in a nursing programme in order to meet long-term societal and health care requirements. Group concept mapping (GCM), a mixed-methods approach, was used. Thirty-four experienced teachers participated. Data was collected during brainstorming sessions in focus groups. Following editing and removal of duplicates, 101 statements remained to be sorted into piles that had similar conceptual representation in nursing education. The final step was then to rate each statement from 1 to 5 (higher values = more important/more feasible). Quantitative analysis using non-metric multidimensional scaling and hierarchical cluster analysis resulted in 11 clusters. Assessment and treatment and Person-centred care were rated as the most important and Scientific theories and methods, Basic caregiving in nursing and Person-centred care had the highest feasibility ratings. Further analyses suggested that the content of nursing education can be seen from a systems theory perspective, represented by the macro, meso, and micro levels. These levels may increase the understanding of the complexity of nursing care. Furthermore, the cluster analysis can facilitate the development of a concept-based curriculum for nursing education.

Development of entrustable professional activities for advanced practice nurses education

BACKGROUND

Entrustable professional activity (EPA) framework has gained popularity within competency-based healthcare education programmes across disciplines, professions, and countries. As opposed to traditional time-based approach, EPAs bridge the gaps between competency framework and clinical practice, however, limited information on nursing EPAs highlights a need to develop EPAs specific to graduate nursing education to promote patient safety and quality patient care.

OBJECTIVES

This paper described comprehensively the four-stage approach used to develop and pilot test a set of core EPAs for advanced practice nurse (APN) education.

METHOD

The four-stage approach used to develop and pilot the EPAs included: 1) team formation, 2) development of conceptual framework, 3) identifying and reviewing core EPAs, and 4) pilot testing the EPAs. Post pilot test and surveys were conducted for the EPA developers, APN preceptors and interns to explore their perceptions and experiences using the EPAs.

RESULTS

A framework of nine core EPAs was developed for APN education, including: 1) perform an initial assessment and formulate management plans, 2) manage follow-up care for a clinical encounter, 3) plan, perform and evaluate care procedures, 4) recognise and manage patients requiring urgent care, 5) manage care transitions within and between health care organisations, 6) recognise and manage pharmacological needs of patients, 7) collaborate with patients, families, and community to improve health through disease prevention and health promotion, 8) participate in health quality improvement initiative, and 9) develop self and others for professional practice.

CONCLUSION

Despite the stakeholders having generally positive attitudes towards the use of EPAs, it has its drawbacks. More research is needed to examine the psychometric properties of the EPA assessment tools and evaluate the effectiveness of EPAs in graduate nursing education. Additionally, the described set of core APN EPAs needs more refinement and rigorous testing before it can be implemented on a larger scale.

The Theory-Practice Gap in Nursing Education During the Pandemic Period from the Perspective of Stakeholders: A Qualitative Study

Objective: The purpose of this study was to understand the experience of theoretical and practical nursing education carried out by distance education during the COVID-19 pandemic and the theory-practice gap in nursing education in Turkey. Methods: This qualitative study used a descriptive qualitative study. This research was conducted with nursing lecturers and students from two universities in two different geographical regions. Lecturers and undergraduate students participated in the research. The data for the research were collected using the online Zoom program during four focus-group discussions. Results: Three main themes emerged for the categories of theoretical and practical education emerged during the study: strong structural conditions (technological integration and accessibility) both strong and weak structural conditions (asynchronous participation and changing comfort levels/routines) and weak structural conditions (cold contact and inequality of opportunity). Conclusion: This study revealed the strengths and weaknesses in the experience of distance nursing education and will guide future planning of nursing education programs and clinical fields.

Clinical teaching practices of nurse educators: An integrative literature review

Clinical teaching practice of nurse educators is important in the development of clinical competence of undergraduate nursing students, but it is often not done according to best practice standards. This study aimed to summarise the best clinical teaching practices of nurse educators teaching undergraduate nursing programmes. An integrative literature review was conducted according to Whittemore and Knafl’s adapted stages. A systematic search of electronic databases, including EBSCOhost and ScienceDirect, for applicable papers from January 2001 to June 2021, was followed by a manual search. The review resulted in selection of 67 papers, and critical appraisal had been completed by two independent reviewers using relevant critical appraisal tools. Papers that were selected revealed six main themes, with sub-themes, outlining best practices for clinical teaching, namely: (1) planning for clinical teaching practice: self-preparation and planning for clinical placement; (2) facilitation of students’ clinical learning: orientation of students, planning for clinical teaching and the clinical teaching process; (3) evaluation of students’ clinical skills: reflection by the nursing student and feedback; (4) modelling professional clinical teaching practice: emotional intelligence, self-evaluation, role modelling and continuous professional development; (5) work-based assessment in the clinical environment: clinical assessment process and clinical assessment tools and (6) clinical teaching in the simulation laboratory. The six identified best practices could assist nurse educators to provide comprehensive clinical teaching.

