Research presentation of mr mwsk ( suggestions to close the gap between theory and practice as students perspective )

1
Muhammad Waqas Shehzad Khan
Post RN BScN Year II semester IV
Session 2015-17

Our presentation will cover:
2. Literature review
2.1 Statement of problem
2.2 Significance of
Research
1. The introduction of research project
1.1 Background
of study
1.2 Rationale of
study
1.3 Aim &
Objectives

8. Limitations of study
7. Recommendations
6. Conclusions
5. Discussion
4. Results of study
3. Methodology of research

 Thanks to Almighty Allah for His beneficence, Grace and
uncountable Blessings on us by which we successfully
completed our research study.
 Our respected faculty members appreciated us to be the part of
research on the topic given.
 We are grateful to the Ilmiyia institute of nursing for the support
given to our research project. 7

 Our respected preceptor made a lot of effort and helped us
to find related articles for research.
 The participants of the research were kind enough to
render their cooperation to us and spared time to help us.
 The institute provided a cool and calm environment to us
for the research that helped us to focus on our work.
8

 We used internet facility under the guidance of computer
lab faculty in the institute to find articles and related
material for our research.
 We used the resources of our institute and we are thankful
for cooperation.
 We communicated our issues in the group frankly and
helped each other when needed.
9

 We exchange our duty shifts for the research purpose and
our in charges helped us to attain our goals in research.
 Senior faculty of Ilmiyia institute Sir Amjad helped us to
correct our mistakes. He gave his precious time to us.
10

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MrMWSK
@Facebook.com/MrMWSK

 Nursing is very noble and kind profession nurses are the back
bone of any hospital.
 Nurses can give better care according to their knowledge. They
are overall responsible for the care and comfort needed by the
patient and this care is related to the practice based on
theoretical knowledge. [1]
12

 That’s why the nursing profession is composed of two main
parts; the theoretical part which reflects the knowledge that is
received in the class room and the practical part which focuses
on giving the student skills in the clinical area. The focus on
both parts is essential to produce high quality nurses for the
care of patient. [2]
13

 The theory part should provide the basis for understanding the
practical part of nursing, all the procedures done in clinical area
are based on the knowledge that nurses receive from their
theoretical professional studies on the other side nurses
practical knowledge is enhanced by the theoretical knowledge
and it’s important for professional development.[3]
14

 Nurses are the persons who always face challenges in clinical
area. [4]
 In clinical area where other senior health care staff is not
available nurses manage all the issues and consequences with
sympathy. Their knowledge, attitude and practice directly
effects nursing profession to make it a noble profession. [5]
15

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MrMWSK

 The theory-practice gap is widely addressed in the
international literature. Knowledge and practice issues have a
long-standing history in nurse education, and are a chronic
source of controversy to which there is no easy or perfect
solution (Hewison, A & Wildman, S., 1996). [6]
17

 This tension between theory and practice and research which
can be usefully exploited in teaching and research (Rafferty,
Allcock, & Lathlean,1996).
 Emphasizing the importance of the issue (Rolfe, 2003), states
that the theory- practice gap is felt most acutely by student
nurses. [7]
18

 They are faced with real clinical situations in which they are
unable to generalize from what they have learned in theory. [8]
 The discrepancy between nursing as it is taught in the
classroom and nursing as it is practiced by students in the
clinical setting has long been a source of concern to teachers,
practitioners, and learners worldwide.[9]

19

 Despite considerable efforts by the profession to bring about
change, the basic problems identified in 1976, by Bendal,
continues to cause concern. Cautioned nurse educators about
producing nurses who were "increasingly proficient on paper
and decreasingly proficient in practice.[10]
20

 She had also cautioned that what nurses were learning in theory
was becoming increasingly divorced from what they were
actually doing in practice.The irony of the debate lies in the
fact that in nursing, which is a practice discipline, theory and
practice cannot be separated. [11]
21

 Knowledge and practice cannot be separated, both are very
critical to any student to may find themselves as professional
nurse.
 Nurses are the first person who interact the patient till
subjective fulfilled or patient cured. The theory part should
provide the basis for understanding the reality of nursing. [13]
22

 Another positive approach is also mentioned in (Rafferty,
Allcock, & Lathlean, 1996) state that the theory/practice gap
can never be sealed entirely; they are by nature always in
dynamic tension, and this tension is essential for change to
occur in clinical practice. [14]
23

 This tension, seen from a positive point of view can motivate
nursing professionals to work on the issue; it also provides
room for avoiding stagnancy in the profession. [15]
24

