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DOI 10.1007/s10734-010-9328-4
Abstract This article asks land grant university leaders and faculty to think of their role
in community engagement not simply as the provision of technical assistance or of
research and development prowess, but as an opportunity for social leadership. It explores
the case of Virginia Techs effort to develop a regionally based model to secure long-term
social and economic change in an economically ailing part of Virginia. The article suggests
how land grant community engagement may be understood as adaptive leadership and
provides a conceptual frame to understand better the role of such research universities in
community change processes.
Keywords Land grant universities Adaptive work
University community engagement Third mission
Introduction
This article asks land grant university leaders and faculty to think of their role in civic
engagement, their third mission, not simply as the provision of technical assistance or of
research and development prowess, but as an opportunity for social leadership (Laredo
2007). The paper explores the case of Virginia Techs effort to develop a regional model to
secure long-term social and economic change in an economically ailing part of Virginia.
As it has sought to provide assistance throughout the Southside region, the university and
its participating faculty have had to re-imagine its role in civic engagement. This has
included thinking afresh about how best to share expertise. The university has had to
redefine engagement as leadership for community and cultural change rather than imagining that it is comprised of technical assistance programs alone. As it has addressed this
challenge faculty members from diverse academic programs have sought to provide support and services that both aligned with the university research mission and served the
M. Stephenson Jr. (&)
Virginia Tech Institute for Policy and Governance, School of Public and International Affairs,
205 West Roanoke Street, Blacksburg, VA 24061, USA
e-mail: mstephen@vt.edu
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regions needs. For the most part, these have included discipline-based professionals from
professional graduate programs, but the initiative has also drawn the long-term interest of
researchers more interested in providing academic training. Whether praxis focused or not,
the universitys third mission effort in Southside reflects a now common view among
research institution leaders and their faculties. As Laredo has observed:
The expectation is not only that universities produce new knowledge, but also that
they do it with social and economic perspectives in mind (2007, 445).
Etzkowitz has labeled this trend the emergence of the entrepreneurial university (1997).
Whatever the descriptor applied, to say the challenge is daunting does not begin to
consider the issues that must be addressed. But it is important to develop a conceptual
approach that, however simplifying, provides faculty and decision-makers with a construct
to help them devise and launch ways to evaluate a range of activities directed at securing
their third mission when that construct is defined as social and economic change. This
paper begins that process. It makes no claim to be a fully realized model or theory. Instead,
it asks that analysts, university leaders and faculty alike broaden their perspective on
research university community engagement to capture how it may be linked to social and
cultural concerns as well as economic ones. Hopefully, the rubric outlined here will assist
others engaged in like efforts to refine further these initial ideas.
The article first outlines the nature of the problems confronted in community change
efforts. Second, the tale of how a research university came to be involved in an effort to reimagine an economically distressed region of its home state is sketched. Third, a tentative
heuristic of how university leaders have proceeded to address its challenge and why they
have moved as they have is outlined. The conceptual frame draws on the leadership, higher
education, community development, planning and nongovernmental/nonprofit organization
literatures to provide a description of the universitys role at various levels of scale and
across multiple social sectors and functions. The paper concludes with a discussion of
several implications of the research.
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re-founding (MDC 2000, 137). The firm proposed a shift to businesses that participated
in, and arose from, the knowledge-based economy. To call for such a transition from the
traditional blue-collar and agriculture-related livelihoods of the region was one thing. But
to realize that transformation quite another, and altogether intimidating, prospect. This
vision of community redevelopment implied potentially profound changes in at least the
following regional attributes:
Education at the elementary, secondary and post-secondary levels, as the workforce for
new business forms required both different and increased levels of education than did
the traditional employment base.
An assessment of the remaining sources of employment in the area and an evaluation of
whether and how they might be positioned better to provide comparative economic
advantage in the nations knowledge-based economy.
An analysis of the regions telecommunication infrastructure since firms offering these
services are now a key lever in the advancement of economic change and growth.
These technologies also require a rethinking of traditional forms of activity and
organization for collective enterpriseitself no small challenge.
Development of a set of strategies, by which to secure broad community awareness of
the need for change and the design of forms of intervention to assist area governments,
businesses, community organizations, churches and other nonprofit entities in
developing a shared vision of needed change in citizen values, attitudes and mores
(MDC 2000).
