Lesson L3-7 · authored fragments (docs/43)
Primary review content — the AI-avatar narration, in order.
First job — where does it go. Don already has a MAR open for January, with his other meds on it. You do NOT start a brand-new MAR just because one new med showed up. You add a new ROW to the MAR he already has. Find the next empty row under his current meds — that row is Don's Albuterol from now on. One client, one MAR for the month, and new orders get added right onto it as they come. Start a fresh MAR halfway through the month and you split Don's record in two, so nobody can see his whole month in one place anymore.
Two quick checks coming up. The first one: build a new-order row and put the right things in it. The second: pick the exact moment it's okay to sign for the first dose. Take your time — these are the two things that trip people up on real shifts.
Now the second job — when do you sign for that first dose. Watch the clock on this one. Say the doctor wrote the order at 10 in the morning. The pharmacy doesn't deliver the inhaler until 3 in the afternoon. Don asks for a puff at 3:15. So when do your initials go on the MAR? 3:15 — after Don actually takes the puff from the inhaler that's now in your hand. Not 10 AM when the order was written; nothing was given then, and the med wasn't even in the home. The MAR records what really happened, at the time it happened. Never, ever initial a dose you did not give. Sign at 10 for a dose that didn't happen until 3 — or didn't happen at all — and the next MAP reads it as done and skips it, or an inspector sees a dose that never occurred. Med's in your hand, client takes it, then you sign.
Second, make the row complete. A good rule to keep a new-order row safe is four things — think of it as everything the next person needs to give this med without guessing. One: the medication and its strength, copied exactly off the label — "Albuterol inhaler, 90 micrograms a puff." Two: the dose and how it's given — "two puffs, inhaled." Three: the schedule — if it's a set time, write the times; if it's as-needed, write PRN and the reason, like "PRN for shortness of breath." Four: who ordered it, and the start date. Leave any of those off and the next MAP is stuck — a name with no dose, or a dose with no schedule, is a row they can't safely act on. And here's the one people get wrong: you do NOT sign this row. Writing the order down is not the same as giving a dose. Your initials go in the day-and-time box later, when Don actually takes it.
Here's a shift you'll have a lot. It's January 9th, and Don's doctor just ordered him something new — an inhaler, Albuterol, to use when he's short of breath. The pharmacy drop-off just hit the counter. So now you've got two jobs, and people mix them up all the time: where does this new order go on the paperwork, and when is it okay to put your initials down for that very first dose? Get those two things straight and a new order lands on the MAR clean. Get them backwards and you either sign for a dose nobody gave, or you give a med that isn't written down anywhere. Let's walk it through.
Last thing, and it's a heads-up more than a step. The first dose of a brand-new med is a moment to pay extra attention. It's the first time Don's body is meeting this medication, so after he takes it you keep an eye on him for anything that looks off. Exactly how to do that — how long to watch, what to look for — is the next lesson. For now, just carry this: a new med's first dose isn't a fire-and-forget. You give it, then you watch.
Now, write that row so it stays put. The MAR is the permanent record of Don's care — the next MAP reads it, your nurse reads it, and if an inspector ever pulls his chart, they read it too. What you write today has to still say the same thing next week. So write it in something permanent — a record that can't be rubbed out or quietly changed later. A row that can be wiped away is a row nobody can trust.
27 of 27 critical claims are verified_by: null (Gate-2 SME sign-off pending → preview only, production-blocked under the Rule-3.6 waiver). · runtime budget: 3:50
# Concept mirror — MA.L3-7.A (Adding a New Order — mid-month MAR entry)
> **MIRROR / NOTES ONLY.** The authoritative concept entry is **docs/42 §E, `MA.L3-7.A`**
> (Instructional Domain Model, Competency C-3.7). This file is the local traceability ledger +
> patient-safety chain + decision queue for the derived-asset bundle; if it ever disagrees with
> docs/42, **docs/42 wins** (docs/43 §22 authority flow).