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MrMWSK

 Nursing is a practice discipline, theory and practice cannot be
separated, both are very critical to any profession.[35]
 Another positive approach is also mentioned that the theory-
practice gap can never be sealed entirely; they are by nature
always in dynamic tension, and this tension is essential for
professional development.[36]
26

 We choose this topic as our research study because it affects
perceptions and impressions regarding nurse to the patient and
other members of the team and it affects the evaluation of a
nurse for the purpose of promotion as professionals.
27

28
MrMWSK

 Shed light on theory and practice gap in nursing education.
 Explore some suggestion to close the gap between theory and
practice.
 Look at the student issues regarding this gap.
 Elaborate student’s point of view about nursing education.
30

 Give some suggestions to close the gap between theory and
practice.
31

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MrMWSK

 The literature shows that there is a gap between the theory of
nursing education and the practice part. Several reasons for
this gap were reported in literature such as using abstraction
meanings to explain some procedures in the clinical
environment [16].
33

 The subjectivity in defining nursing terms and theories and
giving different meanings to these terms formed challenges
for nursing students. Students found it difficult to link what
they learned in the class room with the facts they faced in
the complex clinical environment. The development in
nursing education and the moving toward higher education
also increased the gap [17].
34

 Other reasons were expected to increase this gap such as the
complexity and the continuous change in the need more
support in the clinical area [18].
 Supporting student nurses may take several aspects.
Providing good supervision is an important aspect of support
needed by students[19].
35

 The number of nursing teachers in the clinical area should be
increased. They indicated that nursing teachers should spend
more time in the clinical area to ensure student learning,
linking theory to practice. Providing support also includes
direct application of the theory learned in the classroom to
practice [20].
36

 More importantly, nursing teachers are required to adopt an
advocacy role to enable the student to be understood and
empowered. The traditional way of learning should be
always assessed and evaluated. It is important to examine
students’ learning needs. New modifications and creative
strategies are always needed to improve the quality of
learning [21].
37

 This cooperation reflected in many shapes. The role of both
preceptor and mentor was suggested by some authors to
reduce the gap between theory and practice. Both the mentor
and preceptor are clinical staff with supervision experience.
The job of the mentor is mainly to support the students in the
clinical area, while the preceptor works directly with the
students [22].
38

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MrMWSK

There is a wide gap between the theory of nursing education
and in the practice part of complex clinical area. [16]
For example:
Diploma students read about nasogastric tube insertion
technique in class room and get knowledge about all the
steps that need to follow in clinical settings but when the
student go in clinical area where they see the
professionals who did not follow all the steps and student
learn the practice that create gap between theory and
practice .
40

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MrMWSK

Through our study:
 Patient will get better and standard care.
 Nursing practice should improve and the organization get
productivity in nursing field.
 Professional education of nursing advanced by getting focus
on theory-practice gap.
 Our study help nurses to improve in their skills.
42

43
MrMWSK

 A qualitative design was adopted to identify practical steps to
decrease the gap between theory and practice in nursing
education.
44

 We choose Ilmiyia institute of nursing as per our
convenience for the interviews of students.
45
S.No Name of Class Total students
1 General Nursing First Year 45
2 General Nursing Second Year 45
3 General Nursing Third Year 45

S. No. Working Steps Time (Weeks)
11th April to 11th May 2017
1. Number of days 1 2 3 4 5 6 7 8
2-8 9-15 16-22 23-29 30-05 06-12 13-19 20-26
2. Writing synopsis and approval
3. Data collection
4. Data analyzing
5. Write research presentation
 We started our research on 2nd April, 2018 to end on 26th May,
2018. It take a month to give result.
46
2nd April to 26th May,2018

 The sample was derived from Ilmiya institute of nursing.
47
30 students were involved for qualitative study
because after it data saturation started.
 Purposive sampling technique was used to collect data.
 Thirty students who were participating in the in-depth
interview purposely.

 The population targeted was general nursing diploma students.
We select 1st year, 2nd year and 3rd year G.Nursing students who
studying in Ilmiya institute of Nursing.
The selected students had attended at least two clinical courses
to ensure they would have a full understanding of the topic and
enough clinical practice to compare what’s learned from theory.
48

 We exclude the failure students.
 We don’t take interview from the students of another institute.
 We also exclude the terminated and suspended students.
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MrMWSK

 Ethical approval was obtained from the school of nursing in
which we conduct the research.
 We also inform that the each participant had the right to decide
voluntarily whether to participate in a study, without risking
any penalty or prejudicial treatment and he able to terminate
their participation at any time.
51

 We take informed consent from every participant and do
consider their confidentiality as prior to us.
 We use their given data only for the research purpose.
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MrMWSK

