THEORY-PRACTICE GAP: PERCEPTIONS OF NURSE FACULTY AND NURSING STUDENTS IN UNIVERSITY FOR DEVELOPMENT STUDIES AND CLINICIANS IN TAMALE TEACHING HOSPITAL

ABSTRACT
The overall goal of this research work was to explore the understanding of theory-practice gap from the perspective of nurse faculty and nursing students in University for Development Studies, and clinicians in Tamale Teaching Hospital. Despite several attempts by nurse faculty and clinicians to address the theory-practice gap, it remains a central issue in both nursing education and practice. Most of the initiatives to bridge the theory-practice gap have evolved in geographic areas such as the USA, UK, and other developed nations. Little research addressing the issues is evident in sub-Saharan Africa. A descriptive phenomenological methodology was used. Data were collected using focus group discussions. A purposive sampling technique was used in recruiting 32 study participants. The sample consisted of 32 participants, comprising 8 nurse faculty, 12 clinicians (6 in each discussion session) and 12 nursing students (6 in each discussion session). The study adopted Colaizzi's descriptive phenomenology data analysis process. Five themes were identified: system inadequacies; resource constraints; challenges of the clinical learning environment; clinical placement and supervision; nurse faculty factors. In Ghana, stakeholders in nursing education and practice are yet to realise the implications of the theory-practice gap and its associated challenges on contemporary nursing education and nursing practice.Based on this evidence of the scope and factors contributing to theory-practice gap in Ghana, further research could be conducted to identify and develop research-based strategies to bridge the gap.


CHAPTER ONE
INTRODUCTION
In recent times the clinical competence of nurses has been increasingly criticised to be on the decline. During the past decade, the image of nursing in Ghana has fallen at a steady rate due to poor nursing care rendered to patients by qualified nurses (Ghana Registered Nurses' Association [GRNA], 2011). There is widespread criticism that graduate nurses though proficient in theory are less proficient in clinical skills at the time of registration (Glen, 2009). This has been and continues to be a major concern for all, especially nurse educators in Ghana.
Theintegration of theoretical knowledge and practical skills does not usually occur smoothly; leading to the occurrence of a theory-practice gap in nursing (Bendal, 2006; De Swart, Du Toit, & Botha, 2012; Monaghan, 2015). The gap between theory and practice of nursing is an issue of great concern for nurse faculty, students and clinicians. Though widely studied globally, there is little research on theory-practice gap in sub-Saharan Africa (SSA) (Lugina, 2009).

The chapter is organized into the following sections; background to the study, problem statement, statement of purpose, research objectives, research questions, significance of the study, delimitations, limitations, definition of terms, and organization of the report. The background of the study entails the definition of theory-practice gap, factors influencing theory-practice gap, and effects of theory-practice gap in nursing practice.


Background to the Study
The theory-practice gap in nursing and midwifery has been discussed and debated in the literature for decades. Review of professional nursing literature from several countries in Europe and North America as well as Australia provides sufficient support for the existence of a theory-practice gap in nursing and midwifery (Gardner, 2006; Haigh, 2008; Landers, 2000; Maben, Latter, & Clark, 2006; Rafferty, Allcock, &Lathlean, 1996; Sellman, 2010; Sullivan, 2010; Upton, 1999; Wilson, 2008). Although well documented globally, there is a paucity of research on this topic in sub-Saharan Africa (SSA) (Lugina, 2009). However, there is a general consensus among Ghanaian educators and practitioners that a theory-practice gap exists (Lugina, 2009).
Though often defined imprecisely and subjected to differing individual interpretations, it is rife in scholarly literature that theory-practice gap relates to the discrepancy between classroom theoretical preparation and what nursing students encounter in clinical practice (Baxter, 2007; Corlett, Palfreyman, Staines,
Marr, 2003; Higginson, 2004; Holton, Bates, Bookter, &Yamkovenko, 2007; Maben, Latter, & Clark, 2006, Rolfe, 2002; Scherer & Scherer, 2007; Wolf, Bender, Beitz, Weiland, & Vito, 2004). Seemingly, the theory-practice gap manifests on two main levels: first, for nursing students on clinical practicum placements, and second, for newly qualified nurses (Kellehear, 2014; Monaghan, 2015; Scully, 2010). The gap between the theory and practice of nursing is an
issue of great concern for nurse faculty, students and clinicians given that it challenges the concept of evidence-based nursing practice, which is the basis of contemporary nursing practice (Scully, 2010; Webber, 2010).
Ultimately, this influences the delivery of competent nursing care and patient outcomes. Grounding clinical practice in evidence and research is fundamental in evidence-based nursing practice. Upton (1999) wonders how there could be evidence-based nursing practice when theory-practice gap exists. Moreover, inadequate theory-practice integration results in medication errors and poor nursing care decisions (Gregory, Guse, Davidson, Davis, &Russel, 2009; Jones &Treiber, 2010). Additionally, the theory-practice gap adversely impacts the socialisation of nursing students to their professional roles (Maben et al., 2006; Spouse, 2001).
Given the importance of nursing care in the health delivery system of every country, it is imperative that steps are taken to improve the clinical competence of nurses. Globally, the goal of nursing education is to ensure professional clinical competencies and to enhance the delivery of safe, quality nursing care (Forsberg, Georg, Ziegert&Fors, 2011; Tseng, et al., 2011; World Health Organisation [WHO], 2007). This could only be achieved by ensuring that nursing students apply what they have learned in the classroom and simulation laboratories to real-world situations (Lauder, Sharkey, & Booth, 2004). Skill acquisition is one element of attaining clinical competence in nursing practice and this can be achieved through adequate theory-practice integration.
Several reasons have been proposed as to why the theory-practice gap manifests in nursing education. One of these is the relatively recent increase in the research output and the focus on an evidence-based practice agenda for nursing and midwifery (Gardner, 2006).
Another explanation for the theory-practice gap in literature is the shift of nursing education into the university/college setting, albeit this occurred at different rates globally. Despite the movement of nursing to higher education, providing a new approach aimed at preparing students to meet health care needs, it is argued that those changes have not had much positive influence in bridging the theory-practice gap (Andrews & Reece, 1996; Hewison& Wildman, 1996; Ousey& Gallagher, 2007). They contended that the progression of nursing into higher education demonstrated in a tangible way, the dichotomy between theory and practice in that learning occurs in two separate institutions which hitherto was considered as one. The seeming disconnect has resulted in the theory and practice of nursing being treated as separate entities (Ousey& Gallagher, 2007).

The sheer complexity of the theory-practice gap means that it has remained a perennial problem in nursing. Indeed one of the main criticisms of nursing education programmes today, is the failure to bridge the theory practice gap (Monaghan, 2015). Despite the introduction of several strategies in nursing education, including role models (nurse practitioners, clinical facilitators, nurse educators, mentors and preceptors) to bridge the theory-practice gap, it continues to defy resolution (Bendal, 2006; Clark & Holmes, 2007; De Swardt et al., 2012; Maben et al., 2006; Sedgwick &Yonge, 2008). This phenomenon has plagued nurse educators for decades in their pursuit of ensuring that what is taught in the classroom accurately reflects the realities of clinical practice and that the theory is relevant to current practice in the clinical setting (Corlett et al., 2003).

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Item Type: Ghanaian Postgraduate Material  |  Attribute: 182 pages  |  Chapters: 1-5
Format: MS Word  |  Price: GH50  |  Delivery: Within 30Mins.
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