IntroductionIt is important that theory is synchronous with clinical practices that students engage in. Lack of congruence between theory and practice presents serious problems to students. This study was therefore conducted to determine if there was a theory–practice gap in chest radiography during clinical rotations, and any associated causes and effects on radiography students.MethodA descriptive survey design was used to conduct this study from 2 February to 27 July 2014. A semi‐structured questionnaire consisting of open‐ and close‐ended questions was used to purposively collect data from 26 radiography students in Ghana who had completed theory lessons in chest radiography and had either completed or were undertaking clinical rotations in chest radiography.ResultsTwenty‐five (96%) respondents indicated the presence of theory–practice gap in chest radiography during clinical rotations, where differences between theory and clinical practice were observed. Lack of working materials 16 (62%), heavy workload 14 (54%), equipment breakdowns 14 (54%) and supervisory factors 11 (43%) were identified as the causes. Many students (81%) experienced diverse adverse effects such as confusion 10 (38%), poor performance during clinical examinations 6 (23%) and entire loss of interest in the professional training 1 (4%) of this dichotomy.ConclusionDichotomy between theory and practice found in chest radiography has diverse adverse effects on students. Regular feedback on the quality of clinical practice received by students should be encouraged to determine the existence of any gaps between theory and practice in order to promote effective clinical rotation programmes in radiography.