To induce shifts in any one of these communal characteristics involved large-scale
social learning and adjustment. More difficult still, however entrepreneurial and economically and socially significant to the region, Danville alone could not transform the
region for a new future. The areas largest city did not exist apart from its broader economy
and it was that region that was decliningboth in Virginia and just across the state line in
North Carolina. Ultimately, the critical questions for the Foundation became how to
conceptualize what its leaders now saw as necessary as well as how to identify and secure
the expertise and capacity to develop a strategy to undertake it. The intellectual capital,
research infrastructure and community engagement interests of Virginia Tech, the Commonwealths largest land grant university, represented one possible answer to the Foundations resource quandary.
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decades, this aim was addressed principally through the Extension service, whose primary
remit was originally to assist rural America (McDowell 2003). But as the nation urbanized,
that mission shifted as did the populations Extension served. Now, land grants offer
services and engage with communities not only within their own states and among agricultural stakeholders, but also abroad. Moreover, these institutions are struggling to
determine just what engagement means if it is not simply the provision of technical
assistance to specific subgroups. That controversy extends not only to how to define and
pursue such interventions, but also to evaluate such efforts when faculty members
undertake them (Ellison and Eatman 2008). This was the context in which the Foundation
request occurred. Ferment over what constitutes engagement and how faculty engaged
within it should be regarded continues on land grant campuses across the nation todaythe
relevant national association (Bleiklie and Kogan 2007) the Association of Public and
Land Grant Universitiesmaintains a permanent group for this purpose.1 Meanwhile,
these institutions are daily approached to assist communities with complex social and
economic concerns for which there is no ready technical answer.
Virginia Tech outreach and telecommunications staff ultimately proposed the development of a university center, to be located in Danville, whose mission it would be to
secure social and economic change by drawing on the universitys intellectual infrastructure to galvanize political and popular support across the region. The new organization, dubbed the Institute for Advanced Learning and Research (IALR), initially received
support from Virginia Tech, from the Future of the Piedmont Foundation affiliated businesses and from the local city (Danville) and county (Pittsylvania) governments. Soon
thereafter the new facility garnered state support. Virginia Tech leaders also partnered with
the local community college and a nearby private liberal arts four-year institution to
develop a larger localized infrastructure to support community education and change
efforts.
Strategically, university leaders had agreed to develop means by which to begin to
initiate a movement in support of economic and social reinvention and, given the level of
local unemployment and political angst, to do so in ways that produced at least symbolic
wins as quickly as possible. While university and IALR leaders did not pause to develop a
grand strategy as they sought to provide aid, what follows describes their response to their
challenge in light of specific analytical constructs drawn from the leadership, nonprofit and
community development literatures.
http://www.aplu.org/Netcommunity/page.aspx?pid=255.
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economic landscape in which it was at work and which it sought to regenerate? This was
neither traditional economic development nor political grassroots organizing, but an effort
that appeared to demand that both of these somehow be addressed at once. The need to
develop a new way of thinking about the university role in civic engagement was thus
compelling.
University leaders responded by first assisting the communities in a high profile and
highly symbolic initiative to develop their information technology infrastructureto
install high-end pipe for improved access to the nations information highway. This
approacharguing that the problem these communities faced could be defined and that
it had an answer or authoritative solutionhas been characterized by Harvard Universitys Ronald Heifetz as assuming that one is addressing a Type I problem (Heifetz
1994, 74). Heifetz likened these approaches to physician efforts to treat identified medical
ailments:
These Type I situations are somewhat mechanical: one can actually go to somebody
and get it fixed. Many medical and surgical problems are of this sort and many are
life-saving. The patient appropriately depends on the doctors know-how, and the
doctor depends on the patients trust, satisfaction and willingness to arrange payment
(1994, 74).
However, Virginia Tech leaders and participating faculty quickly came to view this
technical understanding of the nature of the challenge as insufficient because it could not
secure the conditions necessary for effective use of the technology once obtained. These
circumstances had to come from other social processes. Moreover, defining the regions
woes as a Type I problem implied an accepted dependence by the Southside community on
the university as an institutional leader with the expertise and resources to provide
authoritative solutions to its complex social problems. These, Virginia Tech leaders came
to believe, they did not possess. The responses had, instead, to arise, in major part, from the
regions communities and their citizenry (Roper and Hirth 2005).
