Adamson E, Dewar B. Compassionate care: student nurses' learning through reflection and the use of story. Nurse Educ Pract. 2015; 15:(3)155-161

Akram AS, Mohamad A, Akram S. The role of clinical instructor in bridging the gap between theory and practice in nursing education. International Journal of Caring Sciences. 2018; 11:(2)876-882

Bandura A, Adams NE. Analysis of self-efficacy theory of behavioral change. Cognitive Therapy and Research. 1977; 1:(4)287-310

Bosse HM, Huwendiek S, Skelin S, Kirschfink M, Nikendei C. Interactive film scenes for tutor training in problem-based learning (PBL): dealing with difficult situations. BMC Med Educ.. 2010; 10:(1)

Brame CJ. Effective educational videos: principles and guidelines for maximizing student learning from video content. CBE Life Sci Educ.. 2016; 15:(4)

Brookes S, Moseley A. Authentic contextual games for learning. In: Whitton N, Moseley A (eds). New York: Routledge; 2012

Widening participation strategy in higher education in England. 2018. (accessed 20 April 2023)

D'Ardis M. Forum theatre for practice simulation and skills development in nurse education: A student's perspective. Nurse Educ Today. 2014; 34:(8)1136-1137

Department of Health and Social Care. Nursing applications in England up by over a third to 48,830. Press release. 2021. (accessed 27 March 2023)

Dong C, Goh PS. Twelve tips for the effective use of videos in medical education. Med Teach. 2015; 37:(2)140-145

Ellaway R, Masters K. AMEE guide 32: e-learning in medical education. Part 1: learning, teaching and assessment. Med Teach. 2008; 30:(5)455-473

Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004; 79:S70-S81

Falk K, Falk H, Jakobsson Ung E. When practice precedes theory—a mixed methods evaluation of students' learning experiences in an undergraduate study program in nursing. Nurse Educ Pract. 2016; 16:(1)14-19

Reflecting on ‘reflective practice’. Practice-based professional learning paper 52. 2008. (accessed 27 March 2023)

Greenway K, Butt G, Walthall H. What is a theory-practice gap? An exploration of the concept. Nurse Educ Pract. 2019; 34:1-6

Haslam MB. What might COVID-19 have taught us about the delivery of nurse education, in a post-COVID-19 world?. Nurse Educ Today. 2021; 97

Hsin W, Cigas J. Short videos improve student learning in online education. J Comput Sci Coll.. 2013; 28:(5)253-259

King D, Tee S, Falconer L, Angell C, Holley D, Mills A. Virtual health education: scaling practice to transform student learning. Nurse Educ Today. 2018; 71:7-9

Locke EA, Latham GP. New directions in goal-setting theory. Curr Dir Psychol Sci.. 2006; 15:(5)265-268

Lunenburg FC. Goal-setting theory of motivation. International Journal of Management, Business, and Administration. 2011; 15:(1)1-6

McCaugherty D. The theory-practice gap in nurse education: its causes and possible solutions. Findings from an action research study. J Adv Nurs. 1991; 16:(9)1055-1061

McKendry S, Wright M, Stevenson K. Why here and why stay? Students' voices on the retention strategies of a widening participation university. Nurse Educ Today. 2014; 34:(5)872-877

Mcleod P, Steinert Y. Twelve tips for curriculum renewal. Med Teach. 2015; 37:(3)232-238

Miller GE. The assessment of clinical skills/competence/performance. Acad Med. 1990; 65:S63-S67

Nursing and Midwifery Council. The code. Professional standards of practice and behaviour for nurses, midwives and nursing associates. 2018. (accessed 27 March 2023)

Nursing and Midwifery Council. Regulators unite to support reflective practice across health and care. 2019. (accessed 20 April 2023)

Nursing and Midwifery Council. Revalidation. Guidance and information. 2021. (accessed 20 April 2023)

Office for Students. Gravity assist: propelling higher education towards a brighter future. 2021. (accessed 27 March 2023)

Prober CG, Khan S. Medical education reimagined: a call to action. Acad Med. 2013; 88:(10)1407-1410

Robinson KE, Allen PJ, Quail M, Beilby J. Virtual patient clinical placements improve student communication competence. Interact Learn Environ. 2020; 28:(6)795-805

