The nursing education institution under discussion is part of an HEI, offering undergraduate and postgraduate programmes. The four-year undergraduate nursing degree follows a problem-based, competency-orientated, student-centred curriculum (Mtshali & Gwele 2015). Pre-COVID-19, teaching and learning involved face-to-face contact and access to an e-learning platform, with sit-in examinations to assess the learning outcomes. The Discipline of Nursing draws most of its student population from under-resourced settings, predominantly rural areas in and out of the province (Mudaly & Mtshali 2018). Table 1 depicts the core information about the undergraduate nursing students (Year 1–4; N = 307) at the start of the COVID-19 pandemic, as the university transitioned to online teaching and learning, highlighting that nearly two-thirds of the students were from rural areas.

The desired outcome of Universities South Africa (USAf 2020) underpinned the institution’s processes, to save the 2020 academic year, and that no student or faculty should be left behind. Furthermore, the desired outcome focused on processes inherent in the faculty’s provision for and utilisation of structures to facilitate and support teaching, learning and assessment in response to the COVID-19-related intrusion and interruptions in education. The desired outcomes were achieved through structures and processes, consequently adopting Donabedian’s tripartite (2005) model as the article’s framework for the report on the transitioning to online teaching, learning and assessment in the select HEI (Figure 1).

The Department of Higher Education and Training (DHET), the nursing regulatory body (SANC) and the university did not have a disaster management plan targeting an education crisis. The overarching Disaster Management Act, 2002 (Act No. 57 of 2002), with its subsequent regulations relating to COVID-19, provided the legislative framework for all decisions (RSA 2002). In the absence of existing institutional and regulatory body policy guidelines, the Teaching and Learning Committees of the HEI under discussion needed to draw their guidance from the Disaster Management Act, 2002 (RSA 2002) while maintaining their respective professional and educational standards.

For over a decade, the university had promoted e-learning initiatives, reflected through Goal-4 (Excellence in Teaching and Learning) of its earlier strategic plans (2007–2016) (UKZN 2017). Goal-4 required integrating IT networks and communication protocols into teaching and learning settings (UKZN 2017). The heightened IT focus ensured inter-alia efficient IT networks across the campuses and Virtual Private Network (VPN) connectivity for off-campus access of such resources as the library (UKZN ICS 2020).

In addition, there existed a dedicated e-learning or online website, which allowed for multiple bi-directional teaching and learning interactions between the faculty and the learner. The university’s strategic plans (2017–2021) were translated into the policy on teaching and learning of quality online learning environments and resources in line with best practices in technology (UKZN 2017). However, pre-COVID-19, individuals or departments exercised the option to use the website (UKZN 2017) instead of the non-optional requirement of all faculties imposed by the current pandemic. Teaching and learning infrastructures also included well-equipped functional clinical skills laboratories with relevant technology, inclusive of high-fidelity manikins to simulate real-life situations, to meet the clinical component of the nursing programme. Further complimenting the simulated clinical resources, there was an established access to real-life authentic clinical learning in rural and urban settings.

There was a wide variance in digital literacy and access to the e-learning website among the students and faculty. The variance between the digital literacy of the first year and final-year undergraduate students (mean age 20.5 years) can be attributed in part to the shift in student enrolments from lower quintile schools (UKZN 2019), accommodating pupils from lower resourced settings who required upskilling. In particular, first-year students received computer literacy training. The students, except the first year students, had acquired the necessary hardware, laptops and related software through the years. Similarly, the faculties showed differences in their digital ability; hence, they were expected to attend the university technology enhanced learning (UTEL) programme designed for the attendee to embrace technology (UKZN 2019). Despite the opportunities, not all faculties attended the UTEL programme training, leaving a variance in digital capacity (UKZN 2019).

Not only was digital upskilling of importance but it gave recognition to the students’ bio-psycho-social needs. Student support services were available for psycho-social needs, while a campus clinic ensured the meeting of students’ physical health needs.

The process was guided by the National Command Council and legislation (Disaster Management Act No. 57 of 2002 and regulations) (RSA 2002) and driven by the notion that teaching, learning and assessment should continue despite the pandemic (PMG 2020). In keeping with the goal of saving the academic year, The Department of Higher Education and Training Ministry charged HEIs with owning the process for a staggered return of students (PMG 2020). In particular, the legislated concession (Gazette No. 43 486) was given meaning through the DHET Risk Adjusted Strategy for the post-school education and training sector (PSET), which allowed for final-year health science students to return to campus, enabling them to meet their clinical requirements (SA Government 2020b). The regulatory body (SANC) accommodated for its insistence in the completion of the stipulated clinical hours (Circular 5/2020) (SANC 2020a) through a later circular by extending the training period and increasing simulation learning to 20% of the clinical hours (Circular 11/2020) (SANC 2020b). The process in the university aligned with the national desired outcome and the requirement of leaving no faculty or student behind, and accordingly developed a teaching and learning framework from the university disaster management plan, goaled at the recovery of the academic programme of 2020 (Songca 2020a). The Project Plan of Action for Remote Multi-Modal Teaching and Learning (2020) guided teaching, learning and assessment (Songca 2020b).