| Field | Value |
|---|---|
| `concept_id` | `MA.L3-7.A` |
| `competency_id` | `C-3.7` (⇄ `C-2.8` Right Documentation, `C-3.10` First-Dose Observation; builds on `C-3.4` Header/Legend, `C-3.5` Routine Dose, `MA.L3-1.F` Document Immediately) |
| `lesson_ids` | `[L3-7]` (add-a-new-order is route-agnostic; recurs on every route's MAR) |
| `clinical_risk` | **High** → ≥90% KC mastery, spaced repetition. **Not Critical** → the sim flags a premature/missing initial as a *coachable* event, **not** a force-fail; KC keys are **not** SME-locked (`keyProtected: false`). |
| `medication_error_prevented` | A first dose initialed before the med is in the home (a phantom dose the next MAP re-gives, or an auditor reads as given-but-never-happened); **or** a newly ordered med that never lands on the MAR as a row (given with no order of record, or the next MAP never learns it exists) |
| `sme_status` | `in_review` (concept); all derived fragments `draft` |
| `apd_traceability_status` | **partial** — first-dose-after-delivery timing sourced ([APD], safe to lock); add-a-row mechanic + Form 65G-7.008 A cell-grid sourced but with an answer-key-ID discrepancy; **five open `[Needs Owner Review]` anchors** + one `[Waiver360-added]` decomposition |
## Rule-3.6 author-ahead waiver (recorded 2026-07-05)
The concept is `in_review`, not `approved`. Per docs/42 §I.1 / docs/43 §4, this bundle is authored
**ahead of concept approval under a Rule-3.6 waiver** as part of the Oral Route build (Phase 1, the
MAR Simulator new-order branch). Consequence: **every fragment in this bundle is `sme_status: "draft"`,
preview-flag only, and production-publish-blocked** until (a) the concept reaches `approved` and (b) a
Gate-2 SME sign-off is recorded in `content_revisions.sme_signoff_*`. Per docs/43 §15, no
`[Needs Owner Review]` claim in this bundle is locked into narration, a KC answer key, or a video
prompt: each is carried as a `critical_claims` entry with `verified_by: null`, framed instructionally,
and listed in the Decision queue below.
## Source ledger (projects into `payload_json.sources`)
- `curriculum_source`: "APD BMA Module 1 (immediate documentation, s71 + checkpoints v4/v5 Q1) + APD MAR practical exam 'add a new order' answer keys (Don Montana 1/9 Albuterol; scenario-ID reconciliation pending)"
- `form_reference`: "APD Form 65G-7.008 A (MAR)"
| # | Claim | Tag | Source | verified_by |
|---|---|---|---|---|
| C1 | The first dose is charted **only immediately after the client actually takes it**, never before — "never initial a dose you did not give" | `[APD]` | Mod1 s71; checkpoint v4/v5 Q1 (⇄ MA.L3-1.F / C-2.8, both sourced) — **safe to lock** | null |
| C2 | A newly prescribed med is added as a **new row on the client's current MAR** mid-month (never a fresh MAR) | `[APD]` | MAR practical-exam "add a new order" answer keys — **`TODO(source-L37-6)`**: §F cites MAR-MJ/MAR-SW; frozen legacy cites MAR-DM 2c / MAR-MJ 3 / MAR-RS 4 — reconcile which scenarios carry an add-order step before locking citations | null |
| C3 | Form **65G-7.008 A** is the MAR (front-page day/time cell grid + monthly form) the new order is added into as a row | `[APD]` | Form 65G-7.008 A (§I.3.3) | null |
| C4 | Write the new-order row **in pen / blue or black ink** | `[Needs Owner Review]` | Common documentation convention, **not** confirmed against an APD source — **`TODO(source-L37-1)`** | null |
| C5 | **"Never pencil — the MAR is a legal record"** (exact APD phrasing) | `[Needs Owner Review]` | **`TODO(source-L37-2)`** | null |
| C6 | The **exact required new-order-row field set** per Form 65G-7.008 A (is it four fields? is a diagnosis code required?) | `[Needs Owner Review]` | **`TODO(source-L37-3)`** | null |
| C7 | **"Start date = the date the prescriber wrote the order"** (vs. the delivery date — a genuine convention split) | `[Needs Owner Review]` | **`TODO(source-L37-4)`** | null |
