A square peg in a round hole: Theory-practice gap from the lens of Filipino
student nurses

Elisa Monette R. Factor, Evangeline T. Matienzo, Allan B. de Guzman

PII: S0260-6917(17)30165-X
DOI: doi:10.1016/j.nedt.2017.07.004
Reference: YNEDT 3579

To appear in: Nurse Education Today

Received date: 18 September 2016

Revised date: 5 February 2017
Accepted date: 7 July 2017

Please cite this article as: Factor, Elisa Monette R., Matienzo, Evangeline T., de Guzman,
Allan B., A square peg in a round hole: Theory-practice gap from the lens of Filipino
student nurses, Nurse Education Today (2017), doi:10.1016/j.nedt.2017.07.004

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A square peg in a round hole: Theory-practice gap from the lens of Filipino student nurses

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Elisa Monette R. Factor, RN, MAN, Evangeline T. Matienzo, RN, MAN
and Allan B. de Guzman, Ph.D,

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The Graduate School, College of Education, College of Nursing, University of Santo Tomas
Manila, 1015 The Philippines
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Word Count: 4,619
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A square peg in a round hole: Theory-practice gap from the lens of Filipino student nurses

Introduction
Across the globe, the interplay between classroom didactics and clinical practice is

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pivotal in the overall quality of student nurses’ clinical experiences. Scholars widely agreed that

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ineffective interplay between these two creates a “gap” in student nurses learning experience
affecting their clinical performance. This “gap” is commonly referred to as the “theory-practice

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gap” that is claimed to be emanating from the dissociation of theoretical knowledge from the
practical dimensions of nursing (Ajani and Moez, 2011; Scully, 2011). Threading of theory and

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practice together has remained a formidable task and a challenge to nursing education.
Notably, when student nurses are faced with actual clinical situations, they find it difficult to
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generalize and apply learned nursing knowledge and theories as they discover discrepancy
between what was taught in class and how skills are actually carried out in the real setting
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(Ousey and Gallagher, 2007; Ajani and Moez, 2011; Scully, 2011; Dadgaran et al., 2012; Flood
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and Robinia, 2014). Current nursing curriculum seemed to fail in reconciling theoretical with
practical educational content (Hickey, 2010; Dadgaran et al., 2012), thus, leading to student
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nurses’ adaptation difficulty, reality shock and transition mishap (Hickey, 2010; Ajani and Moez,
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2011; Scully, 2011; Dadgaran et al., 2012; Crookes et al., 2013; Yang et al., 2013; Flood and
Robinia, 2014). Also, collaboration between teaching institutions and clinical placements has
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been found to be a weak spot of nursing education (Hall-Lord et al., 2013) that further widens
the gap. Hence, extensive production of nurses who are ill-prepared and skills-short to meet
the demands of actual clinical workplace has been observed (Hickey, 2010; Ajani and Moez,
2011; Yang et al., 2013). Foregoing scenarios describing the theory-practice gap with nursing
profession have gained interest among scholars and practitioners worldwide to revisit and
revise existing nursing curricula and instructional designs (Patelarou et al., 2009; Hickey; 2010;
Ajani and Moez, 2011; Scully, 2011; Dadgaran et al., 2012; Crookes et al., 2013; Yang et al.,
2013; Flood and Robinia, 2014). While efforts to understand the dynamics of theory-practice
gap have been investigated, a substantive paucity in the literature exists in the context of
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Philippine universities. Seemingly, no research has ventured yet to explore the theory-practice
gap experiences of Filipino student nurses.

Hence, the major intent of this qualitative investigation is to describe how theory-

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practice gap is viewed by a select group of senior nursing students in a comprehensive

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university in the Philippines. The collective descriptions generated by this phenomenological
inquiry will help nursing educators and administrators to understand the prevailing dilemma of

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student nurses undergoing clinical experiences which in turn can challenge them to initiate
realignment efforts aimed at producing nurses whose knowledge, skills and attitudes are

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responsive to the ever changing professional practice landscape.
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Methods

Phenomenological Design
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Husserl (1970) defined phenomenology as “the science of essence of the consciousness”

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which focuses on the meaning of lived experiences from the first person point of view (Wojnar
and Swanson, 2007). The purpose of phenomenological inquiry is to explicate the essence of a
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layer of human experience in the search of unity of meaning and its accurate description
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through everyday lived experience (Streubert and Carpenter, 2011, p.28). Specifically this study
is interested to understand senior nursing students’ lived experiences of the theory-practice
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gap rather than conceptualized; hence, this phenomenological investigation.

