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      Experiences and perceptions of the theory‐practice gap in nursing in a resource‐constrained setting: A qualitative description study

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          Abstract

          Aim

          To describe experiences and perceptions of theory‐practice gap in nursing in a resource‐constrained setting. Theory‐practice gap is extensively discussed and studied in some parts of the world. Interventions to bridge the theory‐practice gap have been varied and depend on an understanding of the contextual healthcare environment. Experiences and perceptions of the theory‐practice gap in a resource‐constrained setting have not been comprehensively described.

          Design

          A qualitative description methodology was used.

          Methods

          Maximum variation sampling based on role in the events of theory‐practice gap was used to recruit student nurses, nurse faculty and clinicians from two study sites for focus group discussions. Data were analysed using conventional content analysis.

          Results

          Five themes were identified: system inadequacies; resource constraints; challenges of the clinical learning environment; clinical placement and supervision; and nurse faculty factors. Systems inadequacy and resource constraints formed the spine of the challenges contributing to the theory‐practice gap in the research setting.

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          Most cited references57

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          Three approaches to qualitative content analysis.

          Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.
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            Whatever happened to qualitative description?

            The general view of descriptive research as a lower level form of inquiry has influenced some researchers conducting qualitative research to claim methods they are really not using and not to claim the method they are using: namely, qualitative description. Qualitative descriptive studies have as their goal a comprehensive summary of events in the everyday terms of those events. Researchers conducting qualitative descriptive studies stay close to their data and to the surface of words and events. Qualitative descriptive designs typically are an eclectic but reasonable combination of sampling, and data collection, analysis, and re-presentation techniques. Qualitative descriptive study is the method of choice when straight descriptions of phenomena are desired. Copyright 2000 John Wiley & Sons,
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              E-learning in medical education in resource constrained low- and middle-income countries

              Background In the face of severe faculty shortages in resource-constrained countries, medical schools look to e-learning for improved access to medical education. This paper summarizes the literature on e-learning in low- and middle-income countries (LMIC), and presents the spectrum of tools and strategies used. Methods Researchers reviewed literature using terms related to e-learning and pre-service education of health professionals in LMIC. Search terms were connected using the Boolean Operators “AND” and “OR” to capture all relevant article suggestions. Using standard decision criteria, reviewers narrowed the article suggestions to a final 124 relevant articles. Results Of the relevant articles found, most referred to e-learning in Brazil (14 articles), India (14), Egypt (10) and South Africa (10). While e-learning has been used by a variety of health workers in LMICs, the majority (58%) reported on physician training, while 24% focused on nursing, pharmacy and dentistry training. Although reasons for investing in e-learning varied, expanded access to education was at the core of e-learning implementation which included providing supplementary tools to support faculty in their teaching, expanding the pool of faculty by connecting to partner and/or community teaching sites, and sharing of digital resources for use by students. E-learning in medical education takes many forms. Blended learning approaches were the most common methodology presented (49 articles) of which computer-assisted learning (CAL) comprised the majority (45 articles). Other approaches included simulations and the use of multimedia software (20 articles), web-based learning (14 articles), and eTutor/eMentor programs (3 articles). Of the 69 articles that evaluated the effectiveness of e-learning tools, 35 studies compared outcomes between e-learning and other approaches, while 34 studies qualitatively analyzed student and faculty attitudes toward e-learning modalities. Conclusions E-learning in medical education is a means to an end, rather than the end in itself. Utilizing e-learning can result in greater educational opportunities for students while simultaneously enhancing faculty effectiveness and efficiency. However, this potential of e-learning assumes a certain level of institutional readiness in human and infrastructural resources that is not always present in LMICs. Institutional readiness for e-learning adoption ensures the alignment of new tools to the educational and economic context.
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                Author and article information

                Contributors
                salifu.david@ucc.edu.gh , salifudavid@gmail.com
                Journal
                Nurs Open
                Nurs Open
                10.1002/(ISSN)2054-1058
                NOP2
                Nursing Open
                John Wiley and Sons Inc. (Hoboken )
                2054-1058
                19 July 2018
                January 2019
                : 6
                : 1 ( doiID: 10.1002/nop2.2019.6.issue-1 )
                : 72-83
                Affiliations
                [ 1 ] Principal Health Tutor, Ministry of Health, Nurses' Training College Damongo Ghana
                [ 2 ] Professor Emerita Morehead State University KY USA
                [ 3 ] Global Health Services Partnership US Peace Corps Liberia
                [ 4 ] Senior Health Tutor, Ministry of Health Nurses’ Training College Damongo Ghana
                [ 5 ] Department of Mental Health, School of Nursing and Midwifery, College of Health and Allied Sciences University of Cape Coast Cape Coast Ghana
                Author notes
                [*] [* ] Correspondence

                David Abdulai Salifu, Ministry of Health, Nurses’ Training College, Damongo, Ghana.

                Emails: salifu.david@ 123456ucc.edu.gh ; salifudavid@ 123456gmail.com

                Author information
                http://orcid.org/0000-0003-4301-3170
                Article
                NOP2188
                10.1002/nop2.188
                6279732
                30534396
                884cb4c6-4332-4c92-a826-e44decd5b25e
                © 2018 The Authors. Nursing Open published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 February 2018
                : 14 June 2018
                Page count
                Figures: 1, Tables: 3, Pages: 12, Words: 9029
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                nop2188
                January 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.5.3 mode:remove_FC converted:04.12.2018

                community of learning,nursing education,theory‐practice gap,qualitative description

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