NPT can help inform, guide or structure your initial research focus and questions.  You could think of it in a similar way to Bury's (1) empirical concept of biographical disruption in chronic illness, or Davison, Smith & Frankel's (2) empirical concept of candidacy, in that NPT might inspire or initiate a set of issues and problems that you want to research further.

Introduction

NPT can help you think about the potential direction and focus of your qualitative research project.  As soon as you start to think that an existing technology or a way of working is not somehow 'natural' or 'has just always been that way', but rather is the product of a process - a product of people coming together over time, engaging in concerted cognitive and practical action - you may be inspired to begin to study such processes.

All qualitative research starts from an initial idea, thought or observation and then has to be developed into a set of practically realisable research questions. The NPT can influence that development of research questions and related aims and objectives

NPT may inspire you to conduct some research on how a technology or way of working is 'normalised' within a specific organisation or setting.

  • You may want to explore how new technologies or ways of working are being designed, developed and conceptualised.  So, for example, you may ask how those actually creating new care pathways for say, children with diabetes, take into account, if at all, how the pathway they are developing will impact on day-to-day work practices of staff, the allocation of tasks and responsibilities.
  • You may, if you're lucky, and in the right place at the right time, be able to discover how new technologies or ways of working are actually being implemented, how they are being introduced and rolled-out.  In this way, you may be able to collect valuable empirical data on the context before, during and after the introduction.
  • You may want to focus on technologies or ways of working that have been recently introduced and are still going through a process of 'normalization', to focus on how well they are being embedded. You may not be able to generate first-hand observations that show what life was like prior to the introduction, but you could still gather retrospective interview accounts that could inform your understanding.
  • You may want to explore technologies or ways of working that are already in situ, that are already integrated, that are now 'part of the furniture'.  For example, computers and computerised decision-support tools in medical practitioners consultation rooms are, in historical terms, are relative recent additions.  Such retrospective research may draw on the historical archive, from research articles, organisational documents to television documentaries, alongside more traditional interview or observational research to see how they are currently used.

NPT may help you create a set of specific, reasonably defined research priorities and questions.

  • Given NPTs focus on action and processes you really need to tailor your research focus and questions to discover what people actually, practically, do.  It is not enough to focus on what people feel, think or would like to happen about the introduction of the new technology or way of working but to capture, in enough empirical detail, the often quite mundane routines that make up the tasks they are involved in.
  • Given NPTs awareness that normalization takes place over time, spaces, people and organizational contexts, you really need to consider a quite open and holistic approach to your research.  Above all, you need to follow the action, to be open to the possibility to follow the often quite distributed network of reasoning and activities.

Centrally, given NPTs quite loose definition of 'technology', NPT does not discriminate about what the proper object of your qualitative research should be. It does assume than you will have a primary focus on the actual process of normalization and will wish to focus on some aspect of implementation, embedding or integration.

  • For example, you may be focusing on an actual device or application (e.g. a novel electronic pill dispenser or a new piece of decision-support software), or on how a policy or legislation is developed or enacted (e.g. a new limping child protocol or clinical guideline), on a programme of organisational change (e.g. a new clinical unit or team), an action or routine (e.g. a new handover strategy or a new medication regime) alongside a specific identity (e.g. patients with a new diagnosis, or practitioners with a new role or task).   In many projects, you may be focusing on a combination of these issues.

However, NPT may guide your thinking in certain ways.  The four constructs and their specific components of the theory can simply be used as aide memoirs or as research directives.

  • For example, NPT may remind you to focus on how and in what ways the introduction of technology or ways of working was initially received, how individually and collectively people practically conceptualised and made sense of it (construct: coherence).
  • NPT may be actively used to shape the specific research questions you have.  You may be inspired to focus on the impact of a novel technology or way of working on the trust between groups of people (component: relational integration) and how this in turn shapes face-to-face encounters between them (component: interactional workability).

You also need to think about tailoring and adapting the context-free language of the NPTs mechanisms and components to work with your research project.  You need to make it make sense, to normalize it, in relation to the specific research you are undertaking.

Things to consider

  • NPT can help you define some very general ideas about the proper object of study of your qualitative project as well as shape your research questions.
  • NPT can be used to study technologies and ways or working that have already been normalized, that have recently or are currently being introduced and/or incorporated alongside those that are just being developed.
  • How you work with the theory is entirely up to you.  You do not need to follow it like a protocol, but you do need to be aware of the range of possible ways it could potentially inform your qualitative research.
  • Remember to tailor the context-free language of the theory to your own research project.

References

  1. Bury, M. (1982) Chronic illness as biographical disruption. Sociology of Health and Illness, 4, 167-182.  Back to text
  2. Davison, C., Smith, G.D., Frankel, S. (1991) Lay epidemiology and the prevention paradox. Sociology of Health and Illness, 13, 1-19 Back to text

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How to cite this content

May, C., Murray, E., Finch, T., Mair, F., Treweek, S., Ballini, L., Macfarlane, A. and Rapley, T. (2010) Normalization Process Theory On-line Users’ Manual and Toolkit. Available from http://www.normalizationprocess.org [Accessed on ].