| C8 | **"The first dose is almost always an observation event"** (bridge to C-3.10) | `[Needs Owner Review]` | Framing pending L3-10 — **`TODO(source-L37-5)`** | null |
| C9 | The **four-field decomposition** of the order row (medication+strength · dose+route · schedule/PRN+reason · prescriber+start date) | `[Waiver360-added]` | Instructional structuring of the form — labeled as such, never implied APD-required | null |
| C10 | A phantom initial (signed before delivery) reads as a done dose → the next MAP skips it, or an auditor sees a dose that never occurred | `[Waiver360-added]` | Defensible audit-consequence framing of the [APD] corollary "never initial a dose you did not give" | null |
## Patient-safety chain (owner directive — this is a patient-safety concept)
1. **Medication error prevented.** Two distinct, real errors: (a) a **phantom first-dose initial** —
the MAP signs the 1/9 first-dose cell at 10 AM (order time) for an Albuterol puff that hasn't been
given and whose inhaler isn't even in the home yet; the next MAP reads the MAR as "already given"
and skips it, or an auditor reads a dose that never happened. (b) a **med with no row of record** —
the new order is given but never written onto the current MAR, so the next MAP doesn't know it
exists (no dose, no route, no schedule to act on).
2. **Why staff make this mistake (the real-world reason).** Not "they forgot." When a new order comes
in mid-month, the natural instinct is *"chart it now, while I've got the order sheet in my hand"* —
so the MAP documents at the moment the order is written (10 AM), not realizing the pharmacy won't
deliver for hours (3 PM). And under time pressure a phoned-in order gets given from a sample or a
leftover with **no row added**, because starting a brand-new row mid-month feels like extra work.
The mistake is a timing/sequencing slip driven by convenience, not forgetfulness.
3. **How the lesson/transcript prevents it.** The narration deliberately **splits the two events**:
writing the ROW (do it now — in ink, four fields, on the current MAR) versus initialing the DOSE
(only after the med physically arrives AND the client actually takes it). The delivery moment
(3 PM, `V-L3-7-03`) is shown as the **gate** that unlocks the first-dose cell; "never initial a
dose you did not give" is stated plainly with the plain consequence.
4. **How the simulator reinforces it.** The MAR Simulator **new-order branch** (Don Montana 1/9
Albuterol) will not let the learner initial the 1/9 first-dose cell **until the delivery event
fires**; initialing at order time, or leaving the med off the MAR entirely, raises a **coachable
flag** (High concept → flag, not force-fail) with the same re-anchor clip and a "try again" path.
5. **How the KC verifies mastery.** **Q1** verifies the learner can build a **complete new-order row**
(the row-of-record) and knows **not to sign it**. **Q2** verifies **first-dose timing** with a
concrete clock (order 10 AM / delivery 3 PM / dose 3:15 PM → sign at **3:15, after the puff**),
proving the learner won't initial a dose that wasn't given. ≥90% mastery (High).
## Decision queue → owner / SME (Michele + Nicole)
1. **`TODO(source-L37-6)` — reconcile the add-order answer-key IDs.** §F cites **MAR-MJ / MAR-SW**;
the frozen legacy lesson cites **MAR-DM 2c (Albuterol), MAR-MJ 3 (Januvia), MAR-RS 4 (Tegretol)**.
Confirm which MAR practical-exam scenarios actually carry an add-order step before citations lock.
**This gates C2 (the add-a-row mechanic's source anchor).**
2. **`TODO(source-L37-1)` — pen / blue-or-black-ink convention.** Confirm against an APD source or
badge it `[Waiver360-added]` best practice. Until then the `l37-pen-only` block teaches only the
safe underlying principle (a permanent, un-erasable record) and does **not** assert the specific
ink convention.
