Mapping the Trends on Our Doorstep: The Pace of Change Has Changed — from an article that I did out at — and with — [where LLL stands for lifelong learning]; my thanks to Mr. Amrit Ahluwalia, Managing Editor out at and to his staff as well!
The higher education industry has changed significantly over the past decade, and given the pace and significance of change hitting other industries as a result of technological advances, it’s fair to say the postsecondary space is ripe for further transformation.


From DSC:
From the perspective of those of us working within higher education, we see massive changes occurring in the corporate world, and we see innovations and changes also occurring in the world of K-12. Higher education should also be adapting, changing, questioning, and reflecting upon how we can best prepare our students for a rapidly changing workplace.

Below is another interesting item that I believe gives credence to the idea that we are now on an exponential pace of change. Companies are coming and going on the S&P Index…at an ever faster pace.

The 33-year average tenure of companies on the S&P 500 in 1964 narrowed to 24 years by 2016 and is forecast to shrink to just 12 years by 2027 (Chart 1).


Here is the video:

This is the transcript with the original graphs in it.

This is a nice PDF file from with the transcript, with some different graphics and some other





From DSC:
Here’s a quote that has been excerpted from the announcement below…and it’s the type of service that will be offered in our future learning ecosystems — our next generation learning platforms:


Career Insight™ enables prospective students to identify programs of study which can help them land the careers they want: Career Insight™ describes labor market opportunities associated with programs of study to prospective students. The recommendation engine also matches prospective students to programs based on specific career interests.


But in addition to our future learning platforms pointing new/prospective students to physical campuses, the recommendation engines will also provide immediate access to digital playlists for the prospective students/learners to pursue from their living rooms (or as they are out and about…i.e., mobile access).


The Living [Class] Room -- by Daniel Christian -- July 2012 -- a second device used in conjunction with a Smart/Connected TV



Artificial intelligence working with enormous databases to build/update recommendation engines…yup, I could see that. Lifelong learning. Helping people know what to reinvent themselves to.




Career Insight™ Lets Prospective Students Connect Academic Program Choices to Career Goals — from; also from Hadley Dreibelbis from Finn Partners
New Burning Glass Technologies Product Brings Job Data into Enrollment Decisions

BOSTON—Burning Glass Technologies announces the launch of Career Insight™, the first tool to show prospective students exactly how course enrollment will advance their careers.

Embedded in institutional sites and powered by Burning Glass’ unparalleled job market data, Career Insight’s personalized recommendation engine matches prospective students with programs based on their interests and goals. Career Insight will enable students to make smarter decisions, as well as improve conversion and retention rates for postsecondary institutions.

“A recent Gallup survey found that 58% of students say career outcomes are the most important reason to continue their education,” Burning Glass CEO Matthew Sigelman said. “That’s particularly true for the working learners who are now the norm on college campuses. Career Insight™ is a major step in making sure that colleges and universities can speak their language from the very first.”

Beginning an educational program with a firm, realistic career goal can help students persist in their studies. Currently only 29% of students in two-year colleges and 59% of those in four-year institutions complete their degrees within six years.

Career Insight™ enables prospective students to identify programs of study which can help them land the careers they want:

  • Career Insight™ describes labor market opportunities associated with programs of study to prospective students. The recommendation engine also matches prospective students to programs based on specific career interests.
  • The application provides insights to enrollment, advising, and marketing teams into what motivates prospective students, analysis that will guide the institution in improving program offerings and boosting conversion.
  • Enrollment advisors can also walk students through different career and program scenarios in real time.

Career Insight™ is driven by the Burning Glass database of a billion job postings and career histories, collected from more than 40,000 online sources daily. The database, powered by a proprietary analytic taxonomy, provides insight into what employers need much faster and in more detail than any other sources.

Career Insight™ is powered by the same rich dataset Burning Glass delivers to hundreds of leading corporate and education customers – from Microsoft and Accenture to Harvard University and Coursera.

More information is available at




The 4th Next Generation Learning Spaces event is right around the corner! Make plans to attend this conference -- you won't regret it!

The 4th Next Generation Learning Spaces event is right around the corner!

Take a look at the latest agenda.