So, as the IALR was staffed, its leaders began to work across the university with other
faculty and staff to develop additional responses to its strategic problem. This task is
captured by a concept, also described by Heifetz, called adaptive work:
This study examines the usefulness of viewing leadership in terms of adaptive work.
Adaptive work consists of the learning required to address conflicts in the values
people hold, or to diminish the gap between the values people stand for and the
reality they face. Adaptive work requires a change in values beliefs or behavior. The
exposure and orchestration of conflictinternal contradictionswithin individuals
and constituencies provide the leverage for mobilizing people to learn new ways
(1994, 22).
Without anyone self-consciously identifying their efforts as such, Virginia Tech had
been called upon to help Southsides citizens engage in adaptive work designed to address
the complexities of Type II (defined problem, no clear-cut solution) and Type III (illdefined problem) situations (Heifetz 1994, 7475). This implied a need to develop processes that allowed a broad share of the citizenry to think about that future in light of their
beliefs and values. This responsibility suggested that no single fix would address the
regions woes (Baum 2000). The problems to be addressed were not technical but adaptive
in character. They required that area leaders and citizens rethink their assumptions and
values and, political temptations notwithstanding, avoid claiming nonexistent panaceas.
They had instead to design opportunities and strategies for change that allowed the regions
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population to engage in adaptive work (DeBruijn and Tukker 2002). The redevelopment of
the region was not a challenge that could be solved by the application of technical
expertise alone but one that required citizens to reflect actively on their own values and
cultural assumptions, a much more complex and long-lived task than simply providing a
fix for a technical problem.
The gaps that needed bridging in these communities were large: citizens did not much
value higher education or education in general, as they had never really needed to do so
(MDC 2000, 21). In fact, these communities had prospered for many decades without a
companion need for their populations to pursue higher education. Once one could raise a
family quite nicely on income earned in the local textile mill, furniture factory or on the
tobacco farms. Tobacco, particularly, was historically a very high value crop. As a population, Southside communities were proud of their long-time excellence in agricultural
and textiles production; however, these industries no longer provided the region anything
like the level of income they had previously. It was a paradoxical role for the higher
education institution. Virginia Tech was called upon at once to launch and to orchestrate
opportunities for the communities of the region to grapple with their long-time understanding of themselves in the face of economic decline without letting the conflicts implicit
in that effort get so strong that they either boiled over or undermined the universitys
legitimacy as a participating actor. Moreover, the university had also to keep all stakeholders focused on the tasks ahead rather than, as was tempting, to find a scapegoat to
blame for the regions existing woes.
Heifetz has argued that the responsibilities implicit in this role, of bringing disparate
groups to recognition that there is no easy fix for their collective problems, of holding
stakeholders feet to the hard work of reconciling and compromising among competing
values claims and perspectives, represent the critical and defining characteristic of adaptive
leadership and therefore of adaptive work and social learning. Adaptive leaders help to
define the nature of the work to be undertaken without ordaining the outcome of that effort
(Foster-Fishman et al. 2001). They seek to offer a vision sufficient to bring the parties to
focus on the claims before them without suggesting specifically how their search should be
resolved. It is a difficult and often conflict-filled balancing act:
In this view, getting people to clarify what matters most, in what balance, with what
trade-offs, becomes a central task. How can one sequence the issues or strengthen
the bonds that join the stakeholders together as a community of interests so that they
withstand the stresses of problem solving? Values are shaped and refined by
rubbing against real problems, and people interpret their problems according to the
values they hold. Different values shed light on the different opportunities and facets
of a situation. The implication is important: the inclusion of competing value perspectives may be essential to adaptive success (Heifetz 1994, 2223 Emphasis in
original).
For example, if the schools of the region need better-trained teachers with openness
toward developing technology skills, how do you raise this issue such that the communitys
citizens and institutions may decide how best to address it? Or, if citizens do not consider
higher education a priority because they have never needed it to obtain gainful employment, how do you catalyze broad-scale conversation about this question?
