Dr. Mary had been using paper medical records for 23 years but decided it was time to transition to an electronic medical records (EMR) system. She missed some initial training but learned the system through observation of her nurses inputting patient data. Over several days of observation and practice with nurse feedback, Dr. Mary was able to use the EMR independently with minimal issues.

1. Running Head: UNIT ONE 1
Unit One: Dr. Mary Learns a New System
Behaviorist Perspective
Lauren Fowler-Carter
University of Houston – Clear Lake

2. Running Head: UNIT ONE 2
Unit One: Dr. Mary Learns a New System
Behaviorist Perspective
For 23 years, Dr. Mary Thomas and her staff have been using paper records in their
office for patient medical records. Mary has a personal computer, but does not use it often,
because she struggles at functioning it. Her frustrations carried over into a computer class at a
local community center that she ended up discontinuing the classes.
Since Mary is a family doctor, despite her troubles with computers, she felt it was time
for her office to get up-to-date on the new medical records technologies. She decided to
transfer all the patients’ paper medical records into electronic format. She knew that by doing
this transfer, the patients’ records would be accessed quicker and would save space in the
office.
Dr. Mary missed some of the training for the new Electronic Medical Records (EMR)
system, but she decided to have her nurses and other staff help her in learning the new system.
Using the knowledge that she learned at the training, Dr. Mary tried to teach herself the other
parts of the system. Getting frustrated, by lunch time, Dr. Mary was back to using the paper
charts with the patients. Before Mary came in to see the patients, her nurses were using EMR
to take the patients vitals and other basic information for their chart.
A week goes by and Dr. Mary tries to use EMR in the beginning, but eventually
throughout the day, goes back to the paper records. Her nurses told her that EMR is not that
hard to learn, so Dr. Mary asked if she could observe the nurses inputting the information in the
system about the patients’ vitals and other basic information. Dr. Mary noticed that some of
the sections of EMR that she needed to use, were the same sections the nurses used.
Dr. Mary continued to observe the nurses techniques for about 3 days off and on. Dr.
Mary asked some of the nurses, if they had time, to observe her inputting the information
during the patients’ visit just to make sure she was doing everything correctly. In the beginning,
if there were not any nurses available, Dr. Mary would get a little frustrated because she was
inputting the information into the computer slow while the patient was waiting and watching
her struggle. Eventually, she would pull out a note pad and jot down the information and input
the patients’ information in the computer later. When the nurses find out about Dr. Mary using
the notepad, they do not allow her to observe their EMR use for the rest of the day. After a
couple of more days of observations, Dr. Mary is now able to use EMR by her without much or
any problems.
Initial Focus Questions & Answers
1. What is Dr. Mary learning in this story?
- Dr. Mary is learning how to use a new EMR system through observations in her
environment.
2. What extinction is occurring?
- The extinction that is occurring in this story is the usage of paper medical records.

3. Running Head: UNIT ONE 3
3. Is shaping involved in the learning for this story?
- Shaping is not distinctly involved in this story. (This would be an answer regarding the
learners’ perspective. If examples and details are provided, the learner will be award
points for a correct answer.)
4. What was the main approach (learning outcome) that allowed Dr. Mary to learn?
- Dr. Mary was able to learn how to use the EMR system by observation. She observed the
nurses for some days and the nurses also observed Dr. Mary’s EMR usage to make sure
she was using it correctly.
5. Name a punishment that Dr. Mary had to face during her learning?
- When the nurses found out that she was using a notepad to take patients’ notes when
they were not around, the nurses would not let Dr. Mary observe their EMR
usage/techniques for the rest of the day.
6. What was the deciding factor that led Dr. Mary to want to initiate what was being
learned in the story?
- It is stated in the story that “she felt it was time for her office to get up-to-date on the
new medical records technologies” and also the electronic system would eventually save
space in her office.
7. Who were the instructor(s) in this story?
- Initially the instructor for the new EMR system was the trainer, but since Dr. Mary
missed some of the training, the nurses and other staff became the instructors in Dr.
Mary’s learning.