Here is just a fraction of what you can expect:

  • Explore what’s next in learning spaces + design thinking that breaks the barriers of tradition and inspire innovation
  • Retool your learning environments with virtual & augmented reality
  • Connect your learning space design with strategic planning initiatives
  • Discover next generation learning solutions during our networking breaks
  • Overcome institutional and financial roadblocks to building active learning spaces
  • Redesign spaces with limited budgets


From DSC:
I am honored to be serving on the Advisory Council for this conference with a great group of people. Missing — at least from my perspective — from the image below is Kristen Tadrous, Senior Program Director with the Corporate Learning Network. Kristen has done a great job these last few years planning and running this conference.


The Advisory Board for the 2018 Next Generation Learning Spaces Conference

The above graphic reflects a change for me. I am still an Adjunct Faculty Member
at Calvin College, but I am no longer a Senior Instructional Designer there.


This national conference will be held in Los Angeles, CA on February 26-28, 2018. It is designed to help institutions of higher education develop highly-innovative cultures — something that’s needed in many institutions of traditional higher education right now.

I have attended the first 3 conferences and I moderated a panel at last year’s conference out in San Diego. I just want to say that this is a great conference and I encourage you to bring a group of people to it from your organization! I say a group of people because a group of 5 of us (from a variety of departments) went one year and the result of attending the NGLS Conference was a brand new Sandbox Classroom — an active-learning based, highly-collaborative learning space where faculty members can experiment with new pedagogies as well as with new technologies. The conference helped us discuss things as a diverse group, think out loud, come up with some innovative ideas, and then build the momentum to move forward with some of those key ideas.

If you haven’t already attended this conference, I highly recommend that you check it out.





Top 10 IT Issues, 2018: The Remaking of Higher Education – from by Susan Grajek and the 2017–2018 Educause IT Issues Panel

2018 Top 10 IT Issues

  1. Information Security: Developing a risk-based security strategy that keeps pace with security threats and challenges
  2. Student Success: Managing the system implementations and integrations that support multiple student success initiatives
  3. Institution-wide IT Strategy: Repositioning or reinforcing the role of IT leadership as an integral strategic partner of institutional leadership in achieving institutional missions
  4. Data-enabled Institutional Culture: Using BI and analytics to inform the broad conversation and answer big questions
  5. Student-centered Institution: Understanding and advancing technology’s role in defining the student experience on campus (from applicants to alumni)
  6. Higher Education Affordability: Balancing and rightsizing IT priorities and budget to support IT-enabled institutional efficiencies and innovations in the context of institutional funding realities
  7. IT Staffing and Organizational Models: Ensuring adequate staffing capacity and staff retention in the face of retirements, new sourcing models, growing external competition, rising salaries, and the demands of technology initiatives on both IT and non-IT staff
  8. (tie) Data Management and Governance: Implementing effective institutional data governance practices
  9. (tie) Digital Integrations: Ensuring system interoperability, scalability, and extensibility, as well as data integrity, standards, and governance, across multiple applications and platforms
  10. Change Leadership: Helping institutional constituents (including the IT staff) adapt to the increasing pace of technology change



Also see:

2018 Top 10 IT Issues — from


The Remaking of Higher Education
Higher education’s biggest concerns are converging with technology’s greatest capabilities. Evidence is mounting that digital technology is a major differentiator and a key to productivity and success within higher education. The 2018 Top 10 Issues reveal the broader strategic impact of technology on the entire institution.

IT organizations will be focusing on four areas this year:

  • Institutional adaptiveness
  • IT adaptiveness
  • Improved student outcomes
  • Improved decision-making

IT organizations won’t focus on these areas alone. Leaders from across campus are invested collaborators with IT. When information technology brings strategic value, the solutions and the technologies that power them are less important than the people, processes, and culture—which make all the difference in the 2018 Top 10 IT Issues.



Also see:

Strategic IT and the 2018 Top 10 IT Issues — from by John O’Brien
While those of us in campus IT organizations have long considered the topic of technology as a strategic asset, this year—the 20th anniversary of EDUCAUSE—may well mark a far broader realization of information technology as a strategic asset for higher education.


Still, the landscape and strategic placement of technology has changed. IT advances are constant, not occasional, and technology on campus is ubiquitous and enterprise-critical. Meanwhile, presidents, provosts, and boards — under considerable pressure to improve student success — appreciate that technology offers some of the brightest hopes for moving this hard-to-move needle. For this reason, among others, student success became the foundational focus of the 2017 Top 10 IT Issues. And the 2016 Top 10 IT Issues stressed the degree to which information technology is an institutional differentiator when it comes to not only student success but also affordability, teaching, and research excellence.