The university embarked on alternative means of teaching and learning. Predominant use was made of the flipped classroom, a form of blended learning with content made available prior and after the online classes through various means, for example, triggers material involving case studies (Baloyi & Mtshali 2018). In addition, off-line material (preloaded flash drives, paper-based interactive learning content) was made available on request.

During the pandemic, a shift to obligatory online teaching and learning accompanied the move to a pedagogical approach. Initially, the interaction between the faculty and students employed various virtual platforms, for example, social media and dedicated e-learning websites. In most circumstances, limited student financial resources, unreliable network access (n = 130, 42%), or no device (n = 141, 46%) (Table 1) drove the realistic and relevant decisions on which platform to use. The interim choices bridged the gap until DHET had completed negotiations with mobile companies for reasonable data rates and network providers for zero-rating university-linked websites, thus enabling access to digital resources such as the online library (RSA 2002). The university mobilised the appropriate mobile resources and, every month, provided mobile data to each student (10GB per day, 30GB per night) and faculty (30GB per day, 80GB per night). Only 2% (n = 7) of the students did not require data (Table 1). Video-communication licenses were increased, faculties were provided with modems and funded students received laptops, while privately funded students received loans from the university to purchase laptops, in particular, to meet the deficit in first-year students (20% available device) (Table 1).

The move to a cyclical online learning model involved revising and approving faculty-specific and university teaching and learning structures, module guides, templates and clarifying learning outcomes to align with online learning standards and teaching strategies (Songca 2020b). Individual and virtual group engagement with the available learning resources and the practice of self-assessment ensured that learning was taking place while maintaining the quality (Songca 2020b). Continuous assessments replaced formative and summative assessments, retaining the clinical assessment at the insistence of the regulatory body (Circular 11/2020) (SANCb).

The faculty and students were re-oriented through multiple workshops, by specialist divisions in the university, to the changed pedagogical approach. The pedagogy was not limited to but included faculty and learners’ upskilling on remote teaching and learning involving the flipped classroom and assessment strategies. The remote teaching tools used were online forum discussions, PowerPoint presentations with audio, recorded online lectures, WhatsApp audio messages and chats, distributed through inter-alia e-mails, e-learning platform and online video-conferencing service. Information and Communication Services managed a dedicated online expert technical support team for both software and hardware (Songca 2020b). The capacity building of faculty was not limited to within the university but through inter-institutional collaboration. Other HEIs developed repositories with ready-to-use content for faculty and students and, through collaboration, shared their resources. In addition, publishing houses shared access to their nursing education repository, inclusive of online courses for student learning skills and clinical competencies. Students developed competencies inter-alia in the skills needed for nursing during a pandemic, such as those linked to the efficient use of personal protective equipment (PPE).

As a platform to survey the teaching and learning issues, including monitoring and evaluation, the university timetabled a week for pilot testing the transitioning to online classes (dry-run), followed by a week of mock online assessments. These ring-fenced weeks served as a trial and provided information for relevant adjustments, ensuring no student was left behind. Furthermore, IT-linked student challenges, as previously discussed, were related to network coverage, computer literacy and orientation to the e-learning platform. Student and faculty evaluation showed that faculty needed continuous support to cope with the pandemic’s change and impact (Songca 2020c). Support was provided through weekly meetings (discipline and committees) and regular feedback on institutional updates (Songca 2020c). Faculties also needed capacitation in their online assessments, resulting in further university-driven courses for resource strengthening.

In order to bridge the identified challenges and ensure equal opportunities to access learning, each faculty was expected to develop educational resources and catch-up plans for each student who might have been left behind. The university assigned a week to execute the catch-up plans before the semester re-commenced. The institution offered waivers to avoid penalising students for what was outside their control but a consequence of the pandemic. This involved lifting duly performance requirements and modifying traditional exams while not compromising the regulatory body’s requirements or standards. Faculties were expected to be flexible and understanding in their approach to students who might have difficulty focusing and experienced challenges beyond their control. For example, students with assessment marks less than 50% or who wanted to improve pass marks received remediation and an opportunity to submit new or revised assignments. At the discretion of the faculty, submission dates were extended, and online learning materials were provided to support the completion of assessments (CHS 2020)

In recognition of the adopted logo of ‘Every Student Matters’, the university recognised the changing academic needs of the students and the influence of the pandemic on their bio-psycho-social needs and put countermeasures in place. The campus clinics assumed an active role in their readiness to deal with COVID-19, safeguarding the students’ physical well-being by coordinating COVID-19 tests, liaising with and reporting to the Department of Health, 24/7 availability, which was supportive to the students and faculty alike, administering flu vaccines to all and managing health check-ups (purpose built, daily COVID-19 screening app). In situations where the facilities could not provide PPE, the university provided for the students’ protection. A 4-week psychological first-aid package developed and delivered by faculty addressed the psychological needs of the students.

The time in the clinical skills laboratory was increased to serve more than one goal. The clinical facilities needed to observe COVID-19 regulations and decrease the numbers of students, hence the increased utilisation of the clinical skills laboratory which was permitted by the SANC allowing for additional simulated learning hours (SANC 2020b). Furthermore, the extended time in the clinical skills laboratory allowed for less exposure to the risk of COVID-19 infection, as did the move to online clinical supervision, where students uploaded audio and visual recordings.