Guided reflection as a tool to deal with the theory– practice gap in critical care nursing students

Critical care nursing students experience inconsistencies between the theoretical content they have learnt and what is expected from them in practice, which retards the learning process. This has been described as the theory–practice gap. There seems to be no single solution to address the integration of theory and practice. In an attempt to bridge this gap, a study was done to establish the influence of guided reflection on critical care nursing students in dealing with their theoretical and practical experiences. A qualitative, explorative, descriptive and contextual design was followed. An instrument for guided reflection was designed which was used during semi-structured interviews during the data collection process. Field notes and narrative descriptions were also used as means to collect data. Themes that emerged from the data included a description of incidents experienced, critical analysis of knowledge, critical analysis of feelings and changed perspective experienced. Theory–practice integration occurred to an extent in some of the categories; conversely, the inability to apply theory to practice evoked responses such as feelings of guilt and incompetence. Guided reflection appeared to have assisted the participants in clarifying theoretical and practical experiences, and in reaching a changed perspective by understanding the link between theory and practice. Guided reflection ought to be incorporated in the education of nurses from their basic training in theory and practice so that student nurses will be aware of their own competencies in order to provide optimal patient care.