*2.3. Data Collection Tool*

This survey was developed using two previously validated surveys, the Perceived Stress Scale (PSS) and the Coping Behavior Inventory (CBI) survey. The PSS was developed by Sheu and Lin [20] and measures both the types of stressful events and the degree of stressors within clinical practices. This survey also included three demographic questions: The gender of the participant, their clinical training area, and their academic year of study. The PSS consists of 29 items (See Table 1) on a 5-point Likert scale (from 0 to 4) that are grouped into 6 stress/stressor categories. Those groups are stress from taking care of patients; teachers, and nursing personnel; assignments and workload; peers and daily life; the clinical environment; and lack of professional knowledge and skills.

**Table 1.** The Perceived Stress Scale (PSS) and Coping Behavior Inventory (CBI) questions.



A score of 2.67 and higher was indicative of a high level of stress, a score between 1.34 and 2.66 was indicative of a moderate level of stress, and a score of less than 1.34 indicated a low level of stress [21]. The instrument's reliability showed Cronbach's alpha values of 0.86 and 0.89 [20,22] and a content validity index of 0.94 [22].

The CBI survey was first developed by Sheu and Lin [20] and measures the coping methods nursing students are more likely to utilize and their perceived effectiveness. The CBI survey consists of 19 items (See Table 1) all on a 5-point Likert Scale (from 0 to 4) that are grouped into 4 categories: Avoidance, Transference, Problem-solving, and Stay optimistic. A score of 2.67 and higher was indicative of a high level of coping strategies, a score between 1.34 and 2.66 was indicative of a moderate level of coping strategies, and a score of less than 1.34 indicated a low level of coping strategies. The instrument's reliability showed a Cronbach's alpha coefficient ranging from 0.76 to 0.80 [20,22].