3. **`TODO(source-L37-2)` — "never pencil, the MAR is a legal record" exact APD phrasing.**
4. **`TODO(source-L37-3)` — exact new-order-row field set per Form 65G-7.008 A**, incl. whether a
**diagnosis code** is required. **Gates the KC-L3-7-A-Q1 key** — currently framed as the
`[Waiver360-added]` four-field completeness scaffold, not "the form requires exactly these."
5. **`TODO(source-L37-4)` — start-date definition** (prescriber-write date vs. delivery date). The
`l37-four-fields` block names "the start date" as a field but does **not** define which date.
6. **`TODO(source-L37-5)` — first-dose-observation bridge to C-3.10.** The `l37-observe-bridge`
block gives a soft heads-up only ("pay extra attention; the next lesson covers exactly how"); the
specific observation rule (e.g. a 20-minute watch) belongs to L3-10 and is not asserted here.
7. **Confirm the `[Waiver360-added]` framings** are acceptable: the four-field decomposition (C9) and
the phantom-initial audit-consequence framing (C10).
## Deferred remediation variants (owner decision 2026-07-05 — authored on concept approval)
- `KC-L3-7-A-Q1B` — Marcus Jones scheduled **Januvia** add (`MAR-MJ 3`), `VG-C3.7-001`.
- `KC-L3-7-A-Q2B` — River Short **Tegretol** 24-hour delivery-delay (`MAR-RS 4`), `VG-C3.7-002`.
Referenced in each primary KC's `remediation.onWrong` as "(deferred — authored on concept approval)";
the aggregator records both in the manifest `deferred_variants` so no remediation path dead-ends.
## Proposed exercise types (engineering via CMS registry, docs/41 §8.8)
`mar_new_order_row`, `first_dose_timing_gate` — CMS-ready specs authored in
`../exercise-specs/`; **not built** by authoring.
## Bundle manifest + human index
Owned by the later aggregation step (`../MA.L3-7.A.manifest.json` · `../MA.L3-7.A.README.md`);
not authored in this concept pass.
Don's doctor ordered a new PRN Albuterol inhaler on January 9. Build the new-order row on Don's current MAR: drag the correct entry into each field. Some chips do not belong on the order row.
Why: A complete new-order row tells the next MAP everything they need to give it safely: what and how strong, how much and by what route, when (or PRN plus the reason), and who ordered it with the start date. And notice you did NOT put initials on the row — writing the order is not giving a dose.
Error prevented: A new order that lands on the MAR as an incomplete row the next MAP can't safely act on, or a phantom sign-off on an order that was only written, not given.
Misconception: "The medication name alone is enough," and "the MAP who takes the order signs the order row."
The doctor wrote Don's new Albuterol order at 10:00 AM on January 9. The pharmacy delivered the inhaler at 3:00 PM. Don took his first puff at 3:15 PM. On the timeline, place your initials at the moment it's correct to sign the MAR for the first dose.
Why: 3:15 PM — after Don actually takes the puff from the delivered inhaler. The MAR records what really happened, at the time it happened. Med in your hand, client takes it, then you sign.
Error prevented: A phantom first-dose initial — a sign-off for a dose that hadn't been given (or hadn't happened yet), which the next MAP reads as done and skips, or an auditor reads as a dose that never occurred.
Misconception: "Initial the first dose when the order is written," "sign when the pharmacy delivers," and "you can sign before the med is in the home."
Entry: In the Don Montana MAR Simulator, a new PRN Albuterol order arrives on 1/9 (prescriber order written 10:00 AM). The learner must add it to Don's current January MAR.
Mastery: >=90% mastery; coachable flags on premature/missing initial — NO force-fail (concept is High, not Critical).
Shot: MS Michele at the med cart, group-home kitchen behind; brand bug top-right. Cut to insert B-roll: a pharmacy drop-off bag hitting the counter and Don Montana's open January MAR with an empty row visible under his current meds.
Camera: Open eye-level medium shot; slow push-in on 'you've got two jobs, and people mix them up'; cut to the delivery-bag insert on the 'pharmacy drop-off just hit the counter' beat.