It’s one thing, of course, to ask ourselves about the strategic nature of information technology and quite another to find evidence that those outside the IT organization are experiencing this strategic sea change. Yet in recent months we’ve seen exactly that. One example is the American College President Study 2017, from the American Council on Education (ACE). Written by and for college and university presidents, the report advises presidents to attend fully to technology, especially “using analytics functions to make better decisions and leveraging technology to scale out quality, cost-effective best practices.”



From DSC:
I appreciate the following statement — and have often reflected upon its truth:

While those of us in campus IT organizations have long considered the topic of technology as a strategic asset, this year—the 20th anniversary of EDUCAUSE—may well mark a far broader realization of information technology as a strategic asset for higher education.


On a separate note…while obtaining and reviewing data / analytics certainly helps, often that isn’t enough.

Steve Jobs didn’t acquire data or do focus groups before introducing the Macintosh, nor before introducing the iPod, nor before introducing the iPad, nor before introducing the iPhone. But these devices literally changed the world.

Solid vision and innovation are what really count — they bring about the real game-changers.




From DSC:
DC: Will Amazon get into delivering education/degrees? Is is working on a next generation learning platform that could highly disrupt the world of higher education? Hmmm…time will tell.

But Amazon has a way of getting into entirely new industries. From its roots as an online bookseller, it has branched off into numerous other arenas. It has the infrastructure, talent, and the deep pockets to bring about the next generation learning platform that I’ve been tracking for years. It is only one of a handful of companies that could pull this type of endeavor off.

And now, we see articles like these:

Amazon Snags a Higher Ed Superstar — from by Doug Lederman
Candace Thille, a pioneer in the science of learning, takes a leave from Stanford to help the ambitious retailer better train its workers, with implications that could extend far beyond the company.


A major force in the higher education technology and learning space has quietly begun working with a major corporate force in — well, in almost everything else.

Candace Thille, a pioneer in learning science and open educational delivery, has taken a leave of absence from Stanford University for a position at Amazon, the massive (and getting bigger by the day) retailer.

Thille’s title, as confirmed by an Amazon spokeswoman: director of learning science and engineering. In that capacity, the spokeswoman said, Thille will work “with our Global Learning Development Team to scale and innovate workplace learning at Amazon.”

No further details were forthcoming, and Thille herself said she was “taking time away” from Stanford to work on a project she was “not really at liberty to discuss.”


Amazon is quietly becoming its own university — from by Amy Wang


Jeff Bezos’ Amazon empire—which recently dabbled in home security, opened artificial intelligence-powered grocery stores, and started planning a second headquarters (and manufactured a vicious national competition out of it)—has not been idle in 2018.

The e-commerce/retail/food/books/cloud-computing/etc company made another move this week that, while nowhere near as flashy as the above efforts, tells of curious things to come. Amazon has hired Candace Thille, a leader in learning science, cognitive science, and open education at Stanford University, to be “director of learning science and engineering.” A spokesperson told Inside Higher Ed that Thille will work “with our Global Learning Development Team to scale and innovate workplace learning at Amazon”; Thille herself said she is “not really at liberty to discuss” her new project.

What could Amazon want with a higher education expert? The company already has footholds in the learning market, running several educational resource platforms. But Thille is famous specifically for her data-driven work, conducted at Stanford and Carnegie Mellon University, on nontraditional ways of learning, teaching, and training—all of which are perfect, perhaps even necessary, for the education of employees.


From DSC:
It could just be that Amazon is simply building its own corporate university and will stay focused on developing its own employees and its own corporate learning platform/offerings — and/or perhaps license their new platform to other corporations.

But from my perspective, Amazon continues to work on pieces of a powerful puzzle, one that could eventually involve providing learning experiences to lifelong learners:

  • Personal assistants
  • Voice recognition / Natural Language Processing (NLP)
  • The development of “skills” at an incredible pace
  • Personalized recommendation engines
  • Cloud computing and more

If Alexa were to get integrated into a AI-based platform for personalized learning — one that features up-to-date recommendation engines that can identify and personalize/point out the relevant critical needs in the workplace for learners — better look out higher ed! Better look out if such a platform could interactively deliver (and assess) the bulk of the content that essentially does the heavy initial lifting of someone learning about a particular topic.

