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杉井, 裕 スギイ, ユウ Sugii, Yuh motivation academic performance medical technology paramedical cource departmental bulletin paper 2019-03-31 application/pdf 純真学園大学雑誌 8 45 51 https://junshin.repo.nii.ac.jp/record/261/files/201807_Sugii.pdf https://doi.org/10.18897/00000236 https://junshin.repo.nii.ac.jp/records/261 jpn