Avatar: Michele on-camera for the framing; brief voiceover over the insert; slight lean-in on 'two jobs'.
Visual: Set the real mid-shift moment (a new order arrived today) and split it into the two jobs the whole lesson hangs on — where the order goes, and when you sign the first dose — before any procedure.
Animation: The 'New order 1/9' card types in over the delivery bag; the two-jobs split wipes in; a faint 'wrong way' preview (initials on the order row, and a med with no row) flashes and is set aside as the two errors the lesson closes.
Infographic: Caption card: 'New order - 1/9 - Albuterol PRN' with a two-panel split '1. Where does it go?' / '2. When do I sign?'; a footnote 'two-jobs framing: instructional'.
Shot: Prescriber order-sheet on the left ↔ Don's current January MAR on the right (full page, INF-06); the new order arrows from the sheet into the next empty ROW under Don's current meds; a rejected 'fresh blank MAR' still slides in and gets a red X.
Camera: Static side-by-side; a connector line draws from the order sheet to the target empty row; a quick cutaway to the 'fresh MAR' anti-pattern, then back.
Avatar: Voiceover; land 'one client, one MAR for the month' as one beat.
Visual: Make 'first job - where does it go' concrete: a new order becomes a NEW ROW on the MAR Don already has, never a brand-new MAR mid-month, so his whole month stays readable in one place.
Animation: The new order slides from the order sheet into the next empty row on Don's current MAR; a competing 'brand-new blank MAR' attempt slides in and gets a red X with 'splits Don's record in two'.
Infographic: Callout on the target row 'add the new order HERE - the next empty row'; a red-Xed thumbnail 'do NOT start a fresh MAR'; caption 'one client, one MAR for the month'.
Shot: Tight on a hand writing the new row; a pen writes a clean, permanent entry over a ghosted, erasable pencil version that gets Xed out.
Camera: Macro hold on the pen tip; no camera move so the permanence of the mark reads clearly.
Avatar: Voiceover; reassuring on 'something that can't be rubbed out or quietly changed later'.
Visual: Teach the permanent-record kernel (the MAR is read by the next MAP, the nurse, an inspector; what you write today must still say the same thing next week) without asserting the specific ink rule as APD-stated.
Animation: A pencil entry is rubbed away to show why an erasable row fails; a permanent pen entry writes in over it and holds; a red X lands on the rubbed-out version.
Infographic: Split still: an erasable/rub-out entry stamped 'a row nobody can trust' vs a permanent entry 'stays put'; a badge 'ink convention being confirmed' (never 'APD-required').
Shot: Full-screen animated front-of-MAR; the new empty Albuterol row fills field-by-field as four numbered fields type in; then a cursor hovers the order row and a 'do NOT sign here' stamp lands, redirecting to the day/time cell.
Camera: Digital zoom to the empty row; hold steady while the four fields type in one at a time; a small pan to the day/time cell on the 'your initials go here later' beat.
Avatar: Voiceover; count the four fields one, two, three, four; firm on 'you do NOT sign this row'.
Visual: Make 'second job - a complete row' concrete as four things the next person needs to give the med without guessing, and separate documenting-the-order from giving-the-dose (initials belong in the day/time cell, not the order row).
Animation: The four fields type into the empty row in sequence; an attempt to drop initials onto the order row stamps WRONG and the initials slide to the day/time cell; the start-date field shows '1/9' without labeling which date it means.
Infographic: Four numbered field callouts: '1 med+strength: Albuterol inhaler, 90 mcg/puff', '2 dose+route: 2 puffs, inhaled', '3 schedule: PRN for shortness of breath', '4 prescriber+start: Dr. Reyes, start 1/9'; a badge 'field set being confirmed - no diagnosis code depicted as required'; a red 'do NOT sign the order row' tag pointing off to the day/time cell.
Shot: A horizontal timeline: 10:00 AM order written → 3:00 PM pharmacy delivers (a delivery bag arrives and unlocks the first-dose cell) → 3:15 PM Don takes the puff → initials land in the 1/9 cell. An 'initialed at 10 AM' stamp flips to WRONG and corrects to '3:15 PM, after the puff'.