Selection and study site

A total of 10 senior student nurses were purposively selected to participate in an in-

depth individual interview. The participants consisted of 8 females and 2 males and were
between the age of 19-20. The significant number of RLE contact hours that these students
have spent in the clinical area is believed to have given them opportunities to see and
experience the dynamics of their future profession enough to provide a rich and thick
description of the phenomenon under study.
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The study was conducted in one of the comprehensive universities at the capital of the
Philippines. A consistent top performing school in state licensure examination for nurses, the
College of Nursing in the said university is known as the first in the Philippines to offer the basic

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baccalaureate program in Nursing circa February, 1946. At present, it follows a four-year
competency-based academic program based on the standards set by the Commission on Higher

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Education (CMO, 14, 2009). To qualify for the Related Learning Experiences (RLE) component of

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the program, the students are required to meet a cut-off average set by the admissions
committee prior to hospital/community placement. Students’ clinical rotations are supervised

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and guided by qualified clinical instructors (de Guzman et al., 2007).

Instrumentation
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A two-part semi-structured interview was used to gather narrative accounts needed for
this study. A robotfoto or participant’s preliminary sketch was used to characterize the
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demographic profile of the selection which included their age and gender. Part II is an aide
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memoire purported to elicit the lived experiences of the participants. The interview guide
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focused primarily on classroom environment, clinical setting and mismatch.

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Data gathering and ethical consideration

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Ethical clearances were obtained from the ethics committees of the Graduate School
and the College of Nursing where the study was conducted. After which, a letter of request
addressed to the dean of the College of Nursing was sent asking permission to involve a select
group of senior nursing students. Each interview was conducted based on the students’
availability and willingness to participate. To elicit a more natural response from the
participants, the interviews were done in the participants’ preferred place and time (de
Guzman, Ormita et al., 2007) and was tape-recorded and was subsequently transcribed
(Dadgaran et al., 2012). At the time of the interview, a written consent from each of the
participants was secured explaining the nature, purpose and dynamics of the study. The
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participants were assured of confidentiality and anonymity all throughout the study (Halter et
al., 2006, Dadgaran et al., 2012).

Mode of analysis

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Verbatim transcription of tape-recorded interviews was accomplished to form the field

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text. Corrective listening was employed to assure accuracy and prevention of transfer errors (de
Guzman, Ormita et al., 2007). Through a repertory grid, the extended accounts were subjected

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to phenomenological reduction. Cool and warm analyses were observed to facilitate thematic
analysis. The cool analyses part involves the identification of significant statements which

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consists of both anchors (words and phrases) and phenomenal referrents (specific experiences).
The initial codes and categories identified in this phase were closely examined to see
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similarities and relationships which helped in the emergence of themes. The cluster of themes
was instrumental in the formulation of a collective description.
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The emerged themes were subjected to member-checking procedure to ensure overall

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trustworthiness of the collective description of the essence of the phenomenon under study.
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Findings
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From the individual and collective articulations shared by a select group of Filipino
senior student nurses, an intersection of concerns emanating from the academic and clinical
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exposures is observed. Such intersection creates a chasm of deficits that prompt students to
experience confusion and frustration. Labeled as the theory-practice gap deficit triad (see figure
1), the model provides a clear cut nature and dynamics of deficits in the students’ spectrum of
clinical exposures that encompass aspects that are related to clinical resources (structural
deficit), application of learned concepts from the school setting (pedagogical deficit) and
interaction with staff nurses (relational deficit).

(INSERT FIGURE 1 HERE)

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Structural Deficit: State of Helplessness

In this study, one of the most prevailing experiences of senior student nurses that
begets theory-practice gap is Structural Deficit. This occurs when realities in the actual hospital

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set up such as shortfalls in resources, manpower, procedures and protocols deprive student

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nurses of the opportunity to provide ideal patient care. According to the participants, scarcity
of resources in the hospital restricts them to execute ideal clinical practice. The lack of hospital

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supplies and materials propel student nurses toward improvisation and modification of
practice. As one student nurse shared, “In the hospital, there is lack of necessary resources. You

