Mortell Manfred
Cardiac Critical Care, King Abdulaziz Cardiac Centre, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
J Saudi Heart Assoc. 2009 Jul;21(3):149-52. doi: 10.1016/j.jsha.2009.06.002. Epub 2009 Aug 5.
The theory-practice-ethics gap - a new paradigm to contemplate. Practices based on tradition, rituals and outdated information are placed into a nonscientific paradigm called the theory-practice gap. Within this paradigm there is often a gap between theoretical knowledge and its application in practice. This theory-practice gap has always existed [Allmark, P., 1995. A classical view of the theory-practice gap in nursing. J. Adv. Nurs. 22 (1), 18-23; Hewison, A. et al., 1996. The theory-practice gap in nursing: a new dimension. J. Adv. Nurs. 24 (4), 754-761]. Its creation is often sited as a culmination of theory being idealistic and impractical, even if practical and beneficial, are often ignored. Most of the evidence relating to the non integration of theory and practice makes the assumption that environmental factors are responsible and will affect learning and practice outcomes, hence the "gap". In fact, it is the author's belief, that to "bridge the gap" between theory and practice an additional component is required, called ethics. A moral duty and obligation ensuring theory and practice integrate. In order to effectively implement new practices, one must deem these practices are worthy and relevant to their role as healthcare providers. Otherwise, we fall victims to providing nothing more than a lip service. This introduces a new concept which the author refers to as the theory-practice-ethics gap. This theory-practice-ethics gap must be considered when reviewing some of the unacceptable outcomes in health care practice. The author believes that there is a crisis of ethics where theory and practice integrate, and as a consequence, malfeasance. We are failing to fulfill our duty as healthcare providers and as patient advocates. One practice of major concern, which the author will endeavor to unfold relates to adult and pediatric resuscitation.
理论 - 实践 - 伦理差距——一个值得思考的新范式。基于传统、仪式和过时信息的实践被置于一种非科学的范式中，即所谓的理论 - 实践差距。在这个范式中，理论知识与其在实践中的应用之间往往存在差距。这种理论 - 实践差距一直存在[奥尔马克，P.，1995年。护理中理论 - 实践差距的经典观点。《高级护理杂志》22(1)，18 - 23；休伊森，A.等人，1996年。护理中的理论 - 实践差距：一个新维度。《高级护理杂志》24(4)，754 - 761]。其产生通常被认为是理论过于理想化且不切实际的结果，即使这些理论实用且有益，也常常被忽视。大多数关于理论与实践未整合的证据都假定环境因素是造成这种情况的原因，并且会影响学习和实践结果，因此出现了“差距”。事实上，作者认为，要弥合理论与实践之间的“差距”，还需要一个额外的要素，即伦理。伦理是一种道德责任和义务，确保理论与实践相结合。为了有效实施新的实践，人们必须认为这些实践是有价值的，并且与他们作为医疗服务提供者的角色相关。否则，我们就只是在做表面功夫。这引入了一个作者称之为理论 - 实践 - 伦理差距的新概念。在审视医疗实践中一些不可接受的结果时，必须考虑这个理论 - 实践 - 伦理差距。作者认为，在理论与实践相结合的过程中存在伦理危机，进而导致了渎职行为。我们未能履行作为医疗服务提供者和患者倡导者的职责。作者将努力阐述的一个主要关注点是成人和儿童复苏的实践。
