An experiment in integration of theory and practice in nursing is
described. It took place within the apprenticeship programme of
general nurse education and training in Scotland, 1978/79j and was
evaluated by student nurses, nurse teachers and ward trained staff.
The research approach was that of illuminative evaluation,
incorporating a pre-test/post-test control group design, with an added
retention of learning test. In regard to nursing of patients with
gastro-intestinal disease, experimental group students received a
planned programme of concurrent theory and directly relevant and
supervised nursing practice, while control group students received
teaching of the same subject matter by entirely college-based methods.
Prior to their random allocation to experimental or control groups,
students were paired on the basis of their results on a multiple choice
test, the construction and validation of which is described.
Following an exploratory survey and pilot study, the main study
took place in five colleges of nursing and their associated hospitals.
Data collection methods were pre- and post-experiment opinion
questionnaires, the multiple choice test and college-set essay format
tests, and student study diaries.
Opinions as to aspects of the learning milieu in nurse education
and training were obtained from 119 student nurses, 221+ ward staff and
72 teachers. It was concluded that there was considerable evidence of
practice which differed from theory, and that, when ward trained staff
and trained teachers of nursing were compared, the latter made the
least contribution to ward teaching of student nurses in general
medical and surgical wards.
Test scores were available from 32 matched pairs of experimental
and control group students and an additional 11 experimental group
students. It was concluded that both experimental and control methods
of instruction were effective as both resulted in statistically
significant gain scores from pre-test to post-test and from pre-test
to retention test. However, when the relative instructional
effectiveness of the two methods of instruction was examined, there
was no statistically significant difference within the pairs. There
was a consistent trend, very small at post-test, but more marked at
retention test for students in the experimental group to have higher
scores than those in the control group. There was no statistically
significant difference in retention test scores between students, in
either group, for whom intervening practical experience had been relevant
to the subject matter of the experiment, and those for whom it had not.
Prom post-experiment opinions of 5l student nurses, 58 ward trained
staff and 11 teachers who had been directly involved, it was concluded
that the objectives of the experiment in regard to various aspects of
integration of theoiy and practice in nursing had received a very
positive evaluation. Recommendations made were based upon evidence in
the pre-experiment qualitative data, upon the strong endorsement of the
experiment by student nurses, teachers and ward staff, upon its reported
benefits to the patients, and notwithstanding the lack of a statistically
significant result on the test scores - which latter result was considered
to be not unrealistic in view of the brevity of the intervention. These
recommendations included that nurse teachers should endeavour to teach
nursing where nursing is carried out, with students who are temporarily
freed from the responsibilities for providing service, and that ward
staff and student nurses should be taught how to teach.