Amazon will be able to deliver a cloud-based platform, with cloud-based learner profiles and blockchain-based technologies, at a greatly reduced cost. Think about it. No physical footprints to build and maintain, no lawns to mow, no heating bills to pay, no coaches making $X million a year, etc.  AI-driven recommendations for digital playlists. Links to the most in demand jobs — accompanied by job descriptions, required skills & qualifications, and courses/modules to take in order to master those jobs.

Such a solution would still need professors, instructional designers, multimedia specialists, copyright experts, etc., but they’ll be able to deliver up-to-date content at greatly reduced costs. That’s my bet. And that’s why I now call this potential development The New of Higher Education.

[Microsoft — with their purchase of Linked In (who had previously
purchased — is
another such potential contender.]




Why Don’t Educators in Higher Ed Take Education Classes? — from by Jillian Joyce
If we’re in higher education to educate, Jillian Joyce asks, what keeps college teachers from learning more about teaching?

Excerpt (emphasis DSC):

If we’re in higher education to educate, what keeps college teachers from learning more about teaching? You’re busy. You’ve been doing this a long time. It’s really up to the students to learn the material. You’re already an excellent lecturer. Anyone can teach; it’s not that complicated. While those phrases begin to scratch the surface, I propose we take a step back to examine the internal narratives and pervading ideologies that surround our ideas about teaching at the university.

Three Myths
In her 2003 text Practice Makes Practice, Deborah P. Britzman, a professor at York University in Toronto, describes three myths that summon teachers to the field of education: 1) everything depends upon the teacher, 2) the teacher is the expert and 3) teachers are self-made. While Britzman’s audience is largely teachers at the primary and secondary levels, these myths abound in higher education, as well.

Similarly, professors at a university are typically required to wear two hats: one hat as a researcher and another as a teacher. But only the researcher hat is fashionable. It brings in money for the university, it looks good on a curriculum vitae and it promotes the climb up the academic latter.

In contrast, the teacher hat is slumpy. It’s necessary but not pretty. It’s the kind of hat you wear grocery shopping hoping no one will recognize you. The fancy hat promotes the educator as the expert, while the slumpy hat is seen as “just” teaching. This distinction fosters the idea that teaching is easy and requires little effort. The uncomfortable adage “those who can’t do, teach” suggests that research is “doing,” while teaching is a second-rate activity.


From DSC:
Teaching effectively is a very complex, deep, and difficult task to do well. Those who say it’s easy have likely never tried doing it themselves. Also, in higher education, doing research is one thing, but teaching well is a whole different set of (often undervalued) skills.

My alma mater (Northwestern University) prides itself on faculty who are doing leading edge research. According to this page, there was $676.5 million in annual sponsored research back in 2016-2017. (Brief insert from DSC: For those who say higher ed isn’t a business, how would you respond to this kind of thing? Or this?*) I remember taking courses from researchers like these and many of them shouldn’t have been teaching at all — they weren’t nearly worth the cost of tuition. I also remember taking courses from graduate students who likely hadn’t had any coursework on how to teach either.

The tragedy here is that it’s the students who are paying increasingly huge tuition bills to attend Northwestern and other such universities and colleges. This is not right. Let’s lift up the craft of teaching and let those who do research, research. Researchers can relay the highlights of their research to those who have taken the time to work on their teaching-related skills. 

My vote? If you don’t care about your teaching, you shouldn’t be teaching at all.

As a relevant side question here: What would you say to your doctor if they didn’t keep learning and growing in their skillset?!? How would you feel about that?

If you are teaching, you should have taken some coursework in how to teach — and how people learn — and you should be required to attend several professional development related events: Every. Single. Year.



DSC: Higher education not a business you say? Are you sure about that!?
The University of Alabama is paying its football coach, Nick Saban, more than $11 million this season, which puts him ahead of every coach in the professional National Football League. Clemson University coach Dabo Sweeney will earn $8.5 million, and the University of Michigan’s Jim Harbaugh $7 million, not including money from endorsements.




