A core element of healthcare education is the transfer of information between theory and practice. The transfer is not always 100% accurate, however: when there are elements of theory that do not translate into a staff member’s practice, or they struggle to make that transition, this is called the theory-practice gap.

The theory-practice gap can result in the provision of lower quality care and even less favourable health outcomes for patients and consumers.

Some common questions are: how can this transfer be as efficient as possible? How can organisations track this transfer in their staff, and how can organisations minimise the effects of the theory-practice gap?

What is the theory-practice gap?

According to Ausmed:

The theory-practice gap has always existed in some form, but has become more of a pressing issue for organisations, staff and patients alike as standards of care have become rooted in evidence-based practice. Previously, however, standards of care were rooted in custom and tradition.

As a result of this, there’s a growing discrepancy between what is considered best practice – often out-dated or custom-based care – and what is considered actual practice – new evidence-based practice.

The theory-practice gap most commonly affects newly qualified employees, but can pervade the practice of any practitioner at any stage in their career.

Is it possible to close the theory-practice gap?

There have been many initiatives launched and attempted in order to close, narrow or bridge the theory-practice gap in healthcare. Most of these initiatives relied upon intervention and proactive efforts from nurse educators and mentors.

However, given the general climate of the healthcare industry – staff are overworked, organisations are understaffed and practitioners are largely experiencing burnout – it has become difficult to rely upon these interventions, which in turn has resulted in a proliferation of newly qualified staff who experience larger than usual theory-practice gaps.

As registered nurse and researcher Stephen H Cook explained (1991), it is unlikely that organisations can entirely remove the theory-practice gap from their staff’s practice. However, a better goal than closing the gap is to narrow it.

How can you narrow the theory-practice gap?

Organisations must first assign responsibility for narrowing the gap: though the responsibility cannot fall entirely on staff, practitioners are a core element of the narrowing process. Other groups and individuals who bear responsibility include organisation managers, education directors, team leaders, mentors and newly-qualified staff.

To make sure your organisation has the narrowest theory-practice gaps possible:

• Support must be provided to educators within your organisation.
• A culture of research and evidence-based practice must be encouraged.
• Access to research must be granted for organisation leaders, management and staff on every level.

When it comes to actually instating these changes in your organisation, you must consider what is already in place and how you can enhance it, rebuild it or remove it to make way for the initiatives listed above.

How can Ausmed facilitate these initiatives?

Ausmed's suite of organisational solutions can provide invaluable support to organisation managers and directors who may not have the time or resources to personally direct an entire overhaul of organisation culture.

Ausmed’s resources put the power back in your staff’s hands: mentors can suggest universally-accessible learning activities on the Ausmed platform, staff can complete them on the go with the app, and you can generate reports within seconds to monitor progress.

For example, should an organisation with over 300 staff want to create a culture of research and evidence-based practice, it may create an official mentorship program that pervades every level of its clinical and non-clinical practice. In these mentorship programs, older or more senior practitioners could suggest Ausmed learning activities or topics to younger or less experienced practitioners, and then, after the learning activity has been completed, the mentor could provide practice-based explanations and anecdotes that would narrow the theory-practice gap significantly.

For a smaller organisation, however, perhaps fortnightly meetings to discuss recent learning or CPD. With an Ausmed for Organisations subscription, colleagues could complete a learning activity before the meeting and discuss how it could be applied in practice, hurdles that may present themselves, or anecdotes from seeing the condition in practice previously.

In short, mentorship programs and research-centric cultures are the key to narrowing the theory-practice gap in your organisation. However, tools such as Ausmed create a proactive and peer-led environment that allows education directors to assign relevant learning while also giving mentors and practitioners themselves the ability to re-engage with troubling topics and work alongside peers to narrow their own specific theory-practice gaps as efficiently as possible.

Practitioners will feel a renewed sense of confidence when learning about new topics and providing new forms of care in their practice, and patients will in turn receive better-informed, evidence-based practice and, eventually, greater health outcomes.

References

• Cook, S.H., 1991. ‘Mind the theory/practice gap in nursing.’ Journal of Advanced Nursing. Vol. 16, no. 12. Accessed 1 August 2022 via https://pubmed.ncbi.nlm.nih.gov/1724255/
• Watkins, A., 2018. ‘Closing the Theory-Practice Gap: Is it Possible?’ Ausmed. Accessed 1 August 2022 via https://www.ausmed.com.au/cpd/articles/close-theory-practice-gap/view