Capturing the value and core concepts of the Clinical Research Nurse

Background

As nurses, we identify our profession as a caring one, but how does this identity translate from a conceptual definition, to real-world practice for the Clinical Research Nurse?

Aim

To offer a novel, four-point conceptual model that encapsulates the Clinical Research Nurse's intrinsic value, active leadership, and direct contribution to high quality, person-centered, safe care, addressing current misperceptions of research nursing.

Methods

This paper describes the provision of 'care', safely delivered by the Clinical Research Nurse through a four-point conceptual model and case-driven example.

Discussion

Clinical research nursing is conceptualized within the domains of Care and Trust, Role, Impact, and Integration. The case example demonstrates real-world application of these domains and the expertise required to balance the complexities of clinical needs and research demands in a healthcare environment.

Conclusions

This paper offers a mechanism for understanding the importance of the Clinical Research Nurse and their role in maintaining safety and a high-level view of the care arena. These reflections are considered with an international application for the role.

Health Promotion and Disease Prevention in the Elderly: The Perspective of Nursing Students

Health promotion and disease prevention are closely linked to health literacy. Therefore, intervention to increase individuals’ knowledge is essential if action is to be taken to promote a healthy lifestyle with support from health professionals for decision making on choices leading to behavioral change. Taking into account the growing aging population, nurses and nursing students have to develop interventions to promote health and prevent disease in these people, in order to keep them healthy and with quality of life. This study aims to understand how nursing students’ experiences in a clinical teaching context contributed to the development of their competencies in the promotion of health and prevention of disease in the elderly. Method: Qualitative, exploratory, and descriptive study carried out with ten students about to finish a graduate nursing course in a higher education institution in the South of Portugal. This study was carried out through narratives, one of the most common data collection procedures in social and health investigations. The content analysis technique, more specifically the thematic categorical analysis, was used for data analysis. The study received authorization from the Ethics Committee of the institution where it took place. Results: Three categories were found: “Strategies to promote health and prevent disease in the elderly”, “Health improvements from the implementation of the strategies to promote health and prevent disease in the elderly”, and “The impact your participation in these strategies to promote health and prevent disease in the elderly had on your formative process”. Conclusion: The students developed competencies during their clinical teaching experiences through the implementation of strategies of health promotion and disease prevention adapted to/focused on the needs of the elderly.

Theory-Practice Gap: The Knowledge and Perception of Nigerian Nurses

BACKGROUND

The theory-practice gap can be described as a lack of ability to relate the knowledge acquired in academics and research work with practice. This study aims to assess the knowledge and the perception of Nigerian nurses on the theory-practice gap in Nursing.

MATERIALS AND METHODS

This cross-sectional correlational study was carried out with a sample of 196 nurses who were working in the Federal Medical Centre Keffi and Aminu Kano Teaching hospital in Kano, all from the northern part of Nigeria, from April to June 2019. The participants were selected using a convenient sampling technique, where a self-administered questionnaire was utilized to collect the data and analysis was undertaken using SPSS.

RESULTS

The results of this study showed that 83.80% of respondents had good knowledge and 89.10% of the respondents had good perceptions. The levels of knowledge were significantly different in correlation with the educational level of respondents (χ² = 13.88, df = 6, p = 0.022), which was determined using a Fischer exact test. Also, the level of perception was significantly different when considering the nature of work participants undertook (X² = 7.65, df = 2, p = 0.022).

CONCLUSIONS

Given the participants' awareness and perceptions in this study, it is clear that they are well informed of the theory-practice gap. This is a call for all professionals at an individual and organizational level to work, as it will translate into gap minimization, thereby increasing the quality of health care delivery as nurses constitute the largest part of the health care team in Nigeria.

Development and psychometric evaluation of nurses' perception towards the gap between knowledge and practice

AIM

The aim of the study was to develop a survey instrument and psychometrically evaluate nurses' perceptions of the gap between knowledge and practice. Although the nursing literature has widely documented a gap between knowledge and practice, no instrument has been developed to measure this gap.

DESIGN

Psychometric analysis was done on 513 nurses working in different positions at two large hospitals in Jeddah City.

