Coherence is the sense-making work that people do individually and collectively when they are faced with the problem of operationalizing some set of practices. Like all NPT constructs it has four components.

1.1 Differentiation: An important element of sense-making work is to understand how a set of practices and their objects are different from each other.For example, when doctors use a videoconferencing system to consult with patients, what do they do to understand and organize the differences between face-to-face consultations and videoconferencing.

1.2 Communal specification: Sense-making relies on people working together to build a shared understanding of the aims, objectives, and expected benefits of a set of practices. A great example is the team of investigators leading a clinical trial, as they work out how to integrate a complex clinical experiment into a healthcare setting, and as they try to identify and anticipate the relationship between elements of the trial and everyday clinical practice.

1.3 Individual specification: Sense-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 practices. For example, nurses recruiting patients into a trial need to have a strong understanding of the work they must do to secure informed consent from patients, and how they will go about this.

1.4 Internalization: Finally, sense-making involves people in work that is about understanding the value, benefits and importance of a set of practices.So, returning to the example of doctors using a videoconferencing system to consult with their patients, it's about the work that they do to attribute worth to a new way of working.