Camera: Track left-to-right along the timeline; hold on the delivery-unlock moment, then on the 3:15 sign moment.
Avatar: Voiceover; watch-the-clock cadence; re-land 'med's in your hand, client takes it, then you sign'.
Visual: Lock the source-safe core: the MAR records what really happened, at the time it happened; the first-dose cell can't be signed until BOTH the med is delivered AND Don has actually taken it - 'never, ever initial a dose you did not give'.
Animation: The delivery bag arrives at 3 PM and a lock icon on the first-dose cell opens; an 'initialed at 10 AM' attempt stamps WRONG; the initials move to the 3:15 cell after the puff animation.
Infographic: Timeline chips: '10 AM order (nothing given)', '3 PM delivery (med now in the home)', '3:15 PM Don takes the puff -> SIGN HERE'; a red callout on the 10 AM stamp 'WRONG - dose not given / not even in the home'.
Shot: Don takes his first puff, then a soft 'keep an eye on him' beat - a caregiver stays present and watchful; a dotted arrow points forward to a 'next lesson: first-dose observation (L3-10)' card.
Camera: Gentle medium two-shot of caregiver and synthetic client; slow settle, no rush; the forward-arrow card fades in last.
Avatar: Voiceover; warm, protective on 'you give it, then you watch'.
Visual: Plant the soft heads-up that a brand-new med's first dose is a moment to pay extra attention, WITHOUT teaching the observation rule itself (deferred to C-3.10) - a fire-and-forget first dose is the thing to avoid.
Animation: After the puff, a soft attention ring pulses around the client; a dotted bridge arrow draws to the 'first-dose observation (L3-10)' card and holds.
Infographic: A 'give it, then watch' chip; a forward-pointer card 'How long to watch / what to look for -> next lesson (L3-10)'; a footnote 'observation specifics: L3-10, not asserted here'.
Shot: MS Michele on camera with a split-screen reference of the finished 1/9 Albuterol row (complete four-field row + a signed 3:15 PM first-dose cell); close on centered Michele for the sign-off with the disclaimer footer.
Camera: Return to medium shot; picture-in-picture the completed 1/9 Albuterol row; end centered for the close.
Avatar: Michele on-camera; calm close; cue the two checks (build the row / pick the moment to sign).
Visual: Tie the two jobs together as one finished, readable record and cue the two knowledge checks (build a complete new-order row; pick the exact moment it's okay to sign the first dose).
Animation: The completed 1/9 Albuterol row + the signed 3:15 cell slide together into one reference still (reused as the KC review still); the mantra chip fades in; the disclaimer footer settles last.
Infographic: Closing chip 'Add the row, then sign only what you gave'; two check thumbnails 'KC1: build the row' / 'KC2: when to sign'; disclaimer footer 'APD-aligned educational content. Not an APD-approved training program.'
New-order row filling field-by-field on Don's current front-of-MAR: four numbered fields (med+strength, dose+route, schedule/PRN+reason, prescriber+start date) type into the empty Albuterol row; an attempt to sign the order row is redirected to the day/time cell. Built on APD Form 65G-7.008 A layout.
🖼 image prompt: Clean flat-vector medication administration record (MAR) grid, top-down, on a generic Florida APD MAR layout; a synthetic client's new empty medication row being filled with four labelled fields - 'Albuterol inhaler, 90 mcg/puff', '2 puffs, inhaled', 'PRN for shortness of breath', 'Dr. Reyes - start 1/9'; four small numbered field callouts; a red tag 'do NOT sign the order row' pointing to a separate day/time cell; a badge 'field set being confirmed'; neutral clinical palette, high legibility, synthetic content only, no logos, no real names. [APD] cell grid + [Waiver360-added] four-field completeness scaffold; [Needs Owner Review] TODO(source-L37-3) exact field set (no diagnosis-code field depicted as required) + TODO(source-L37-4) start-date meaning not defined.
