Karry Ming LIU has completed her PhD from Chiang Mai University 2005. She is the Dean of the School of Health Sciences, Macao Polytechnic Institute. She has published more than 40 papers in international and domestic journals and also several books and book chapters. She has been serving as an editorial board member of couple of journals.


This study aimed at investigation of the stress perceived by nursing students in the clinical learning environment, and reviewing teaching and learning modality of nursing education in Macao. The study recruited 203 nursing students and SINS-CN was used to measure nursing students’ stress. The overall SINS-CN mean score was 3.33 (SD = 0.49), while the scores for different dimensions were 3.03~3.44. Study year had a statistically significant association with stress level(p=0.000~0.026). The high stress scores could be results of inadequate preparation and lack of confidence. Students often worry that any mistake then make will affect their grade and even their status. According to the currently implemented clinical placement procedures, any mistake made by student would be suspended from his/her clinical placement. The other most common stressors were related to the heavy workload. This might be a result of the heavy curriculum with too many clinical placement hours. The 4-year Bachelor of Nursing program in Macao was designed with 160 learning credits, among which 46 credits (1,840 hours) are clinical placement. Another notable result is worth to reflect is that year one students had a highest perceived stress. Though, this result is similar with several other studies’ findings, the consequence is very adverse in Macao context since we found the first year withdrawal rate is incredibly increasing in recent years. It may be a useful way to help junior nursing students to prepare well before clinical placement and adjusting assignments as well as the performance assessment modality.