When and how do professionals incorporate input from lay audiences

• In Event: Organizations, Occupations, and Work Section Roundtables
  In Refereed Roundtable (90 minute): Table 23: Audiences and Evaluation

Abstract

Professionals routinely draw on input from expert audiences such as peers and critics, but have historically been more hesitant to engage lay audiences who lack knowledge and skills. In recent years, however, shifting cultural and market dynamics have expanded lay audiences’ expectations to participate in professional decision-making, even in high-stakes domains. This study examines when and how professionals incorporate input from lay audiences, and with what consequences for expert judgment. Drawing on a 15-month ethnographic study of cancer treatment decision-making in a U.S. hospital, I analyze 84 consultations in which patients sought to revise recommended plans of care. I find that professionals’ responsiveness to lay input hinges on the composition of the lay audience and the experienced sense of accountability it triggers. When accountability heightens, professionals tend to reject lay input in order to prevent what they perceive as foreseeable errors. By contrast, when accountability shifts away from professionals and toward lay audiences that witness, endorse, or advocate alternative courses of action, input is more likely to be incorporated. Overall, this study advances a situated understanding of professional accountability as interactionally experienced and shows that expert judgment is contingent on audience composition and interactions.

Author

• Valerio Iannucci, Boston University