METHODS

Cronbach's alpha was used to determine the internal consistency and reliability of the research instrument, and a panel of experts evaluated the validity of the tool's content.

RESULT

The content validity index computed from expert rankings was 0.89. Factor analysis yielded four major components: knowledge, practice, environment and learning. Cronbach's alpha indicated a high level of internal consistency and reliability for the component items. The newly developed scale will facilitate measuring nurses' perceptions of the knowledge-practice gap in clinical settings.

Perception and Attitude of Health Care Personnel Regarding Integration of Nursing Education and Nursing Services for Patient Care at a Tertiary Care Center of Northern India

This study aims to assess the perception and attitude of health care personnel regarding integration of nursing education and nursing services. Using purposive and stratified random sampling technique, 92 medical faculty, 32 nursing faculty and 346 nursing officers were enrolled. A three-point Likert scale consisting of 15 items and six open ended questions was used to collect the data. Overall, the concept of integration of nursing education and nursing services at their institute was welcomed by 74.4% of health care personnel. Medical faculty (47.8%), nursing faculty (37.5%) and nursing officers (57.5%) scored the concept of integration as very good.

Solutions to bridge the theory-practice gap in nursing education in the UAE: a qualitative study

BACKGROUND

The theoretical knowledge of nursing underpins the practice, while the practice environment determines the circumstances within which the theoretical knowledge is applied. The biggest challenge facing nursing as an academic field is the theory-practice gap, which is a universal issue in nursing. This study aimed to raise solutions to close the gap between theory and practice in nursing education through the eyes of nursing students in UAE.

METHODS

A qualitative descriptive approach was followed; whereby 25 Emirati nursing students were interviewed.

RESULTS

Two main themes are discussed in this study: 'Clinical Culture Creation' and 'Curriculum Content Reformation'. The students suggested to decreased the loud and stress on their clinical educators. They also suggested creating synchronization between what is taught in classrooms and labs and what is offered in the clinical training. Moreover, some of the students expected to have more benefit if they get their clinical training in health institutions owned by their college. On the other side, many of the participants suggested to move from the integration system to the block system. Another interesting suggestion includes having the same college staff to teach the theory and the clinical. The final suggestion includes decreasing the paper work during clinical training.

CONCLUSIONS

This study explored the solutions to bridge the theory-practice gap in nursing education in the UAE. The study has implications for nursing education and practice within the UAE and is imperative for graduating workplace ready professional nurses within the country.

The effect of competency-based education on clinical performance of health care providers: A systematic review and meta-analysis

AIM

This study aimed to investigate the effects of competency-based education on the clinical performance of health care providers.

BACKGROUND

Having in mind the importance of developing an intervention to enhance the clinical performance of health care providers, the researchers carried out the present study to investigate the effect of competency-based education on the clinical performance of health care providers.

METHODS

This was a systematic review and meta-analysis carried out by searching six international electronic databases including PubMed, Ovid, Cochrane Library, Web of Science, ProQuest, Scopus and Google Scholar, as well as two national electronic databases including IranMedex and SID. The studies relevant to the research aims were included in the study. To assess the quality of the studies, the Cochrane Collaboration's Risk of Bias Tool was used.

RESULTS

Based on the random effects model, competency-based education could enhance the clinical performance of the health care providers in the intervention group compared with that of the control group (standardized mean difference [SMD] = -2.717, 95% CI: -3.722 to -1.712). However, more recent studies have shown that competency-based education has little effect on clinical performance (β = -.255, 95% CI: -0.319 to -0.192, P < .001).

CONCLUSION

Competency-based education can enhance the clinical performance of health care providers. However, there is increasing concern over the attenuation of the positive effect of competency-based education on the clinical performance of health care providers, which deserves further studies.

Managing the theory-practice gap in nursing education and practice: Hearing the voices of nursing students in the United Arab Emirates

AIM

The aim of this study is to explore factors contributing to the theory-practice gap in nursing education in the United Arab Emirates.

BACKGROUND

The gap between what is taught in nursing classrooms and what is practised in clinical settings creates challenges for nursing students, practitioners, managers and educators. This has important implications for the United Arab Emirates and other developing countries as their healthcare systems require a permanent nursing taskforce that is well supplied with ready to practice graduates.

METHODS

A qualitative descriptive approach was used, whereby 25 senior student nurses were interviewed about their perceptions of the theory-practice gap.

RESULTS

The major theme that emerged in this study was the 'tripod of clinical practice', with three subthemes: prepared students, aware and supportive preceptors and qualified clinical faculty. The other theme that emerged was 'real life outside the simulated lab', with two subthemes: various and unfamiliar psychomotor skills and communication with real patients.

