Rationale for the study

Despite continuous improvements in nursing curricula and educational strategies, a persistent gap between theoretical instruction and clinical practice remains a major challenge in nursing education. This theory–practice gap limits the ability of students to apply classroom knowledge in real clinical settings, weakens clinical judgment, reduces professional confidence, and compromises the quality and safety of patient care. The gap is further widened by inadequate clinical exposure, the shortage of skilled clinical instructors, weak coordination between academic institutions and healthcare facilities, and limited learning resources.

Several international studies have documented the existence of the theory–practice gap, but limited empirical evidence is available for Ethiopia, particularly in the west and southwest Shewa Zones. The lack of localized data makes it difficult for educators, policymakers, and health institutions to design effective strategies tailored to the nursing education context in Ethiopia. Therefore, generating context-specific evidence is essential to guide curriculum reform, strengthen clinical teaching, improve institutional integration, and enhance the overall quality of nursing education and patient care.