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would need to think of alternative ways to provide patient care. Most of the time, what was
ideally taught in class cannot be done in the actual clinical setting. You would need to figure out
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another strategy to do a certain procedure just because of insufficient hospital materials and
supplies. This is the usual problem.” [R1] Another student stated, “It depends on the resources
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available at hand. You need to consider and make use of what is actually available at the
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hospital.” [R10] The student nurses also claimed that scarcity of resources led to problematic
rampant reusing of hospital supplies. As shared by the respondents:
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“For example, in class, we were taught that a suction catheter is for single use only. You need to
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dispose the suction catheter every after suctioning. But in the hospital, as long as the suction
catheter is intact they kept on reusing it.” [R7]
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“According to the book, sterile gloves should only be used once then disposed. But in other
hospitals, they autoclave and recycle the sterile gloves.” [R7]
“In the ideal setting, it was taught that the IV site should be changed every three days. But when
I was in the ward, I have experienced that 3-day-rule is not being observed.” [R5]

Remarkably, the financial status of the patients dictated the quality of care the student
nurses can provide them. The limited finances of the patients hinder the student nurses from
utilizing supplies ideally. As expressed by one respondent, “Most of the patients cannot afford
the price that goes with the ideal care they deserve to receive.” [R7] Another participant added,
“The ideal clinical practice taught in lectures is not applicable to those financially-challenged
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patients. They don’t have the money to pay for the ideal utilization of materials and supplies. In
situations like this one, I need to improvise.” [R3]
Further, institutions have operating procedures and protocols different from what was
taught as theoretically ideal in the classroom setting. These differences also affect the clinical

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practice of the student nurses as one of them stated, “Institutions have varied rules. You need

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to adapt and do things according to their ways.” [R1] Another student added, “Even the
laboratory values differ from one institution to another. Ranges of the normal laboratory values

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depend on the hospital’s policy.” [R9] As articulated, “Since my clinical exposure is in that
particular hospital, I am obliged to follow the institution’s rules and policies.” [R5]

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In regard to manpower, a shortage of bedside nurses was also seen, resulting in patient
assignment overload. As one participant exclaimed, “We can’t blame the nurses because there
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were only a few staff and a lot of patients. Hence, they could hardly practice ideal set up.” [R9]
Another student affirmed, “The nurse-patient ratio in the hospital is not ideal. The staff nurses
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are usually outnumbered by loads of patients.” One student nurse further shared, “Staff nurses
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do not take ideal clinical practice seriously and they take shortcuts in carrying out doctors’
orders and procedures because they are always in a rush as due to toxic scenario in the
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hospital.” [R1]
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As nursing students continue to experience shortfalls described above, they found

themselves in a state of helplessness. As expressed:
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“Being in that situation, there is nothing else I can do but perform the tasks expected of me with
minimal mistakes as possible.” [R10]
“I just go with the flow. I can only compare my learning from the institution with my school
lectures. That’s all.” [R1]
“I just accept the fact that is how actual hospital setting really is. I can do nothing about it but to
follow the hospital rules and policies.” [R5]

Pedagogical Deficit: State of Dissemblance

Classroom didactics received by the student nurses appeared to be impractical to actual
clinical practice. This is when Pedagogical deficit transpires. Consequently, student nurses find
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themselves in a state of dissemblance where theories, principles, operations and procedures

learned in class were not fully supported by what hospital setting actually offers. As one
student claimed, “I wonder why there is a need to study intently the ideal clinical practices if we
cannot really apply it during our actual clinical rotation. If the substandard is acceptable then

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why teach the ideal? I don’t see the relevance of the theoretically ideal practice if such is not

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applicable in real-life hospital scenarios.” [R3] Another student shared, “It upsets me that the
things we learned in class were not being applied in the clinical area.” [R2]

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According to the respondents, classroom didactics should enable them to thrive in
actual hospital setting. However, it does not, as one of them shared, “I want to suggest that

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they teach ideal clinical practice side by side with how things are actually done in the hospital
setting even before our clinical placements.” [R4] This is even supported by the following
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comments:
“What we learned from class were all ideal ways of carrying out procedures. But during our
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clinical exposure, mostly everything being done was far from what we have learned in the
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lectures and skills laboratory. I find it difficult to adjust.” [R10]

“I feel struggling inside because I am forced to do things in ways far from how I learned in
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class.” [R5]
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“I was shocked and irritated at the same time by the idea that this is not how I learned it in class
and now I am forced to do it differently.” [R5]
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Moreover, student nurses verbalized uncertainty in their clinical practice during clinical
exposures. The participants were lost and confused as one of them shared, “I am torn between
following how things were taught in class and how things are actually done in the clinical
setting.” [R1] Another student nurse added, “I am confused because I was taught to perform
ideal clinical practice and I cannot exercise it during our clinical rotations in the hospital.” [R7]