In short, when it offered to seek to assist Southsides communities Virginia Tech
confronted a need not merely to deliver a technical fix for the region (none existed in truth),
but to spark a process of social learning and change that might take years or even decades
to come to full fruition. Its leaders needed to spur social learning, but do so in a highly
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adaptive and evolutionary way. The essential question became how to begin this process
while sustaining the legitimacy of the universitys civic engagement role and providing the
community some degree of hope for the future. Too much focus on the university as
potential savior could interfere with the adaptive work necessary for long-term community
success. Too little visible progress could rob the citizens of hopeamidst ongoing and
highly publicized plant closings that together made that virtue even more preciouseven
as the effort began (Luke 1997). The third mission of the university became the successful
transfer not only of research-related knowledge, but shepherding a long-term process of
social change in concert with a range of local stakeholders from governments, businesses
and civil society.
The functional imperatives and levers for change in the holding environment
Given the character of its strategic challenge, the university has had to seek points of
comparative economic advantage for Southside while also facilitating social understanding
and learning among a wide variety of stakeholders in the region. Virginia Tech has sought
to take up both challenges by developing two basic strategic interventions or forms of
collaboration. The first might be labeled education and acculturation and has entailed the
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use of several different strategies. The second might be christened technology transfer and
research and development. These categories are not absolute and their boundaries are
porous. The first approach encourages community change and learning indirectly while the
second involves a more direct sharing of university intellectual capital for the principal
purpose of developing comparative economic advantage over time. But social learning can
yield comparative economic advantage and technology transfer can surely yield social
learning (Laredo and Mustar 1996; Coombs et al. 2003). Nevertheless, broadly, education
and socialization initiatives are aimed foremost at encouraging social learning while
technology and research knowledge transfer have been targeted to provide highly visible
gainswhether they encourage social learning directly or not. The explicit hope of Virginia Tech leaders has been that successful technology and research sharing will accord
social and institutional legitimacy to the university and encourage support for the change
process itself. Brief descriptions and examples of these collaborative initiatives in
Southside follow.
Category one: Collaboration with education and acculturation institutions
Few social processes are so potentially powerful as education in the development of
individual perspectives, values and beliefs. One key place to look to secure community
change is to public (and private) institutions of education. If dropout rates are high or
numbers of students going on to higher education are low as in Southside, and changes in
the economy demand that these trends be addressed, modifications in who teaches and how
as well as what they teach can help reshape social expectations and outcomes (MDC 2000,
2628). Accordingly, to facilitate or encourage a necessary rethinking of community
values concerning education, an adaptive leader might seek to seed changes in the forms of
that education, in curricula and in teacher training. Virginia Tech has advanced initiatives
related to all of these by developing a magnet school oriented to information technology,
by working with the Danville school system to develop new curricula that integrate
technology more effectively, especially in elementary and middle schools and by developing new forms of teacher training in information technology (Coombs et al. 1996). These
interventions may begin as technical assistance, but to succeed they must allow those
engaged to develop new capacities and fresh ways of thinking about their roles. Otherwise,
those targeted will not change their habits of mind and values and behave differently and
any apparent Type I gains attained will be rapidly undone by the citizenrys inability to
undertake needed adaptive work.
Education does not proceed in a vacuum. If parents do not consider higher education
a priority, do not encourage study or if they encourage exploration of only that which they
perceive to be useful in accord, in this case, with past employment opportunities in the
region which always provided a sufficient standard of living, the chances are high their
children will follow suit. So, formal education can only be part of the story in securing
community-based learning and change. Another way to reach family members is to
develop the community organizations with which they are engaged and which serve in part
to acculturate them to their habits, values and beliefs. Virginia Tech has sought to create
management and leadership development programs for the Southside nonprofit communitys institutions as well as to assist such organizations with increasing their organizational and fiscal capacities to play their roles more effectively. Such capacity-building
interventions allow those leading these organizations to share the vision that community
social change is necessary without demanding allegiance to one or another perspective
a priori.
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all three sectors of the regions political economy, synergies among them hold the promise
of reshaping the workforce over time to equip it for new kinds of knowledge-based
employment. Notably, none is adequate by itself and none may properly be viewed as
addressing a Type I problem for which a technical fix is available.
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Learning action networks as sketched here bear a close kinship to what David Booher
has recently dubbed collaborative complex adaptive networks (2008, 111148). He offers
his conception as an ideal type and emphasizes many of the same concerns developed here.