🎬 video prompt: Four fields type into an empty MAR row one at a time - med+strength, dose+route, schedule/PRN+reason, prescriber+start date - into an 'Albuterol inhaler' PRN order; then a cursor drops initials onto the order row, stamps WRONG, and the initials slide to the day/time cell; no camera move; transparent background. [APD]+[Waiver360-added]; strike-free; TODO(source-L37-3/4) not locked (field set + start-date meaning modeled, not asserted).
Pen-only / permanent-record still: a permanent pen entry writes in over a ghosted, erasable pencil version that is rubbed away and Xed out - teaching that the MAR row must stay put (un-erasable), without asserting the specific ink rule as APD-stated.
🖼 image prompt: Close-up of a hand writing a new MAR row: on the left a faint pencil entry being erased/rubbed away stamped 'a row nobody can trust'; on the right a permanent ink entry that stays put stamped 'stays put'; a badge 'ink convention being confirmed'; neutral clinical palette, high contrast, synthetic content only, no real names. [Needs Owner Review] TODO(source-L37-1) pen/ink convention + TODO(source-L37-2) exact 'never pencil - the MAR is a legal record' phrasing - modeled as the permanent-record principle, never printed as 'APD-required'.
🎬 video prompt: A pencil MAR entry is rubbed away to nothing; a permanent pen entry then writes in over the same spot and holds; a red X lands on the erased version; no camera move; transparent background. [Needs Owner Review] (TODO source-L37-1/2 - permanence taught, ink rule not asserted as APD wording).
First-dose timing timeline: 10:00 AM order written -> 3:00 PM pharmacy delivery (a delivery bag arrives and unlocks the first-dose cell) -> 3:15 PM Don takes the puff -> initials land in the 1/9 cell; an 'initialed at 10 AM' stamp flips to WRONG and corrects to '3:15 PM after the puff'.
🖼 image prompt: Horizontal timeline diagram, left to right: '10:00 AM - doctor writes the order (nothing given)', '3:00 PM - pharmacy delivers the inhaler (med now in the home)', '3:15 PM - Don takes his first puff -> SIGN HERE'; a lock icon on the first-dose MAR cell that opens at delivery; a red callout on the 10 AM point 'WRONG - dose not given, not even in the home'; neutral clinical palette, synthetic content only, no real names. [APD] Module 1 s71 first-dose timing (source-safe core); scenario is Don Montana synthetic MAR practice, TODO(source-L37-6) step-ID reconciliation pending.
🎬 video prompt: The timeline plays: at 3 PM a delivery bag arrives and a lock on the first-dose cell opens; an 'initialed at 10 AM' attempt stamps WRONG; after a 3:15 PM puff animation the initials move into the 1/9 cell; no camera move; transparent background. [APD] (Mod1 s71 - safe to lock); scenario synthetic (Don Montana).
Completed 1/9 Albuterol row reference still: the finished four-field new-order row + a signed 3:15 PM first-dose cell, combined with the closing mantra chip and the compliance disclaimer footer; reused as the KC review still.
🖼 image prompt: Composited still: a completed MAR row 'Albuterol inhaler, 90 mcg/puff | 2 puffs, inhaled | PRN for shortness of breath | Dr. Reyes, start 1/9' with a signed '3:15 PM' initial in the 1/9 day/time cell; a chip reading 'Add the row, then sign only what you gave'; a footer reading 'APD-aligned educational content. Not an APD-approved training program.'; neutral clinical palette, synthetic content only, no real names. [Waiver360-added] mantra chip + [APD] four-field/first-dose model; field set/start-date badged per TODO(source-L37-3/4).
Prescriber order-sheet ↔ current-MAR side-by-side: the new order arrows from the order sheet into the next empty ROW on Don's existing January MAR; a competing 'fresh blank MAR' attempt is crossed out.
