助産学生を対象としたキャリア選択における意思決定ガイドの効果：パイロットランダム化比較試験

Effectiveness of a Decision Aid for Career Choice Among Midwifery Students: A Pilot Randomized Controlled Trial

要旨

　目的：助産学生が自身の価値観や希望する働き方に基づいて就職先を主体的に選択できるよう支援する「助産学生キャリアガイド（Decision Aid：DA）」の有用性および検証的ランダム化比較試験（RCT）の実施可能性を検討した．

　方法：修士課程1年の助産学生を無作為に介入群（DA使用）と対照群に割り付け，DAをURLで配布し，2時点で調査を実施した．プライマリアウトカムは32項目の職業的アイデンティティ尺度，セカンダリアウトカムは7項目の選択に対する納得尺度とし，変化量と効果量を算出した．

　結果：分析対象は47名（介入群23名，対照群24名）で，学生からはDAに対する肯定的評価が得られたが，効果量はいずれも小さく，明確な介入効果は確認されなかった．

　結論：DAの有用性は一定程度示唆され，検証的RCTの実施は倫理的・運営的に可能と判断された．

ただし，対象設定や評価指標の課題は改善が求められる．

　Objective: This pilot randomized controlled trial (RCT) evaluated the effectiveness of a decision aid (DA), the Midwifery Student Career Guide, developed to help midwifery students make informed first workplace choices aligned with their values and work preferences. The study also assessed the feasibility of conducting a larger RCT.

　Methods: First-year graduate midwifery students were randomly assigned to an intervention group (DA use) or a control group. The DA was accessed via a web link, and data were collected through two surveys. The primary outcome was measured using the 32-item Professional Identity Scale; the secondary outcome used the 7-item Satisfaction with Career Choice Scale. Change scores and effect sizes were computed to evaluate impact.

　Results: Forty-seven students participated (23 in the intervention group; 24 in the control group). Intervention group participants reported favorable impressions of the DA. However, effect sizes for both outcomes were small, and no statistically significant differences were observed between groups.

　Conclusion: The usefulness of the decision aid (DA) was partially supported, and the implementation of a confirmatory randomized controlled trial (RCT) was judged to be ethically and operationally feasible. However, issues related to participant selection and outcome measures need to be addressed.