The theory-practice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education

J Adv Nurs. 2012 Apr;68(4):868-77. doi: 10.1111/j.1365-2648.2011.05789.x. Epub 2011 Jul 27.


Aim: This paper is a report of a correlational study of the relations of nursing students' acquired reflective skills, practical skills and theoretical knowledge on their perception of coherence between theory and practice.

Background: Reflection is considered a key factor in bridging the gap between theory and practice. However, it is not evident whether reflective skills are primarily generic in nature or whether they develop from a theoretical knowledge base or the acquisition of practical skills.

Method: This study is a secondary analysis of existing data. The data are part of a student survey that was conducted among third-year nursing students in Norway during the spring of 2007. A total of 446 nursing students participated in this study and the response rate was 71%. Structural equation modelling analyses were performed.

Findings: The results indicate that students' perception of coherence between theory and practice during initial nursing education is directly influenced by reflective skills and theoretical knowledge. The results also reveal that reflective skills have mediating effects and that practical skills have a fully mediated and theoretical knowledge a partially mediated influence on students' perception of coherence.

Conclusion: The findings imply that helping students perceive coherence between theory and practice in nursing education, developing students' reflective skills and strengthening the theoretical components of the initial nursing education programme might be beneficial. The results suggest that reflective thinking is not merely a generic skill but rather a skill that depends on the acquisition of relevant professional knowledge and experience.

MeSH terms

  • Adult
  • Clinical Competence / standards
  • Cross-Sectional Studies
  • Education, Nursing*
  • Educational Measurement
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical*
  • Norway
  • Nursing Education Research
  • Nursing Theory*
  • Sense of Coherence
  • Students, Nursing / psychology*
  • Thinking*
  • Young Adult