Roblyer MD, Doering AH. Integrating educational technology into teaching, 6th edn. Harlow: Pearson; 2013

Rolfe G. The theory-practice gap in nursing: from research-based practice to practitioner-based research. J Adv Nurs. 1998; 28:(3)672-679

Roper N, Logan WW, Tierney AJ. The Roper-Logan-Tierney model of nursing: based on activities of living.Edinburgh: Elsevier Health Sciences; 2000

Rudolph J. A brief review of Mentimeter—a student response system. Journal of Applied Learning and Teaching. 2018; 1:(1)35-37

Saifan A, AbuRuz ME, Masa'deh R. Theory practice gaps in nursing education: a qualitative perspective. Journal of Social Science. 2015; 11:(1)20-29

Schön DA. Educating the reflective practitioner: toward a new design for teaching and learning in the professions.San Francisco: Jossey-Bass; 1987

Shoghi M, Sajadi M, Oskuie F, Dehnad A, Borimnejad L. Strategies for bridging the theory-practice gap from the perspective of nursing experts. Heliyon. 2019; 5:(9)

Spaska AM, Savishchenko VM, Komar OA, Hritchenko TY, Maidanyk OV. Enhancing analytical thinking in tertiary students using debates. European J Ed Res.. 2021; 10:(2)879-889

Sweller J. Cognitive load during problem solving: effects on learning. Cogn Sci.. 1988; 12:(2)257-285

Swift A, Banks L, Baleswaran A COVID-19 and student nurses: a view from England. J Clin Nurs. 2020; 29:(17-18)3111-3114

Waugh A, Donaldson J. Students' perceptions of digital narratives of compassionate care. Nurse Educ Pract. 2016; 17:22-29

Whitton N, Maclure M. Video game discourses and implications for game-based education. Discourse: Studies in the Cultural Politics of Education. 2017; 38:(4)561-572

Yew EHJ, Goh K. Problem-based learning: an overview of its process and impact on learning. Health Prof Educ.. 2016; 2:(2)75-79

Zhang J, Shields L, Ma B The clinical learning environment, supervision and future intention to work as a nurse in nursing students: a cross-sectional and descriptive study. BMC Med Educ.. 2022; 22:(1)

Implementation of a virtual student placement to improve the application of theory to practice

11 May 2023
Volume 32 · Issue 9



The primary aim of undergraduate, pre-registration nursing education is to prepare students to be nurses who can apply theory to practice, with clinical placements to support the practice element of the clinical programme. However, the theory-practice gap is a longstanding problem within nurse education, as nurses continue to practise with incomplete knowledge to support their actions.


In April 2020, the COVID-19 pandemic caused a reduction in clinical placement capacity that affected student learning opportunities.


Based on Miller's pyramid of learning, a virtual placement was created using evidence-based learning theories and an array of multimedia technologies with the intention of replicating real-life experiences and promoting problem-based learning. Scenarios and case studies were collated from clinical experiences and mapped against student proficiencies to produce an authentic and immersive learning environment.


This innovative pedagogy provides an alternative to the placement experience while enhancing the application of theory to practice.

In the UK, the standards for undergraduate nursing education as well as practice are established and enforced through the Nursing and Midwifery Council (NMC) (2018), which expects registered nurses and nursing students to effectively apply theory to practice through its requirement that clinical practice should be evidence based. Therefore, the ability to apply theory to practice is a fundamental pre-registration requirement for all nursing students.

However, Greenway et al (2019) and McCaugherty (1991) observed that there is a disparity between theory and practice, highlighting that the complexity of clinical environments can never be described on paper in their entirety. There are many causes for the gap. For example, Shoghi et al (2019) found that the high student:educator ratio in undergraduate education created barriers to implementing innovative pedagogy around the application of theory to practice. Furthermore, they identified that both students and educators found research confusing and difficult to implement. Numerous commentators have asserted that it is the role of the nurse educator to minimise the theory-practice gap (Rolfe, 1998; Saifan et al, 2015; Akram et al, 2018) and to motivate and empower students to apply theory to practice (Falk et al, 2016).

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