For example, he contends that to be successful, community change must involve actors and
institutions from all three sectors in a community. Those seeking change (the university as
catalyst in this example) must work with nonprofit organizations, with government officials, with business leaders and with families to offer opportunities for reflection and
adaptive work as well as for technical change. Booher captures this idea neatly:
Complex adaptive networks are networks of agents that interact dynamically and
nonlinearly in an open system so as to generate novelty and emergent adaptive
patterns. These patterns create a tension that maintains the system between falling
into stasis and spinning off into chaos (Booher 2008, 113).
Leaders engaged in catalyzing adaptive change must work with other leaders of a wide
range of stakeholders, that cross sectors to develop forums that allow broad groups of
citizens to ponder what must change and how and why and whether they are prepared to
support the social, political and economic costs that such choices imply. These leaders
must finally also develop the long-term conditions and strategies that conduce to the
realization of citizen-supported aspirations. Booher notes that collaborative complex
adaptive networks exhibit the following characteristics which align neatly with Heifetz
conceptions of adaptive work and holding environments:
Distributed networks mediated or catalyzed by facilitators whose aim is to elicit
community voice and not to provide one or another solution. Initiatives coming
from grassroots as well as leaders, evolving goals determined by processes aimed at
maximizing stakeholder involvement, system outcomes determined by the interaction of multiple stakeholders rather than by top down fiat, no single actor in charge or
authoritatively able to speak for the community alone, multiple and varied opportunities to inform and discuss goals and aspirations and their implications for their
values and beliefs (Drawn from Booher 2008, 135).
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alike to grapple with the central questions confronting their communities. This role is
the university equivalent of Boohers facilitator in collaborative complex adaptive
networks (2008, 132133). Unmediated conflict or poorly constructed understanding of
the issues in play can poison an opportunity for a community to reconceive its
possibilities and the university engaged in a community intervention may properly be
held accountable if it allows conflict to come to such a level that it undermines the
possibility for constructive change. Just as physicians caring for the sick and dying
must manage the coping processes of both their patients and their families, university
faculty must do the same for those citizens and their communities with whom they
engage when the aim is to secure basic social change. The role entails deep ethical
tensions between the potential for paternalism or manipulation and dignifying
empowerment that are best mediated by active and ongoing attempts by university
representatives to ensure that those who are involved are consistently engaged and
viewed as critical participants and decision-makers who bring vital knowledge and
experience to social choice-making processes.
University faculty and officials playing these roles should conceive of the levers or
tools of change they may possess in light of how they might interact and affect social
learning. Will they help to form learning action networks? Will specific interventions
offer opportunities directly or indirectly for public, nonprofit and business organizations to rethink their strategic assumptions and roles? (Rowley 1997, 887893).
Will citizens find ways and means by which to share their concerns and especially their
fears as an integral part of any decision processes undertaken? If not, learning action
networks are unlikely to arise.
The leader (university officials or faculty members seeking civic engagement) should
be open to learning and should see all of the processes in which it plays roles in
adaptive and evolutionary terms. Circumstances and contexts change and these deserve
attention for their own sake. Values, mores and cultural assumptions do not shift
overnight. Thus, initiatives aimed at securing such adjustments should be built on
norms of patience, honest experimentation and openness to rethinking paths for
encouraging network development.
All network development activities, whether direct or indirect as distinguished above,
should be viewed as opportunities to encourage collaboration and cooperation. The
more dense and variegated those relationships the better.
Concluding reflections
Virginia Tech cannot yet claim success in its attempt to lend its human and social capital to
assist in a regions mobilization to secure adaptive social and economic change, but much
has occurred. The university and its allies have founded an important institution, IALR,
now actively engaged in diffusing the products of research in ways that inure to the
comparative advantage of the region. University faculty have similarly galvanized concern
over continuing low education levels in the region and sought to assist local officials and
civic leaders as they develop strategies to address these including the development of a
new magnet school for science and technology and new pedagogic strategies exhibiting a
renewed emphasis on arts, science and mathematics in school curricula.
It can also be said that the university can now identify its internal contradictions and
challenges. Its representatives may now also possess an organizing heuristic for their
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References
Baum, H. S. (2000). Fantasies and realities in university-community research. Journal of Planning Education and Research, 20, 234246.
