Period 1	Period 3
1A. Good baseline visit organization skills: In this baseline visit, the clinician enters the room, greets the patient warmly, commenting on the presence of the video camera, “Do you have stage fright like me?” As there is no desk in the room, the clinician places the paper chart on a supply cabinet opposite the patient and leans toward him as they discuss his concerns. The clinician begins writing in the chart as the patient speaks, but looks up from time to time to make eye contact with the patient. Shortly after the patient finishes speaking, the clinician notes that they had spoken on the phone about the problem and comments that “I was looking at my notes before I came in,” thus making visible additional interest in the patient's care.	1B.Amplification of good visit organization skills while using an exam-room computer: The clinician enters the room, introduces the computer, and explains confidentiality of information in the electronic medical record, before eliciting an agenda from the patient. After some discussion, the clinician glances at the computer screen, clarifies the patient's goal for the visit, and solicits for additional concerns. The patient adds an additional concern about a spot that she was told might be cancer. The clinician immediately gets up from the computer, examines the spot, and confirms to the patient that it is not cancerous. The clinician then returns to the computer and continues to deal with the patient's less pressing concerns.
2A. Poor baseline visit organization skills: In this baseline visit, the clinician never sets a formal agenda. The patient has multiple medical concerns. Problems are discussed serially as the patient brings them up and without regard to their number, relationship, or severity. The visit appears quite inefficient and poorly organized. Each of the patient's concerns is quickly superseded by the next concern; some of the patient's concerns are never fully addressed by the end of the visit.	2B. Amplification of poor visit organization skills while using an exam-room computer: After the introduction of the computer, the clinician appears to have the same visit organization style observed in period 1, except that now there is an increase in the number and complexity of visit tasks associated with the computer. The clinician does not set a formal agenda in this visit. Instead, the clinician appears to become confused between concerns that the patient raises and information on the computer screen. Whenever the clinician looks at the computer, the information on the monitor becomes the topic of discussion, often displacing the on-going topic of conversation. The changes in topics and lack of resolution before switching topics appear to confuse the patient. The presence of the computer multiplies the sense of disorganization of this visit, and extends its length.