Relational Deficit: State of Blind Conformity

When the resident staff nurses fail to model good practice, Relational deficit ensues.
Seemingly, the participants shared how most staff nurses failed to be role models of ideal
clinical practice as one student nurse stated, “Actually, one of the major issues is that the staff
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nurses do not abide with the ideal set-up.” [R9] Another participant elaborated, “The clinical
skills performed by most staff nurses were different from what was taught in our class.
Sometimes the staff nurse would tell you ‘don’t you ever do that’ or ‘what you are doing is
incorrect’ that’s why I would alter how I do things based on how that staff nurse tells me. It

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sometimes contradicts the things I learned in our lectures in the skills laboratory.” [R1] As the

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respondent disappointingly added, “It was also taught to them (referring to the staff nurses)
before but they don’t practice it anyway. I hope that they would be role models to us student

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nurses.” [R1] Another student articulated, “I wish that I won’t turn out to be like them someday
because the patients are the ones who suffer.” [R3]

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Student nurses also shared instances where lax behaviors of some staff nurses were
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made evident. As verbalized:
“One time I witnessed how a staff nurse committed something wrong in the documentation but
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simply said ‘That’s just okay. I was really shocked because the nurses’ notes are considered as
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legal documents.” [R8]

“In terms of giving patient’s medication, ideally you should be supervising the patient if he/she
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has really taken the drug. However, what the staff nurses do is just placing the medication at
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the bedside and leaves the patient’s room. I even asked one of my patients where was the
medication and the patient replied that the staff nurse just left it on the bedside table.” [R9]
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The foregoing situations have brought the nursing students into a realm where they
endure a state of blind conformity in order to avoid any sort of conflict with the staff nurses. As
one student shared, “I just tend follow whatever they say because they are my superiors. So
when I was told not to do hand washing anymore and just use sterilium instead, I complied. I
don’t want to be reprimanded and avoid remarks that I am sluggish.” [R7] Another participant
affirmed, “I am afraid that if I will not follow what the staff nurses told me to do; they might get
mad at me. They might tell me off and say that I’m doing things the wrong way.” [R5]
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Discussion
This phenomenological inquiry emerged a model labelled as the Theory-Practice Gap
Deficit Triad, which provides description of the nature of shortfalls and hitches relative to
clinical exposure experiences of a select group of Filipino senior student nurses.

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Evidently, the theory-practice gap continues to challenge the rudimentary concept of

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nursing 1profession - research based practice and remains as a pressing issue in nursing
education globally (Scully, 2011). In this study, the structural deficit described as the scarcity of

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resources in hospital materials, supplies and manpower deprived the student nurses the
opportunity to perform ideal practice learned in class during clinical rotations. The

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unavailability of hospital supplies and materials at the bedside limits the student nurses from
executing ideal patient care thus compels them to improvise and find alternatives. The same
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situation was experienced by the Malawian students who were continuously immersed in a
resource poor clinical setting where gross lack of equipment and supplies made them use
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improvised equipment in performing nursing procedures that brought a negative impact to

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their clinical learning (Msiska et al., 2014). Ousey (2007), for her part, posited that common
sense will lead students to question the aptness of clinical practice, yet they are well aware that
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lack of available resources hinders them to undertake procedures in the manner they have
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been taught in class (Ousey and Gallagher, 2007). Another issue observed by the student nurses
in this study was the rampant reusing and recycling of hospital supplies and materials that
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seemed to violate infection control principles learned in class. Such practice in the clinical
setting proliferates as a makeshift solution to scarce hospital materials and supplies. However,
one study found that infection control in developing countries markedly differs from that in the
developed countries due to high costs involved and local factors like socioeconomic and
demographic conditions (Raza et al., 2004). Additionally, in countries with low and middle
income like the Philippines, public hospital’s operating costs are rarely sufficiently supported by
the government budgets (James et al., 2015) since significant revenues of the government are
used to service international debt (Raza et al., 2004). As suggested by Raza et al. (2004),
infection control policies can be diversified and be considerate of local conditions, ‘owned’ and
practiced by local experts and workers so as not to undermine the on-going efforts in a specific
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country. Participants in this study also shared that the patients’ capability to pay seemingly
dictates the quality of care that student nurses can do. If the patient cannot afford to pay the
necessary supplies, the student nurses adjust and modify the procedure depending on the
patients’ supplies at hand. One recent study on public hospital care in the Philippines (James et

