Nursing professionals are at the central pillar of primary secondary and tertiary healthcare services. The delivery of quality health care services is anchored on the scientific expertise and the clinical preparedness of nurses to address the various health care needs of the public.
Given this nursing education plays a central role in imparting graduate nurses with the necessary clinical skills/theory to deliver high-quality healthcare services. Clinical skills alone are not enough to ensure the delivery of high-quality healthcare services because they need harmonizing with practical skills. Nurse graduates who possess both skills successfully transits in the workplace because they are adequately prepared. However the gap between nursing education and clinical skills continues to be a major problem in nursing. The gap between nursing education and clinical skills often present various challenges for newly graduated nurses in their place of work. The challenges include physical practical and psychological challenges in bridging the educational and clinical divide. The nursing education issues that create the gap relate to the faculty students the syllabus and association among stakeholders in the field of practice and academic. In contrast the practice issues that create the gap include issues on the quality of care and means of bridging the gap such as coaching orientation and mentoring. In this literature review seven empirical research articles will be examined with the aim of answering the question with the gap between nursing education and clinical skills being a major problem in nursing are new graduate nurses ready for the workplace.
(Raurell-Torred et al. 2015)
In their study Raurell-Torred et al. (2015) compared the skills shown by undergraduate students with no past clinical practice and nurses with clinical practice registered in Continuing Professional Education (CPE) courses. According to Raurell-Torred et al. (2015) the undergraduate students who did not undertake Case-Based Learning (CBL) scored lower on patient assessment compared with those that undertook CBL. Moreover the CPE nurses made more rule-based mistakes such as failure to identify patient correctly and failure to examine for allergies before giving medication compared to the undergraduate students undertaking CBL classes. Raurell-Torred et al. (2015) concluded that the undergraduate students with no past clinical experience but who incorporated CBL in their classes developed better patient assessment skills compared to others groups. The significance of the study results is that including CBL in the nursing curriculum can bridge the gap between nursing education and clinical practice because it enhances nurses preparedness for the workplace. Additionally nursing educational programs that incorporate CBL play an active role in nurses skills acquisition process.
(Numminen et al. 2014)
Using a cross-sectional comparative design Numminen et al. (2014) assessed whether learning outcomes of nurse education met the needs of the nursing practice. Numminen et al. (2014) explored the correspondence between nurses instructors and nurse administrators evaluation of new graduate nurses professional skills. According to Numminen et al. (2014) nurses instructors evaluated new nurses skills to a significantly higher level compared to nurse administrators in all skill areas. According to Numminen et al. (2014) active collaboration during evaluation of new nurses ensures they are fit for practice. According to the findings of this research the lack of collaboration between nurses instructors and nurse administrators during the evaluation of new nurses results in a gap between nursing education and clinical skills.
The findings of the research support the hypothesis that the nursing education and practice are disconnected such that stakeholders in the field of practice and academic are not working together to prepare nurses for the workplace. Citing the results from the Numminen et al. (2014) study additional research is needed to find ways of ensuring collaboration between nurses instructors and educators besides having standardized criteria for evaluation of new nurses competence level. These mechanisms would ensure nurses know what is expected of them in the workplace and not suffer transition shock.
(Esmaeili Cheraghi Salsali & Ghiyasvandian 2014)
According to Esmaeili et al. (2014) practical clinical education prepares new graduate nurses for the workplace. In this research Esmaeili et al. (2014) described the expectations of nursing students as regards what comprises an effective clinical education. According to Esmaeili et al. (2014) student nurses considered appropriate communication and relations between them and their instructors as a key to bridging the gap between theory and practice in nursing. The findings also showed that evaluating students based on an appropriate benchmark could reduce the gap between theory and practice.
The nursing students also felt that having instructors who were highly qualified knowledgeable and motivated could reduce the gap between nursing education and practice because students nurses learn better because what they observe/learn in the presence of the instructors they remember later. For instance a fifth-term nursing student remarked that
We had an instructor who performed well with patients once a patient asked a question he was so knowledgeable and explained so well that patients respected him more than they respected the unit personnel and we also had a lot of pride for him (Esmaeili Cheraghi Salsali & Ghiyasvandian 2014 p. 465).
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