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Table 2 Four generative mechanisms of Normalization Process Theory

From: Patchy ‘coherence’: using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC)

Generative mechanism

Description

Components

Coherence

The sense-making work that people do individually and collectively when they are faced with the problem of operationalizing some set of practices.

Differentiation

Communal Specification

Individual Specification

Internalization

Cognitive participation

The relational work that people do to build and sustain a community of practice around a new technology or complex intervention.

Initiation

Enrolment

Legitimation

Activation

Collective action

The operational work that people do to enact a set of practices, whether these represent a new technology or complex healthcare interventions.

Interactional Workability

Relational Integration

Skillset Workability

Contextual Integration

Reflexive monitoring

The appraisal work that people do to assess and understand the ways that a new set of practices affect them and others around them.

Systemization

Communal Appraisal

Individual Appraisal

Reconfiguration