Institutional and instructor-related factors

Institutional and instructor-related factors were identified as significant contributors to the theory–practice gap. Limited availability of learning resources, restricted access to self-directed learning tools such as libraries and internet services, and insufficient opportunities for practical skill development appeared to hinder the effective integration of theory into practice. These findings are consistent with evidence from Iran highlighting the critical roles of supervision, evaluation, and structured educational processes in minimizing the theory–practice gap in nursing education.11 The observed similarities may reflect broader systemic challenges that are common in developing countries, where constraints on human resources and educational infrastructure limit the quality and effectiveness of clinical teaching.

Students generally perceived that universities provided some level of practice-based teaching, as reflected by the moderate mean score and mainly positive responses. This finding is comparable to a study conducted in the Gaza Strip, Palestine, which also reported moderate to high student satisfaction with clinical teaching. However, despite this apparent emphasis on practice, the findings obtained in the present study indicate that clinical training may lack sufficient depth and effective integration with theoretical instruction.4 This suggests that the issue is not due to the availability of practice opportunities, but instead to the quality, consistency, and alignment of clinical teaching with classroom learning.