Discussion

This study aimed to assess the theory–practice gap in undergraduate nursing education and identify the underlying factors in selected teaching institutions in the west and southwest Shewa Zones. The findings indicated a substantial gap between theoretical instruction and clinical practice, where nearly all participants reported inconsistencies between classroom learning and clinical practice learning, thereby highlighting a persistent challenge in applying theoretical knowledge to clinical competence.

These findings are consistent with those obtained in previous studies conducted in Lahore, Pakistan, indicating a clear gap between theoretical and practical components of nursing education, which was largely attributed to poor integration between classroom and clinical training, and low student self-confidence.12 Similar challenges have been reported in Namibia, where nursing students experienced difficulties applying theoretical knowledge in clinical settings.3 Evidence from Pakistan further indicates that a substantial proportion of nurses had poor knowledge regarding theory–practice integration, reflecting their limited awareness and application of theoretical concepts in practice. Overall, these findings suggest that the theory–practice gap may be more common in low- and middle-income countries, possibly due to systemic constraints, such as limited educational resources, inadequate clinical infrastructure, and insufficient support for practice-based learning.