THEORY PRACTICE GAP AMONG GENERIC BSN NURSING INTERNEES IN ISLAMABAD: A QUALITATIVE STUDY

Abstract

Background The separation between classroom teaching and clinical care can leave newly graduated nurses unable to apply evidence based knowledge under the conditions they meet in practice. Evidence from Pakistan is limited, particularly for nursing internees working in high volume tertiary hospitals. Objective To explore how Generic Bachelor of Science in Nursing internees experienced the gap between theoretical preparation and clinical nursing practice in tertiary care hospitals in Islamabad. Setting Shifa International Hospital and the Pakistan Institute of Medical Sciences in Islamabad, Pakistan. Methods A descriptive exploratory qualitative design was used. Six graduated Generic BSN nursing internees with at least three months of internship experience were selected purposively. Face to face semi structured interviews lasting 30 to 40 minutes were audio recorded and transcribed verbatim. The transcripts were read repeatedly, meaningful statements were coded, and related codes were grouped into categories. Recruitment ended when no substantively new categories were identified. Results Six categories described the theory practice gap: the landscape of current nursing care practice; nursing practice aligned with the curriculum; integration of academic and clinical domains; facilitation of nurses to provide quality care; continued professional development; and training needs during the undergraduate programme. Participants described high patient loads, staff shortages, limited family involvement, departures from taught infection control and procedural standards, insufficient supervised practice, and difficulty applying knowledge under pressure. They recommended earlier clinical exposure, stronger academic clinical coordination, simulation, administrative rotations, supportive supervision, continuing education, and training in communication, coping, language, and cultural competence. Conclusion The gap was experienced as both an educational and organisational problem. Curriculum revision alone is unlikely to be sufficient unless hospitals also provide realistic workloads, consistent protocols, supervision, and opportunities for continued learning. Contribution The findings identify practical changes that nursing colleges and tertiary hospitals in Islamabad can make jointly to support the transition from student to practitioner.