🖼 image prompt: Two-panel diagram: left a prescriber order sheet for a new PRN Albuterol order; right a full-page front-of-MAR for a synthetic client with existing medication rows and one next-empty row highlighted; a connector arrow from the order sheet into the highlighted empty row labelled 'add the new order HERE'; a small crossed-out thumbnail of a fresh blank MAR labelled 'do NOT start a new MAR'; caption 'one client, one MAR for the month'; neutral clinical palette, synthetic content only, no real names. [APD] add-a-row-on-the-current-MAR mechanic; [Needs Owner Review] TODO(source-L37-6) MAR answer-key step-ID reconciliation pending.
🎬 video prompt: The new order slides from the order sheet into the next empty row of the current MAR; a competing 'brand-new blank MAR' attempt slides in and gets a red X with a caption 'splits the record in two'; no camera move; transparent background. [APD]+[Needs Owner Review] (TODO source-L37-6 step IDs not locked).
Hook caption card 'New order - 1/9 - Albuterol PRN' with the two-jobs split ('1. Where does it go?' / '2. When do I sign?'), over the pharmacy-delivery B-roll.
🖼 image prompt: Caption card reading 'New order - 1/9 - Albuterol PRN' with a two-panel split below it '1. Where does it go?' / '2. When do I sign?'; a small footnote 'two-jobs framing: instructional'; warm neutral background, high legibility, no faces, no logos, synthetic content only. [Waiver360-added] two-jobs decomposition (badged, instructional); scenario dose traces to APD MAR practical exam (Don Montana), TODO(source-L37-6) step-ID reconciliation pending.
🎬 video prompt: The card scales in over a pharmacy delivery bag hitting a counter; the two-jobs split wipes in; a faint 'wrong way' preview (initials on the order row; a med with no row) flashes and is set aside; 3s; transparent background. [Waiver360-added] (two-jobs framing badged as instructional, not APD-verbatim).
Observe-after-the-first-dose bridge: after the first puff a soft attention ring pulses around the synthetic client and a dotted arrow points forward to a 'first-dose observation (L3-10)' card - a soft heads-up only, not the observation rule.
🖼 image prompt: A caregiver and a synthetic client after a first inhaler puff, with a soft attention ring around the client and a 'give it, then watch' chip; a dotted bridge arrow to a card reading 'How long to watch / what to look for -> next lesson (L3-10)'; a footnote 'observation specifics: L3-10, not asserted here'; warm neutral palette, no real names, synthetic content only. [Needs Owner Review] TODO(source-L37-5) first-dose-observation bridge framing pending L3-10 (soft heads-up only).
🎬 video prompt: After a first puff, a soft attention ring pulses around the client; a dotted arrow draws to a 'first-dose observation (L3-10)' card and holds; no observation rule is stated; 2.5s; transparent background. [Needs Owner Review] TODO(source-L37-5) (bridge only).
Full sample front-of-MAR page (reused from MA.L3-4.A / MA.L3-5.A / MA.L3-8.A) showing the medication/time rows, day columns, and the signature-legend strip; used as the backdrop that locates Don's existing meds and the next empty row for the new order.
🖼 image prompt: Flat-vector full-page MAR: medication/time rows down the left, day-of-month columns across the top, a signature-legend strip at the bottom with columns for printed name / signature / initials; neutral clinical palette; synthetic content only, no real names; exact legend column labels left generic (deferred to MA.L3-4.A TODO(source-3)). [APD]
Target runtime: 3:50 · 7 chapters · not rendered (url: null)
Learner sees an ordered timeline of scenario events (order written, delivery, administration, etc.) and places their initials on the single event at which it is correct to sign the MAR for the first dose. The correct event is gated: initials unlock only after BOTH the delivery event and the actual administration event. Selecting an earlier event fires an event-specific rationale (nothing given yet / med not in the home / med here but not given) and routes to remediation.
Learner completes a new empty row on a rendered MAR by dragging each candidate field chip into its labeled field slot. Every required slot must be filled with its correct chip. Distractor chips (e.g. an order-taker's initials, a stray day/time dose initial) belong in NO slot and route to a chip-specific rationale + remediation. The exercise verifies row completeness AND the 'do not sign the order row' rule (initials belong in the day/time cell, not the order row).