VOICES FROM THE WARD: QUALITATIVE INSIGHTS INTO NURSING STUDENTS’ CHALLENGES TRANSLATING THEORY INTO PRACTICE” IN PAKISTAN

Abstract

Background: Nursing theories underpin nursing practice, research, education, and professional growth. However, their application in clinical settings is frequently inadequate, revealing challenges in integrating theory into practice. The present study aimed to explore the barriers experienced by nursing students and clinical instructors in applying nursing theories within clinical environments.

Methodology: A qualitative case study design was adopted to examine challenges related to theory-to-practice integration among 8th-semester Bachelor of Science in Nursing (BSN) students and clinical nursing instructors in Khyber Pakhtunkhwa (KP), Pakistan. Semi-structured interviews were conducted with ten participants, including five students and five instructors. Interviews were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s thematic analysis approach.

Results: Analysis revealed four overarching themes: (1) discrepancies between classroom instruction and clinical realities, characterized by idealized theoretical content, limited hands-on practice, and conflicting guidance from educators and ward staff; (2) insufficient clinical supervision and support, reflected in limited instructor availability, weak academic–clinical collaboration, and inconsistent mentoring practices; (3) organizational and resource-related challenges, including heavy patient workloads, shortages of equipment, and routine-driven ward practices; and (4) student-related barriers, such as low self-confidence, communication difficulties, and inadequate recall of foundational theoretical knowledge. These findings illustrate the complex and multidimensional nature of the theory–practice gap in nursing education

Conclusion: The theory–practice gap in nursing education in KP arises from intertwined educational, organizational, and learner-related factors. Addressing this gap requires strengthened academic–clinical partnerships, enhanced clinical mentor-ship, improved resource provision, and practice-oriented teaching strategies to foster students’ clinical competence and professional readiness.