This paper investigates how healthcare professionals articulate the relationship between patient experience and "evidence", creating hybrid forms of knowledge. We propose a Bakhtinian dialogical framework to theorise this process. Drawing on ethnographic work from patient involvement initiatives in England, we show how patient experiences are rearticulated by professionals who add their own intentions and accents in a dialogical process which incorporates diverse forms of knowledge and the conflicting demands of healthcare services. In this process, patient experiences become useful epistemic commodities, helping professionals to respond to workplace pressures by abstracting experiences from patients' biographies, instrumentalising experiences, and privileging 'disembodied' forms of involvement. Understanding knowledge as relational and hybrid helps move beyond the assumption that there is a clear dichotomy between 'objective science' and 'subjective experience'. This paper illuminates how new knowledge is produced when professionals engage with "lay" patient knowledge, and helps inform the sociology of knowledge production more widely.
At a time when organizations are asked to imagine themselves anew in order to survive, organizational treatments of ‘imagination’ lack engagement with its profound political and generative nature. To address this gap, the paper draws on the works of Cornelius Castoriadis (1922–1997) and proposes a politically situated theory of imagination for organization studies. We build on Castoriadis’s core ideas of representation, signification and affect to develop a radical proposition: imagination is ‘where it all begins’, an inexhaustible psychosocial force driving organizations and organizing, and setting the institutionalization process in motion. To illustrate the great potential contributions of this proposition for organization studies, we discuss how three key persisting dualisms in organizational thinking, those between ‘representational’ and ‘non-representational’ inquiry, ‘body’ and ‘mind’, and between the ‘private’ and ‘public’, begin to dissolve when considered under our suggested framework. We then draw some important implications of Castoriadian imagination for charting alternative futures at times of economic and social crises, and identify some directions for future research.
This paper examines citizen participation in health research, where funders increasingly seek to promote and define 'patient and public involvement' (PPI). In England, the focus of our study, government policy articulates a specific set of meanings attached to PPI that fuse patients' rights and responsibilities as citizens, as 'consumers' and as 'lay experts'. However, little is known about the meanings those who take part in PPI activities, attach to this participation. Drawing on ethnographic data of PPI in three clinical areas (stroke, cancer and pre-term birth) we investigate citizen participation in health research as political ritual. We identify tensions between policy-driven and ground-level performance of citizenship, and use ritual theory to show how such tensions are accommodated in participatory structures. We argue that the ritual performance of PPI neutralises the transformational potential of citizen participation, and we draw wider sociological implications for citizen participation beyond the health arena.
Entrepreneurs develop activities that challenge the status quo, break the rules and subvert systems. How can such a thing be taught/learnt in a business school? This article contributes to current debates within entrepreneurship studies that aim to address the subversive nature of entrepreneurial activity. We conducted an ethnographic case study of an entrepreneurship course that seeks to redefine the teaching and learning boundaries of subversive activity in a leading European business school. Drawing on the theory of Bakhtin, which has thus far been overlooked in entrepreneurship studies, we unpick the potentiality of art practices in the learning and experiencing of the subversive dimension of entrepreneurship. We employ the concept of 'dialogical pedagogy' in order to address calls for more 'relationally experienced' approaches to management learning that foreground the conflicts, emotional strains and uncertainties that are embedded in the fabric of entrepreneurial practice. We show how 'subversive dialogues' are enacted between students and teachers as they engage in the learning process and discuss implications for critical entrepreneurship teaching in an increasingly commoditized education environment.
Citizen participation in deliberation activities within public health systems is increasingly seen as essential in achieving more patient‐centred, equitable and democratic care. However, recent studies show that patients' lived, affective experience of illness and care remains poorly understood within deliberative fora. In response, this article argues that emotion is central in mediating deliberation, and in conditioning deliberative outcomes. To understand how this occurs, we use a sociologically informed notion of ‘biographical affect’ to address links between emotion and social and political action. Benefits of this approach for healthcare deliberation are illustrated through an in‐depth case study of a major citizen participation forum in the UK National Health Service. Our conclusions call for alternative orientations to participation that involve committed engagement with participants' affective experiences.
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