Table 2

The constructs of NPT (adapted from59)

CoherenceDifferentiationAn important element of sense-making work is to understand how a set of practices and their objects are different from each otherCODI
Communal specificationSense-making relies on people working together to build a shared understanding of the aims, objectives and expected benefits of a set of practicesCOCS
Individual specificationSense-making has an individual component too. Here participants in coherence work need to do things that will help them understand their specific tasks and responsibilities around a set of practicesCOIS
InternalisationFinally, sense-making involves people in work that is about understanding the value, benefits and importance of a set of practicesCOIN
Cognitive ParticipationInitiationWhen a set of practices is new or modified, a core problem is whether or not key participants are working to drive them forwardCPIN
EnrolmentParticipants may need to organise or reorganise themselves and others in order to collectively contribute to the work involved in new practices. This is complex work that may involve rethinking individual and group relationships between people and thingsCPEN
LegitimationAn important component of relational work around participation is the work of ensuring that other participants believe it is right for them to be involved, and that they can make a valid contribution to itCPLE
ActivationOnce it is underway, participants need to collectively define the actions and procedures needed to sustain a practice and to stay involvedCPAC
Collective ActionInteractional workabilityThis refers to the interactional work that people do with each other, with artefacts, and with other elements of a set of practices, when they seek to operationalise them in everyday settingsCAIW
Relational integrationThis refers to the knowledge work that people do to build accountability and maintain confidence in a set of practices and in each other as they use themCARI
Skill set workabilityThis refers to the allocation work that underpins the division of labour that is built up around a set of practices as they are operationalised in the real worldCASW
Contextual integrationThis refers to the resource work—managing a set of practices through the allocation of different kinds of resources and the execution of protocols, policies and proceduresCACI
Reflexive MonitoringSystematisationParticipants in any set of practices may seek to determine how effective and useful it is for them and for others, and this involves the work of collecting information in a variety of waysRMSY
Communal appraisalParticipants work together—sometimes in formal collaboratives, sometimes in informal groups to evaluate the worth of a set of practices. They may use many different means to do this drawing on a variety of experiential and systematised informationRMCA
Individual appraisalParticipants in a new set of practices also work experientially as individuals to appraise its effects on them and the contexts in which they are set. From this work stem actions through which individuals express their personal relationships to new technologies or complex interventionsRMIA
ReconfigurationAppraisal work by individuals or groups may lead to attempts to redefine procedures or modify practices—and even to change the shape of a new technology itselfRMRE
  • EPOC, Effective Practice and Organisation of Care; NPT, normalisation process theory.