Journal of Microbiology & Biology Education

In the United States, STEM graduate programs and workforce do not represent the demographics of the population. Obstacles, including a lack of transparency, community, and accessible information in navigating academia, disproportionately affect students from underserved backgrounds. Peer mentoring networks can address these disparities. Here, we describe Cientifico Latino, Inc.s Graduate Student Engagement and Community (CL-GSEC) program, a nationwide, group-based peer mentorship program that has served first-year graduate students across the U.S., especially those from underserved backgrounds. Surveys indicate CL-GSEC positively impacts the first-year graduate experience. We highlight key program features, challenges, and insights, such as financial strains faced by first-year graduate students. We offer suggestions for how faculty and departments can better support students during this critical early stage of graduate training. We hope that reporting on CL-GSECs program structure, evaluations, and findings will guide educational leaders in expanding programming for junior graduate students.

Course-based undergraduate research experiences (CUREs) can expand undergraduates access to research and motivate students to stay in science. Yet, little research has examined how CURE instruction shapes student motivation. We leveraged a motivation-related characterization of non-content talk of 48 CURE and non-CURE instructors to predict the motivation-related outcomes of 462 students. We fit a series of multi-level models (MLM) in which we regressed students post-course scientific self-efficacy, task values, scientific identity, and science-related intentions onto instructors self-efficacy and task values-related talk, controlling for students pre-course levels. We also fit an MLM to explore whether instructors relationship-building talk (immediacy talk) was associated with students rapport with their instructor. Instructors self-efficacy talk did not affect students self-efficacy, and instructors immediacy talk had a marginally positive but non-significant association with students rapport ratings. Instructors task values talk positively influenced students scientific identity and some but not all of their task values. Instructors task values talk also positively influenced students intentions to pursue a science career, but not graduate education or research careers. Collectively, these results suggest that instructors task values talk may underpin some of the motivational effects of CURE instruction, but that task values talk need not be limited to CUREs. HIGHLIGHTWe examine whether instructor talk predicts students motivational outcomes in CURE and non-CURE lab courses. Self-efficacy talk had no effect on student self-efficacy. Task values talk positively affected students science identity and career intentions, and some value beliefs. Immediacy talk was marginally related to student-instructor rapport.

Lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) students continue to face violence, exclusion, and barriers at school, including in STEM education. A key underexamined factor in diversity, equity, and inclusion (DEI) efforts is the content of the life science curriculum, which is uniquely positioned to reinforce or refute bioessentialist, binary, and heteronormative biases. Outdated science curricula not only conflict with current scientific evidence but can also perpetuate beliefs that contribute to sexism and LGBTQIA+ marginalization. To address this, we designed four gender and sexual diversity (GSD)-inclusive biology activities, aligned with NGSS standards, and informed by inclusive curriculum frameworks. Using a mixed-methods approach, we studied 127 high school students who participated in two or more inclusive biology activities. Surveys conducted before and after implementation showed significant reductions in essential, binary beliefs about sex and gender, and increases in affirming attitudes toward sex and gender diversity. Interviews conducted after implementation further revealed differences between LGBTQIA+ and straight students conceptualizations of biological sex. Our findings demonstrate that even brief curriculum interventions can shift student attitudes, although we hope future studies will explore the impact of sustained interventions. Updating life science instruction is essential for educational equity and scientific accuracy.

Graduate-level genomics courses require students to integrate dense material across subfields, concepts and methods. In modular, multi-instructor courses, students may struggle because the coherence between lectures can be difficult to navigate, while the course structure may be visible to instructors. We evaluated a 2025 navigation redesign of BIO322, a graduate genomics course at the Norwegian University of Life Sciences, while preserving course content, multi-instructor teaching, modular organization and assessment framework. The redesign includes introducing a standardized self-learning guide, expanded syllabus, enriched online quiz feedback, and added support for a final group research proposal. Using anonymized course evaluation scores from 2021-2025 and aggregated learning management system access data from 2023-2025, we examined student experience and resource use. In 2025, five of six course evaluation items reached their highest observed BIO322 scores, while one, lecture-specific score remained within the previous range. The consolidated self-learning guide was accessed by nearly all students, whereas access to optional readings declined across the course sequence, despite comparatively stable page views per accessing student. These course-level findings are consistent with improved perceived navigability following the introduction of standardized learning support. However, some students continued to report difficulty identifying priorities and connections among course components, indicating that challenges in perceived course coherence remained for part of the cohort despite the redesign. Practitioner PointsO_LIMaking course structure explicit may improve students perceived navigability in multi-instructor graduate genomics courses. C_LIO_LIA centralized self-learning guide can broaden access to preparatory guidance without changing core course content or assessment. C_LIO_LIOptional learning supports may be used unevenly, so resource availability should not be assumed to translate into uniform resource access. C_LI

Biodesign is an interdisciplinary research domain that incorporates principles from design and the life sciences to develop new systems, processes, and objects. Collegiate biodesign educators face unique pedagogical challenges, including an absence of relevant scholarship on curriculum design and instructional best practices for cultivating student scientific literacy. These difficulties may be overcome with newly available technologies, like generative AI systems, that enable personalized learning through domain-specific semantic spaces. This article examines the instructional value of one such domain-specific LLM, Biodesign Buddy, through a mixed-methods analysis of an eight-week study involving 64 students participating in an international biodesign competition. Results indicate strong support for integrating AI into biodesign coursework. Surveys captured attitudes toward AI, scientific literature, and learning experiences to assess AIs impact on learning outcomes. Findings suggest that integrating AI into biodesign pedagogy can meaningfully redress conceptual issues in biodesign while informing broader debates on AIs role in higher education. Impact StatementThis article introduces Biodesign Buddy, a domain-specific generative AI system for collegiate biodesign education, and reports on its exploratory deployment, offering design principles and preliminary findings to inform the development of AI-supported pedagogies for interdisciplinary biodesign instruction.