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al., 2015) runs parallel with this finding, albeit, coming from the doctors’ viewpoint. As shown,

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due to financial factors and payment arrangements the patients with equal health needs were
treated unequally; those who were more capable to pay receive a more favourable treatment

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and care (James et al., 2015). In regard to shortage in manpower, patient assignment overload
contributed to staff nurses’ substandard clinical practice and procedural shortcuts in meeting

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patients’ needs. Student nurses have seen how bedside nurses also find themselves exhausted
and helpless in situations of uneven nurse-patient ratio that inadvertently poses a threat to
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patients’ health and safety. This finding is reinforced by a study which found that nurse staffing
levels in the hospital has an impact in measuring the overall hospital nursing care performance
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(Needleman et al., 2007). Higher nurse staffing levels are found to be related to improved
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patient outcomes (Holden et al., 2007; Munier, and Porter, 2014) and prevented adverse events
even in the presence of increased patient risk (Donaldson and Shapiro, 2011). Further,
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prioritizing adequate staffing ensures not only high quality patient care but also reduces the
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physical and mental load of the nurses (Negi and Bagga, 2015). Findings of this paper strongly
suggest that structural deficit can be addressed through sufficient allocation of healthcare
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budget by the respective healthcare sectors. Check and balance and collaboration among and
between the government, nursing academe and hospital institutions should be performed to
ensure that standards of patient health care delivery are adequately met.

Along with structural deficit, student nurses in this study also experienced certain deficit
emanating from a pedagogical aspect. Pedagogical deficit transpires when the tutelage
received by student nurses from class seemed to be impractical during their actual clinical
exposure. This in turn situates student nurses in a state of dissemblance where theoretical
underpinnings taught in class were not fully supported by the practices in the real hospital
setting. Notably, several studies run parallel to this finding as student nurses are found to
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struggle in establishing linkages between didactics and actual clinical scenarios that serves as a
limiting factor to students’ clinical learning (Ajani and Moez, 2011; Crookes et al., 2013; Flood
and Robinia, 2014; Falk and Ung, 2015). Seemingly, this is a result of the weak collaboration
between universities and clinical placements (Hall-Lord et al., 2013). The currently existing

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nursing curriculum seemed to ineffectively prepare nursing students to the demands and

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realities of today’s health care environment (Hickey, 2010) as it fails to cultivate clinical skills
that are at par with the requirements of actual hospital setting (Yang et al., 2013). Flood and

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Robinia (2014) argued that there is need for clinical coordinator appointment whose main
responsibility is to cultivate collaboration and communication between didactic and clinical

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faculty staff to ensure attuned classroom and clinical teaching. Further, one study suggested
that educators must always consider the student nurses’ varying prerequisites for learning as
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some must learn the theory prior to practice while some needed to practice first in order to
internalize the theory (Andersson and Edberg, 2012). Moreover, most of the literatures are one
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in claiming that nursing education must evolve from traditional passive lecture styles toward
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incorporation of innovative pedagogical techniques of making explicit connection between

nursing theories and practice (Crookes et al., 2013). Corollary to this thinking, a nursing
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curriculum that is responsive to the individual learning needs of students facilitated by

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proactive, innovative and change-enabling faculty staff must be geared toward reducing theory-
practice gap. Also, the role of a clinical coordinator should be given judicious deliberation to
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serve as a communication bridge between educators and clinicians to ensure theory and
practice alignment.
In this study, student nurses also shared how resident staff nurses’ failure to model
good nursing practice engendered relational deficit. The staff nurses’ hospital routine practices
contradicted the knowledge and skills that student nurses learned in class. Naturally, student
nurses have high expectations set for staff nurses since they are important exemplars that
impact student nurses’ clinical learning (Aghamohammadi-Kalkhora et al., 2011; Dadgaran et
al., 2012; Henderson and Eaton, 2013, Lúanaigh, 2015; Solum et al., 2015). However, due to the
challenges faced by staff nurses in the always busy hospital environment (Solum et al., 2015),
they find it difficult to perform at their expected level and provide adequate support and
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supervision to student nurses (Clements et al., 2015). Disheartened by fear and inferiority,
student nurses instead blindly comply with observed clinical practices in order to shun away
from conflicts with staff nurses. Student nurses remained mindful of the hierarchical structure
of nursing staff in the hospital (Ousey and Gallagher, 2007). In a study conducted on Malawian

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students, student nurses come to the clinical area with fresh eyes that can easily detect

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shortcomings in procedures and practices but to avoid being labeled as faultfinders, they lose
self-confidence and opt to adjust and follow the observed practices instead (Solum et al., 2015).

