Introduction

The theory–practice gap is defined as the difference between hypothetical practice and common practice, and the difference between taught general principles and the difficulty in interpreting them for application to a specific situation. In particular, it is the gap between taught abstract nursing theory and its use in practice in nursing education.1

According to the Oxford English Dictionary, a theory is a series of statements or principles developed to explain a collection of facts or occurrences, particularly one that has been put to the test time and time again, is generally accepted, and can be used to forecast natural phenomena. Practice refers to an action or a process that is used to perform an action. These terms have opposing definitions but when considered in the context of a professional setting, they must facilitate putting theory into practice.2

Nursing education has a theoretical component and clinical component. Theoretical elements support the knowledge and insights provided in the classroom3 as a framework to allow nursing students to comprehend the profession's history, the human body, diseases, and nursing techniques. The aims of the clinical learning component are to enhance clinical nursing abilities and characteristics.4

The clinical learning component is essential for assessing a nursing student's performance in the clinical setting and giving students the opportunity to hone their abilities, forge their professional identities, learn more, and apply their theoretical and practical knowledge in the clinical setting.5

The three pillars of nursing are practice, research, and theory. The interactions between these three pillars are reciprocal and cyclical. Clinical practice generates knowledge to support theory as well as research topics. Our practice is influenced by research, and growth of theory furthers our understanding. Research and practice are improved by theory. Applying knowledge, skills, compassion, and artistic ability to provide patients with effective, efficient, and thoughtful care is a necessary component of excellent nursing practice. Research findings have contributed significantly to knowledge that is utilized to guide clinical nursing decisions. All decisions regarding patient treatment should ideally be supported by research findings. A protocol is created using research findings, and then applied to everyday nursing practice.6

The theory–practice gap is highly relevant because it endangers patient safety, and high adherence rates to guidelines are difficult to achieve if there is a gap between theory and practice. Nursing implementation programs should be well planned and consider the features of the target group, and the social and organizational context. Nursing theory is of crucial importance for helping healthcare workers to understand the rationale that underlies guidelines.7

The theory–practice gap is the difference between what nurses learn about theoretical nursing concepts in the classroom and what they actually encounter on practical rotations8 in clinical placement (i.e., nursing practice).9

In nursing education, the theoretical component has begun to gain ground, where new programs and subspecialists are being created, and the emphasis on clinical education has reduced as a consequence. In addition, nursing educators have started to place more emphasis on theory and research than practical competencies. Due to placing clinical education second to prioritizing services, the existing curriculum content and clinical experiences fail to meet the needs of learners in terms of clinical settings.5

The best care plans can be written by nurses who have strong understanding of theory, but they may find it difficult to put their knowledge of pathophysiology and treatment strategies into practice10 Conversely, nurses with strong clinical practice abilities frequently find it challenging to justify care in terms of theory.11

The theory–practice gap also affects the motivation, confidence, and professional identity of nurses. Studies have shown that inconsistencies between classroom teaching and clinical experience can lead to confusion, stress, and reduced preparedness for clinical practice,10 where the contributing factors include educational content, clinical exposure, institutional support, and organizational challenges.11

Therefore, understanding the magnitude of the theory–practice gap and any contributing factors is essential for improving nursing education and strengthening clinical practice systems.