Examples of the Theory-Practice Gap

The theory-practice gap has been defined as the difficulty faced when “matching textbook descriptions of clinical situations with the reality of practice” (Scully, 2010). Essentially, the idea is that one may learn a theory regarding a task or process in the classroom and find that there is a better way of actually performing the same task or process in the ward. As well, practices in the real world may lag behind theory, resulting in a failure to use the most optimal methods for patients. This gap may be because of textbooks lagging behind better methods that have been found in practice, or because of an attitude of “we have always done it this way” in the workplace. As well, a failure to keep up with continuing education and overall nursing remediation may result in dated practices being used.

Haigh, in her 2009 editorial in the Journal of Clinical Nursing, discussed three examples of the theory-practice gap to illustrate the different ways the gap may become a reality. She recalls that the use of pressure sore risk assessment tools marked a nurse as a “progressive and forward-thinking research radical” (2009, 1) in the workplace, and then reminds us that such tools are “fundamental to care.”

She uses pain assessment methods to further illustrate a way the gap occurs. She relates that the reason behind improvements in pain assessment and pain management is to improve patient care. The implication is that practical knowledge of the need for improvement drove the development of new theoretical tools, but for a period of time there may have been a gap between the two.

Finally, she describes the fact that administrative requirements may get in the way of keeping current on new theoretical practices, stating that clinicians seem to worry more about “manpower and financial constrictions than any theoretical…treatments for…different wounds” (2), implying that there is potential for gap between theory and practice in this area.

However it happens, the theory-practice gap exists, and it affects patient care. Knowing the varying reasons for the gap will help nursing staff to recognize when a gap is present in order to choose (or learn) the best method of completing a particular task and to give the best care possible.

References

Haigh, C. (2009). Editorial: Embracing the theory/practice gap. Journal of Clinical Nursing, 18(1): 1-2. doi:10.1111/j.1365-2702.2008.02325.x

Scully, Natashia Josephine (2010). "The theory-practice gap and skill acquisition: An issue for nursing education." Collegian, 18(2): 93-98.