We assessed the impact of COVID- 19 on the academic activities of final year nursing students in Lusaka and Mufulira Districts of Zambia.
Our findings show that most students strongly agreed that COVID-19 caused failure to complete course content (32.7%), concepts poorly taught (41.3%), delayed their examinations (86.1%), and prevented students from doing their clinical attachments (51.5%). These results, therefore, mean that the academic performance of students could be affected by such disturbances. These findings were in tandem with the UNESCO 2020 report that deduced that school closures as a result of COVID-19 have a huge impact on the education sector though it was difficult to measure the specific impact . In Egypt, Shehata et al. (2020) similarly reported that students experienced challenges with regards to learning clinical skills due to a lack of clinical placements . Evidence has shown that University and College students were worried about their academic progress because of COVID-19 and the introduction of online learning [33, 34]. Similarly, a study by Charles et al. (2020) on alcohol abuse among college students during the COVID pandemic reported that students experienced significant educational disruptions as the pandemic interfered with their academic functioning . This is because the closure of tertiary-level educational institutions suspended face-to-face teaching-learning sessions hence interrupting the regular flow of academic programs [34, 36]. Some schools had to postpone or cancel the students’ examinations . This can lead to an impact on the mental health and academic performance of the students [4, 26, 33, 38].
Our study revealed that students’ periods of clinical attachments were disrupted and shortened due to the pandemic. Similarly, another study reported that the clinical placements of nursing students were cancelled, despite the future nurses being among the frontline workers . The lack of an effective clinical learning environment for student nurses prevents them from effective learning and growth . As a result, the growth and development of their skills were to be influenced. Studies showed that the students' non-effective exposure to the clinical learning environment had increased dropout rates. Some nursing students had left the profession as a result of challenges they faced in the clinical settings .
From our findings, it can be inferred that nursing schools in Zambia had postponed or rescheduled exams and introduced alternative methods of learning such as online and home-based assessments. The common challenges emerging included issues of fairness and the feasibility of alternative assessments. Noting a distinct trend towards online assessments, it was noted that not all courses and competencies can be assessed online. Similarly, it was reported that there have been challenges regarding the methods of summative assessments using online methods .
Findings on the effectiveness of online infrastructure suggest that most students strongly disagreed (40.3%) that their school has an effective e-library. The students strongly agreed (40.3%) that some students missed assessments and lectures due to poor internet access and they strongly disagreed (36.7%) that their school has effective wireless facilities to be used for online learning. Goh et al. (2020) reported that the introduction of online learning was a positive way for continuity of learning, despite the many challenges that technology comes with . Some University and College students have little or no access to internet services, making it difficult for them to learn during the COVID-19 pandemic .
Similarly, it has been reported that successful and sustainable e-learning implementation continues to remain a challenge, particularly in Information and communications technology (ICT)-challenged environments such as rural areas . This literature acknowledges the fact that there is a disparity in terms of access to ICT in different geographical locations within a country. A study conducted in Bangladesh reported that respondents explained that online education would not be the best way to use for teaching-learning in the context of Bangladesh as many universities did not have enough resources for running online education urgently . The participants also said that while some teachers tried to take online classes on their initiatives, they faced some issues regarding virtual learning courses on online platforms. Some of them had no electronic devices such as computers, laptops, smartphones, or tablets to take part in online classes and no internet access at home.
Arguably, in midst of the implementation of the COVID-19 guidelines in Zambia, learning institutions were depending on the online modes of teaching to maintain continuity of education. Schools were launching apps, conducting classes over Google Hangouts or Zoom, and sending interactive worksheets and videos for learning. Even though internet-based teaching was the most appropriate stop-gap arrangement, it had highlighted the inequalities in the education system . A majority of the student population were being left out in the pursuit of basic education, especially those facing financial challenges and lack of internet access [33, 34].
A policy brief by the United Nations policy eluded that in ensuring learning continuity during the time of school closures, it became a priority for governments all over the world to turn to ICT, requiring teachers to move to online delivery of lessons . In various countries, some ICT modalities have been used more than others, depending on education level, with variability across regions. In areas with limited connectivity, governments had used more traditional distance learning modalities, often a mix of educational television and radio programming, and the distribution of print materials. Relatively few countries were monitoring the effective reach and use of distance learning modalities. However, estimates indicated variable coverage: distance learning in high-income countries covers about 80–85 per cent, while this drops to less than 50 per cent in low-income countries. This shortfall was largely attributed to the digital divide, with the disadvantaged having limited access to basic household services such as electricity; a lack of technology infrastructure; and low levels of digital literacy among students, parents, and teachers. All challenges with regards to the use of technology for online learning must be taken into consideration [42, 43].
With regards to the findings on the measures to be put in place to remedy the effects of COVID-19 on nursing education, final year students indicated that their schools should provide face masks (51.9%) and hand sanitisers (46.8%). Besides, most students (40.5%) suggested that their lecturers should study refresher courses in ICT and (49.2%) recommended that the schools should improve their e-library. According to the United Nations report, many educators lack basic ICT skills . Many challenges may arise when students are exposed to a different mode of learning . However, introducing students to online learning and assessments ensures that they continue learning and never be delayed in their academic progression . Hence, there is a need for urgent steps to be taken to provide technical resources and improve internet connection for ensuring uninterrupted online education . This will in turn fulfil the education needs of tertiary level students in this period of the COVID-19 pandemic.