 Detailed data is gathered through open ended questions.
An individual semi-structured, in-depth interview was
selected as the method of data collection.
• The interviewer is an integral part of the investigation.[25]
• Qualitative research was expected to provide deeper understanding
of student’s experiences and the meanings that they give to
interpret their actions.[26]
54

 We check the answers of every student and made a
resembling conclusion on the basis of data that we gather
during the study.
 We used Braun and Clarke’s technique of thematic analysis
to analyze our data.
55

56
MrMWSK

It based on five phases of analyses that are following. [28]
57

58
MrMWSK

59
 The findings of the current study were expected to shed some
light on the nursing education.
 Most of the students in the current study showed that there is a
huge gap between the classroom theoretical contents and in the
complex clinical environment.
 This study was particularly focused on identifying the
suggestions and intervention to decrease the theory-practice
gaps in nursing education.

60
 The statements of students were collected and built into four
major suggestions that are following:
Required open channels between theory and practice.
Students need to be supported more.
Increasing the competency of clinical instructors, and
Preparing and improving the skill labs.

61
MrMWSK

62
 This study is one of a few studies that adopted qualitative
design to explore the gaps between the theoretical and the
practice parts in nursing education.
 Most of the interviewees explained that there is a clear gap
between the theory and the practice in nursing education.

63
The findings of the current study is in agreement with the
findings of previous studies, who found that nursing students do
not receive good support in the clinical training.[29]
 The instructors qualifications were viewed crucial to improve
the nursing education level.[30]

64
This may explain the views of many nursing students in the
current study who thought that nursing teachers and instructors
were not qualified to teach or that they did not consider different
methods of teaching.
Many students stressed on the importance of building bridges
between the nursing teachers in the School and in clinical area.

65
In the current study, all the students agreed that there should be
a rhythmic relationship between the theory materials and the
practical training.
The theory should start the journey and the practice will
continue it.[31]
Linking the theoretical information with practice was one of
the challenges that faced the students in the current study.

66
Many of them explained that they do not know exactly how to
use this information in their clinical training.
More interestingly, some of the students thought that
theoretical education was in one world and the practice was in
different world.
The importance of supporting nursing students in the clinical
area was discussed in several studies.[32]

67
It was explained that clinical instructors should have special
communication skills and they should receive special training
and preparation to deal with the students in the clinical area.[33]
Failing to support nursing students in the clinical area may
produce feelings of dissatisfaction and frustration for these
students.[34]

68
In the current study, it was indicated by some of the students that
they did not receive good support during their clinical training.
Some of them indicated their upset of the way of communication
from some of the clinical instructors.
Therefore, the findings of this study suggest the need of support
for students and provide open channel between theory and practice.

69
In current study suggest the clinical instructors to increase
their competence of doing their job. This could be achieved by
passing them through special communication skills courses and
by increasing their clinical competences.
In the current study, it was indicated by some of the students
that the skill labs need improvement with latest techniques and
equipments.

70
MrMWSK

 The implementation of nursing education in both government
and private institutions are facing the problem to relate theory
with practice that need focus to close the gap between theory
and practice to improve the nursing profession in Pakistan.
71

 The Pakistan nursing council and affiliated nursing institute
and university have been not fostered increased awareness in
use of nursing theory with practice through any kind of short
courses, demonstration, seminars and workshops.
72

 If all theses discipline strictly followed nursing knowledge in
practice than will be the skills of nurses increases, and that
knowledge also change their attitude and behavior regarding
nursing profession.
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MrMWSK

The following recommendations were made based on the
findings:
 Nursing schools should organize regular seminars, workshops
and symposium focused on the practical implementation of the
nursing theory in their schools to diminish the gap between
theory and practice.
75

 The representative of Nursing in the states(Directorate General
of nursing and Pakistan nursing council) should collaborate
with the hospital Administration to ensure the smooth practice
of the nursing practice through supervision of nurses at work.
76

 Hospital managements including the medical superintendent,
medical directors, chief nursing superintendent, should be
focus in removing gap between theory and practice by making
policies and protocols regarding nursing procedures to
implement the theory in practice.
77

 Nurses should be proactive in practice and be interested in
improving nursing profession through reduce the gap and
attending continuing education programs.
 There should be mandatory and adequate center of attention
required for the nursing student’s clinical.
 Students should regularly supervised by the clinical superior.
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MrMWSK

 Participant could not openly express their feeling.
 Due to shortages of time and work load we are not able to take
interviews of other institute‘s students.
 Students have a lease interest regarding interviews in research
setting.
 Students did not cooperate to fill the data question.
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MrMWSK

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MrMWSK

Research presentation of mr mwsk ( suggestions to close the gap between theory and practice as students perspective )

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