Theory and practice gap in teaching nursing students and associated factors at teaching institutions: Mixed study

Nursing education involves various teaching and learning techniques, as well as sharing information, wisdom, and sound judgment, aiming to close the knowledge-practice gap and reaching the ultimate goal of improving quality of care and benefiting the population served.

This study aimed to assess the theory-practice gap in teaching nursing students and associated factors at teaching institutions in west and southwest Shewa zones, Oromia, Ethiopia during 2024.

An institutional-based explanatory sequential cross-sectional study was conducted using both quantitative and qualitative approaches from June to August 2024. In total, 422 undergraduate nursing students participated in the quantitative component using a structured self-administered questionnaire, and 16 nursing instructors were purposively selected for in-depth interviews. Quantitative data were analyzed using descriptive statistics and binary logistic regression, whereas qualitative data were analyzed by thematic analysis, with triangulation applied to integrate the findings.

Almost all participants (99.1%) reported the presence of a theory-practice gap, with an overall mean score of 3.6. Students who practiced in non-teaching hospitals were significantly more likely to experience the theory-practice gap than those in teaching hospitals (adjusted odds ratio = 2.83; 95% confidence interval: 1.43-5.60). The qualitative findings identified several contributing factors, including excessive emphasis on theoretical teaching, limited clinical integration, inadequate communication between theoretical and clinical instructors, insufficient learning resources, and weak institutional collaboration between universities and healthcare facilities.