5 trends poised to shake up higher education in 2018 — from by Autumn Arnett


  1. Blurred lines: nonprofit and for-profit providers will work together toward new business model
  2. U.S. higher education as a top international export
  3. Re-imagining physical campus space
  4. More unbundling and microcredentials
  5. Continued focus on accelerating mobile apps




DC: The next generation learning platform will likely offer us such virtual reality-enabled learning experiences such as this “flight simulator for teachers.”

Virtual reality simulates classroom environment for aspiring teachers — from by Charles Anzalone, University at Buffalo

Excerpt (emphasis DSC):

Two University at Buffalo education researchers have teamed up to create an interactive classroom environment in which state-of-the-art virtual reality simulates difficult student behavior, a training method its designers compare to a “flight simulator for teachers.”

The new program, already earning endorsements from teachers and administrators in an inner-city Buffalo school, ties into State University of New York Chancellor Nancy L. Zimpher’s call for innovative teaching experiences and “immersive” clinical experiences and teacher preparation.

The training simulator Lamb compared to a teacher flight simulator uses an emerging computer technology known as virtual reality. Becoming more popular and accessible commercially, virtual reality immerses the subject in what Lamb calls “three-dimensional environments in such a way where that environment is continuous around them.” An important characteristic of the best virtual reality environments is a convincing and powerful representation of the imaginary setting.


Also related/see:


    TLE TeachLivE™ is a mixed-reality classroom with simulated students that provides teachers the opportunity to develop their pedagogical practice in a safe environment that doesn’t place real students at risk.  This lab is currently the only one in the country using a mixed reality environment to prepare or retrain pre-service and in-service teachers. The use of TLE TeachLivE™ Lab has also been instrumental in developing transition skills for students with significant disabilities, providing immediate feedback through bug-in-ear technology to pre-service teachers, developing discrete trial skills in pre-service and in-service teachers, and preparing teachers in the use of STEM-related instructional strategies.






This start-up uses virtual reality to get your kids excited about learning chemistry — from Lora Kolodny and Erin Black

  • MEL Science raised $2.2 million in venture funding to bring virtual reality chemistry lessons to schools in the U.S.
  • Eighty-two percent of science teachers surveyed in the U.S. believe virtual reality content can help their students master their subjects.


This start-up uses virtual reality to get your kids excited about learning chemistry from CNBC.



From DSC:
It will be interesting to see all the “places” we will be able to go and interact within — all from the comfort of our living rooms! Next generation simulators should be something else for teaching/learning & training-related purposes!!!

The next gen learning platform will likely offer such virtual reality-enabled learning experiences, along with voice recognition/translation services and a slew of other technologies — such as AI, blockchain*, chatbots, data mining/analytics, web-based learner profiles, an online-based marketplace supported by the work of learning-based free agents, and others — running in the background. All of these elements will work to offer us personalized, up-to-date learning experiences — helping each of us stay relevant in the marketplace as well as simply enabling us to enjoy learning about new things.

But the potentially disruptive piece of all of this is that this next generation learning platform could create an of what we now refer to as “higher education.”  It could just as easily serve as a platform for offering learning experiences for learners in K-12 as well as the corporate learning & development space.


I’m tracking these developments at:



The Living [Class] Room -- by Daniel Christian -- July 2012 -- a second device used in conjunction with a Smart/Connected TV


*  Also see:

Blockchain, Bitcoin and the Tokenization of Learning — from by Sydney Johnson


In 2014, Kings College in New York became the first university in the U.S. to accept Bitcoin for tuition payments, a move that seemed more of a PR stunt than the start of some new movement. Much has changed since then, including the value of Bitcoin itself, which skyrocketed to more than $19,000 earlier this month, catapulting cryptocurrencies into the mainstream.

A handful of other universities (and even preschools) now accept Bitcoin for tuition, but that’s hardly the extent of how blockchains and tokens are weaving their way into education: Educators and edtech entrepreneurs are now testing out everything from issuing degrees on the blockchain to paying people in cryptocurrency for their teaching.





OER Adoptions on the Rise — from by Lindsay McKenzie
The number of faculty members choosing open educational resources over traditional textbooks has nearly doubled in the last year, but awareness over all remains low.


More and more instructors are choosing open educational resources over traditional textbooks, a survey of more than 2,700 faculty members reveals.

The “Opening the Textbook” survey, published by the Babson Survey Research Group today, reports that the number of faculty members at two- and four-year institutions using OER as textbooks has nearly doubled in the last year — from 5 percent in 2015-16 to 9 percent in 2016-17.