CONCLUSION

The tripod of clinical practice must be achieved for quality clinical practice. Further, attention should be directed to development of skills (e.g., communicating with real patients) that are difficult to acquire while dealing with simulated patients.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing students need longer immersion in simulated clinical settings, coupled with experienced clinical faculty and supportive, aware and prepared preceptors.

Anticipated nursing care as perceived by nursing students: Findings from a qualitative study

AIM

To explore the perceptions of nursing students on the phenomenon of anticipated nursing care.

DESIGN

A descriptive-qualitative study was performed in 2019 according to the Consolidated Criteria for Reporting Qualitative Research principles.

METHODS

Data were collected using 16 face-to-face, audio-recorded interviews across four Italian Bachelor of Nursing degrees. Then, content analysis was performed, identifying, analysing and describing the anticipated nursing care phenomenon as perceived by nursing students.

RESULTS

Administering medications, providing fundamentals of care, managing some clinical procedures, freeing up the patient's bed and starting the shifts early emerged as the most anticipated nursing interventions. Stable, older patients who were more functionally dependent were reported to receive some fundamental nursing care before the expected time, while older, stable and more independent patients were used to receiving medications in advance. Anticipated nursing care is triggered by factors at the time management, resource, programming, professional and organizational levels.

Including administrators in curricular redesign: How the academic-practice relationship can bridge the practice-theory gap

AIM

Health care administrators provided information through semi-structured interviews as to how one faculty of nursing (FoN) was preparing students for practice.

BACKGROUND

There is a long-standing disconnect between the nursing education and the clinical arena known as the theory-practice gap. The FoN wanted to redevelop their curriculum to better prepare students for practice and bridge the gap.

METHOD

Using developmental evaluation, 36 administrators were interviewed and asked about their expectations of newly graduated nurses, the FoN curriculum, and changes to be made.

RESULTS

Four themes were identified: entry to programme; curricular content, delivery and structure; clinical recommendations; and stronger relationships.

CONCLUSION

Strong academic-practice partnerships are still needed. The current lack of communication and partnership has compromised students' quality of education and their transition into the workforce.

IMPLICATIONS FOR NURSING MANAGEMENT

Leaders in both the education and practice settings can better prepare newly graduated nurses and bridge the theory-practice gap by co-creating a joint committee and creating more touchpoints with one another. A joint committee can develop appropriate entry-to-programme guidelines, discuss relevant trends in practice and shape the curriculum. Clinical experiences for students may also act as extra touchpoints whereby the two groups can discuss clinical mentorship needs and build stronger academic-practice relationships.

Perceived professional preparedness of senior nursing students' questionnaire: Development and psychometric evaluation

BACKGROUND

Nursing students' perceptions of their professional preparedness help them perform their independent nursing role with self-confidence.

OBJECTIVES

To develop and psychometric testing of an instrument, the "Perceived Professional Preparedness of senior Nursing Students" questionnaire.

DESIGN

Mixed-method exploratory study.

METHODS

We conducted this study in two phases: (1) development of initial questionnaire through interview and literature review; (2) evaluation of psychometric properties of the instrument to introduce a reliable, valid tool.

SETTINGS AND PARTICIPANTS

We assessed qualitative and quantitative face validity of initial questionnaire by administering it to 10 nursing students. Then, a panel of 10 nursing specialists determined the Content Validity Index. After modifying items, we assessed the construct validity of the 45-item questionnaire. A sample of 159 senior nursing students completed the questionnaire, and we conducted exploratory and confirmatory factor analysis using this data. To assess the test-retest reliability, 30 students completed the instrument twice with a two-week time interval.

RESULTS

The Content Validity Index with the modified Kappa coefficient was calculated as ≥0.72, which is considered satisfactory. In exploratory factor analysis using the maximum likelihood method and varimax rotation, we extracted 19 items in four factors. This structure included 61.91% of the total variance. The factors were clinical competency, evidence-based practice, framework-oriented performance, and patient-centered care. Cronbach's alpha coefficient and McDonald's omega values higher than 0.70 and inter-class correlation coefficient above 0.90 for all factors confirmed reliability. Confirmatory factor analysis indicated a suitable fitting of the final developed model.

CONCLUSION

The developed questionnaire is a valid, reliable tool to assess the perceived preparedness of senior nursing students for transition to the clinical setting. Further psychometric testing for this questionnaire on larger populations and in different contexts is suggested.