Sources of the knowledge-practice gap in nursing: Lessons from an integrative review

The ultimate value of learning lies in the transfer of knowledge to real-life settings. The gap between knowledge and practice can be described as the disconnection between acquired knowledge, the skills learned in nursing school, and those skills needed to practice safely and independently. This is a concerning issue that needs to be investigated deeply to address all the circumstances and factors contributing to the gap.

To reveal the full range of factors leading to the knowledge-practice gap in nursing by means of a thorough survey of the most recent evidence and updates.

An integrative review design was selected. Three data bases (MEDLINE, CINAHL Plus and ERIC) were searched electronically for research articles from 2009 up to June 2020 on the gap between knowledge and practice. The 406 articles that appeared were appraised for inclusion or exclusion using the JBI Critical Appraisal Checklist for qualitative research.

Eight qualitative studies were included in the review, which identified three major themes and subthemes. The first theme is personal factors, with the following subthemes: internal motivation, learning style and attitude. The second theme is educational structure, with the following subthemes: clinical instructor role, preceptor effect and curriculum. The third theme is organisational characteristics, with the following subthemes: resources, clinical setting features and staffing.

The review revealed that the knowledge-practice gap has deep roots in multiple factors. Considering all dimensions of these factors is the key to bridging the knowledge-practice gap.