Bleiklie, I., & Kogan, M. (2007). Organization and governance of universities. Higher Education Policy, 20,
477493.
Booher, D. (2008). Civic engagement as collaborative complex adaptive networks. In K. Yang & E. Bergrud
(Eds.), Civic engagement in a network society (pp. 111148). Charlotte, NC: Information Age
Publishing.
Clarke, S. (1999). Knowledge networks and sustainable technology management: An international study of
organizational practice. Doctoral thesis, York University, Ontario, Canada.
Clarke, S., & Roome, N. (1995). Managing for environmentally sensitive technology: Networks for collaboration and learning. Technology Assessment and Strategic Management, 7(2), 191215.
Coombs, R., Harvey, M., & Tether, B. (2003). Analysing distributed processes of provision and innovation.
Industrial and Corporate Change, 12(6), 11251155.
Coombs, R., Richards, A., Saviotti, P. P., & Walsh, V. (Eds.). (1996). Technological collaboration.
Cheltenham: Edward Elgar.
DeBruijn, T. J. N. M., & Tukker, A. (Eds.). (2002). Partnership and leadership: Building alliances for a
sustainable future. Boston, MA: Kluwer Academic Publishers.
Edmond, J. B. (1978). The magnificent charter: The origin and role of the Morrill land grant colleges and
universities. Hicksville, NY: Exposition Press.
Ellison, J., & Eatman, T. (2008). Scholarship in public: Knowledge creation and tenure policy in the
engaged university. Syracuse, NY: Imagining America.
Etzkowitz, H. (1997). The entrepreneurial university and the emergence of democratic corporatism. In H.
Etzkowitz & L. Leydesdorff (Eds.), Universities and the global knowledge economy: A triple helix of
university-government relations (pp. 141152). London: Cassell Academic.
Foster-Fishman, P. G., Berkowitz, S., Lounsbury, D., Jacobson, S., & Allen, N. (2001). Building collaborative capacity in community coalitions: A review and integrative framework. American Journal of
Community Psychology, 29(2), 241261.
Glasser, M., Holt, N., Hall, K., Mueller, B., Norem, J., Pickering, J., et al. (2003). Meeting the needs of rural
populations through interdisciplinary partnerships. Family and Community Health, 26(3), 230245.
Heifetz, R. (1994). Leadership without easy answers. Cambridge, MA: Belknap/Harvard University Press.
Laredo, P. (2007). Revisiting the third mission of universities: Toward a renewed categorization of university activities? Higher Education Policy, 20, 441456.
Laredo, P., & Mustar, P. (1996). Benchmarking of RTD policies in Europe: A socioeconomic approach to
state intervention in innovation. In R. Coombs, A. Richards, P. P. Saviotti, & V. Walsh (Eds.),
Technological collaboration (pp. 143164). Cheltenham: Edward Elgar.
Luke, J. (1997). Catalytic leadership: Strategies for an interconnected world. San Francisco, CA: JosseyBass Publishers.
McDowell, G. (2003). Engaged universities: Lessons from the land grant universities and extension. Annals
of the American Academy of Political and Social Science, 585, 3150.
MDC Inc. (2000). Learning. Working. Winning: Bringing the new economy to the Dan River region (pp. 1
35). Chapel Hill, NC: MDC Inc.
Nevins, A. (1962). The origins of the land grant colleges and state universities: A brief account of the
Morrill Act of 1862 and its results. Washington, DC: Civil War Centennial Commission.
Rodale, R. (1983). Regenerative technology. Resurgence, 98, 3235.
Roome, N., & Clarke, S. (2002). Sustainable business: Learning-action networks as organizational assets.
In Partnership and leadership: Building alliances for a sustainable future (pp. 77101). Boston, MA:
Kluwer Academic Publishers.
Roper, C., & Hirth, M. (2005). History of change in the third mission of higher education (A): The evolution
of one-way service to interactive engagement. Journal of Higher Education Outreach and Engagement, 10(3), 322.
Rowley, T. (1997). Moving beyond dyadic ties: A network theory of stakeholder influences. Academy of
Management Review, 22(4), 887910.
Wallenstein, P. (1997). Virginia Tech: Land grant university: History of a school, a state and a nation:
18721997. Blacksburg, VA: Pocahontas Press.
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