When you are out of studio mode there are two ways to interact with a CareProgram. You can view the original (what is created through the studio) and you can SAVE A COPY of the original and begin interacting with the items. It will save automatically if you click "got it" or an answer choice in the lightning box the first time you view an item. That being said, once you've saved a list, you have saved that copy to your account and that is what you will see from now on when you are in patient mode viewing that specific CareProgram. If you switch back to the studio as a provider and make edits, the saved copy that you interacted with as a patient will not update, because as a patient, you are working off of the old saved copy. IN PATIENT MODE, you need to delete the CareProgram from your activity feed to see the new updated version.