Awareness of OER — openly licensed and freely accessible teaching and learning materials — has also increased. Twenty-nine percent of faculty described themselves as “aware” or “very aware” of OER this year, up from 25 percent last year and 20 percent the year before. The proportion that reported they had never heard of OER fell from 66 percent in 2014-15 to 56 percent this year.

But while increases in adoption and awareness have been significant, Jeff Seaman, co-director of the Babson Survey Research Group, points out that over all, awareness of OER is still low. He noted that many faculty members also continue to report significant barriers to wider adoption of OER, particularly finding and evaluating the quality of materials.



Also see:






From DSC:
Regarding the article below…why did it take Udacity needing to team up with Infosys to offer this type of program and curriculum? Where are the programs in institutions of traditional higher education on this?  Are similar programs being developed? If so, how quickly will they come to market? I sure hope that such program development is in progress..and perhaps it is. But the article below goes to show us that alternatives to traditional higher education seem to be more responsive to the new, exponential pace of change that we now find ourselves in.

We have to pick up the pace! To do this, we need to identify any obstacles to our institutions adapting to this new pace of change — and then address them immediately. I see our current methods of accreditation as one of the areas that we need to address. We’ve got to get solid programs to market much faster!

And for those folks in higher ed who say change isn’t happening rapidly — that it’s all a bunch of hype — you likely still have a job. But you need to go talk with some people who don’t, or who’ve had their jobs recently impacted big time. Here are some suggestions of folks to talk with:

  • Taxi drivers who were impacted by Lyft and by Uber these last 5-10 years; they may still have their jobs, if they’re lucky. But they’ve been impacted big time…and are likely driving for Lyft and/or Uber as well as their former employers; they’re likely to have less bargaining power than they used to as the supply of drivers has skyrocketed. (By the way, the very existence of such organizations couldn’t have happened without the smartphone and mobile-related technologies/telecommunications.)
  • Current managers and former employees at hotels/motels about the impacts on their industry by AirBnB over a similar time frame
  • Hiring managers at law firms who’ve cut back on hiring entry-level lawyers…work that’s increasingly being done by software (example)
  • Employees who worked at brick and mortar retailers who have been crushed by’s online-based presence (in not that long of time, by the way). For example, below is what our local Sears store looks like these days…go find an employee who used to work at Sears or a Sears automotive-related store:


This is what our local Sears store looks like today

This picture is for those who say there is no disruption.
You call
this hype?!


The above example list — that’s admittedly woefully incomplete — doesn’t include the folks displaced by technology over the last several decades, such as:

  • Former bank tellers who lost their jobs to ATMs
  • Checkout clerks at the grocery stores who lost their jobs to self-service stations
  • Check-in agents at the airports who lost their jobs to self-service stations
  • Etc., etc., etc.

Institutions of traditional higher education
need to pick up the pace — big time!


Infosys and Udacity team up to train 500 engineers in autonomous technologies — from by Leah Brown
Infosys’ COO Ravi Kumar explains how these individuals can apply what they learn to other industries.

Excerpt (emphasis DSC):

Infosys, a global technology consulting firm, recently partnered with online learning platform Udacity to create a connected service that provides training for autonomous vehicles, and other services for B2B providers of autonomous vehicles.

TechRepublic’s Dan Patterson met with Infosys’ COO Ravi Kumar to discuss how autonomous technology can help create new industries.

Autonomous technology is going to be an emerging technology of the future, Kumar said. So Infosys and Udacity came together and developed a plan to train 500 engineers on autonomous technologies, and teach them how to apply it to other industries.


Per Wikipedia:
Udacity is a for-profit educational organization founded by Sebastian Thrun, David Stavens, and Mike Sokolsky offering massive open online courses (MOOCs). According to Thrun, the origin of the name Udacity comes from the company’s desire to be “audacious for you, the student.” While it originally focused on offering university-style courses, it now focuses more on vocational courses for professionals.



But times are changing. Artificial intelligence (AI) and robotics are facilitating the automation of a growing number of “doing” tasks. Today’s AI-enabled, information-rich tools are increasingly able to handle jobs that in the past have been exclusively done by people—think tax returns, language translations, accounting, even some kinds of surgery. These shifts will produce massive disruptions to employment and hold enormous implications for you as a business leader. (




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