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Nevertheless, the fact remains that healthy and positive nursing staff-student relationship
impacts the overall theory-practice integration in the clinical learning environment (Arries,

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2009; Aghamohammadi-Kalkhora et al., 2011; Dadgaran et al., 2012; Henderson and Eaton,
2013, Ha, 2015; Lúanaigh, 2015; Rebeiro et al., 2015; Solum et al., 2015). Undoubtedly,
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students develop nursing knowledge and skills from respected staff nurses who are capable of
describing and demonstrating the ‘tricks and trade’ and the ‘little things that matter’ in terms of
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rendering nursing care (Lúanaigh, 2015). Hence, it is imperative to reinforce and support the
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staff nurses in their roles as models and mentors to student nurses (Rebeiro et al., 2015). As
bedside nurses have designated caseload, adequate support in terms of preparation and
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workload planning are vital for them to fulfill such roles while delivering patient care
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(Henderson and Eaton, 2013). Staff nurses are expected to host students in a way that they
‘treat students as a nurse’ but at the same time protecting students’ status as learners
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(Hagenbarth et al., 2015). Impliedly, the teaching hospital institutions are hereby challenged to
place the staff nurses clinical practices’ quality to a higher level. Developing staff nurses who
are exemplars of clinical nursing practice and enablers of clinical learning must be a top priority.
This can be achieved by the hospital nursing administration’s provision of training updates,
appropriate workload assignment and adequate staffing. These actions can ultimately promote
patient safety and quality healthcare.
To address the foregoing deficits, academia-service partnership should be established
(Huijer et al., 2012; Ha, 2015). A joint academia-service committee should be created to serve
as overseer of all issues related to clinical education and service (Huijer, 2010). Through this
collaboration, constructive exchange between academia and health care institutions in relation
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to clinical practice can be achieved (Ha, 2015). Moreover, keeping the partnership between
academic institution and service areas holistic, integrative, and strategic will call for a true
shared governance over understanding and working with knowledge that is beneficial to the
health service and generates measurable publishable research outputs for universities (Walsh

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et al., 2012).

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Conclusion

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Capitalizing on the unique power of naturalistic inquiry to research, this
phenomenological paper purported to capture and describe how senior student nurses viewed

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theory-practice gap in a comprehensive university in the Philippines. Impliedly, the emerged
theory-practice gap deficit triad afforded an eidetic description of the dynamics of the
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prevailing shortfalls and mishaps in student nurses’ clinical learning milieu that circumscribes
facets associated with hospital setting resources (structural deficit), applicability of didactics
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into actual practice (pedagogical deficit), and student-staff-nurses interrelation (relational

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deficit). Clearly, deficits identified from this study underscore the existence of the “gap” that
formidably injures not only the student nurses’ clinical learning experience but the nursing
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profession as a whole. Hence, nursing educators, practitioners, and administrators are

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challenged to collaborate and synergize efforts in initiating pathways and mechanisms aimed at
reducing the gap. A committee of partnership between academe and hospital institutions
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should be established to serve as the overseer and coordinator of all concerns and issues
associated with clinical education and practice. Through this collaboration, alignment of the
theoretical and practical nursing dimensions can be maintained and ensured. Ultimately, the
end goal of reducing the “gap” is the provision of care characterized by empathy, quality and
equity to all individuals healthy and not.
While the findings of this study cannot make generalizable statements that can reflect
local and international student nurses’ theory-practice gap experiences, this paper progresses
the current literature by shedding light on the theory-practice gap experiences of Filipino
student nurses which is not previously cited although concurring with previous international
investigations. It is suggested that the emerged theory-practice gap deficit triad served as a
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fecund foreground that is noteworthy to spearhead future research initiatives such as scale
development and modelling. This study concludes with a view to increase scholars’ cognizance
to dilemmas related to student nurses’ clinical experiences.

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Figure 1 Theory-practice gap deficit triad

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Research Highlights:

Theory-practice gap has remained to be a formidable task and a foregoing challenge to the
nursing profession.

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A dearth in literature exists in the context of a developing country like the Philippines and

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seemingly, no research has ventured yet to explore the theory-practice gap experiences of

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An interesting conceptualization labeled as the Theory-Practice Gap Deficit Triad which

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consists of (a) Structural, (b) Pedagogical, and (c) Relational deficits was emerged in this study.

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