Understanding what is requisite for attaining a biomedical faculty career is crucial for guiding trainees preparing for these roles. For nearly two decades, we have collected accounts of biomedical training and career transitions from a large cohort through annual in-depth interviews and tracking of competencies and achievements. This paper elucidates the common and varied credentials of 40 who entered research-intensive faculty careers (RIFCs). Participants completed PhDs and postdocs in a range of research-intensive institutional settings. Developing research independence and a niche were essential to RIFC attainment, and mentors played a crucial role in this development. Counter to common assumptions, high-prestige publications and grants were not in and of themselves necessary for RIFC attainment. Our findings can aid RIFC aspirants and mentors who guide them.

Seismic shifts within academia over the last several decades have seen the growth of biomedical PhD recipients alongside the relative stagnation of tenure-track research-intensive faculty careers (RIFCs). This hypercompetitive academic job market has prompted interest in the paths of those who attain RIFCs. Understanding what drives recent biomedical PhDs to make their career decisions and persist toward them requires a clear picture of how career perceptions, motivations, and intentions develop and crystallize over time. Using annual in-depth interviews across nearly two decades, this report explores the evolution of career thinking and differentiation among 40 who attained a RIFC from diverse starting points to their attainment of a RIFC. Participants strategies for navigating early scientific experiences were patterned by their varied educational and socioeconomic backgrounds. Nearly half of participants did not start with or maintain stable interest in RIFCs, exhibiting changes in both PhD and postdoctoral phases. Participants highlighted six drivers toward RIFCs including desire for independence/autonomy and contributing to knowledge/health. Our results are instructive for trainees and mentors guiding career exploration and differentiation.

Improving diversity in U.S. Alzheimers disease (AD) research is a pressing need. By 2050, Hispanic and Latino Americans will comprise 30% of the population. Hispanics are 1.5 times more likely and Blacks are twice as likely to develop AD compared to Whites, yet both remain vastly underrepresented in clinical trials research. Aging and AD research mentorship of underrepresented STEM undergraduates is designed to promote entry into related professions by students committed to decreasing disparities in AD research participation and clinical care. The NIA-funded MADURA program recruited 93 students from backgrounds historically underrepresented in STEM majors and/or from NIH-defined disadvantaged backgrounds. Trainees were placed in aging/AD research labs and received weekly training and mentorship from faculty research PIs and other types of supervisors (postdoctoral researchers, graduate students, research assistant staff...) Our study examined student ratings of the program and mentor behaviors, using a program-specific survey and the Mentoring Competency Assessment-21 (MCA-21). Trainees were highly satisfied with both mentoring relationships and the overall program. Student rated MCA-21 competency areas were quite high for both P.I.s and other types of research mentors. However, there were striking differences in associations between competencies and relationship and program satisfaction, by mentor type. For PI mentors, no MCA-21 competencies were associated with relationship satisfaction, but five of six competencies were associated with relationship satisfaction for other mentor types. Similarly, no PI mentor competencies were significantly correlated with overall placement satisfaction, but all six competencies were correlated with overall placement satisfaction for other mentor types. The authors discuss the likelihood of differing student expectations of faculty PI versus other types of research mentors, recommendations for assessing role-specific student expectations (including functions primarily possible only for senior faculty PIs), and utilizing nearer-peer plus PI faculty mentors to comprehensively address the gamut of mentee needs.

Microbiome science is increasingly important in modern biology education because microbial communities influence human health, ecosystems, and environmental processes. However, undergraduate microbiome instruction is often limited by the high cost and technical complexity of sequencing-based workflows, restricting opportunities for authentic student-driven research. To address this challenge, we developed a low-cost, inquiry-based curriculum that enables undergraduate students to conduct complete microbiome studies using 16S rRNA gene sequencing. The module integrates project design, environmental sample collection, microbial cell processing, PCR amplification, sequencing, and bioinformatic analysis using open-source tools such as QIIME 2. Cost-reduction strategies included centrifugation-based cell collection and a surfactant-assisted direct PCR workflow that eliminated the need for commercial DNA extraction kits. Students designed independent research projects investigating microbial communities in local environments, including campus water sources and gym equipment surfaces. Assessment data from post-course surveys, knowledge checks, and student research products demonstrated strong learning gains in microbiome concepts, molecular biology techniques, scientific communication, and computational analysis. Students reported high confidence in PCR, experimental design, and microbiome interpretation, while also identifying bioinformatics as the most challenging yet rewarding component of the curriculum. All participants expressed increased interest in future research in microbiology or bioinformatics. Overall, this curriculum provides an accessible, scalable framework for integrating next-generation sequencing into undergraduate education while promoting inquiry-driven learning, student ownership, and engagement in authentic scientific research.

Virtual reality (VR) offers immersive and interactive learning environments that can improve student engagement and 3D visualization. However, its application in medical education is mostly limited to clinical settings and its potential for better understanding complex concepts, or empathy with the patients, remains underexplored. Here, we describe SIGHT (Simulated Immersive Guidance for Human Training), an immersive VR application, designed to teach core concepts in the physics and functional neuroanatomy, or neurophysiology of human vision. Its two integrated learning modules allow first-person experience of normal and pathological conditions: the optics module enables users to manipulate lenses, experience refractive errors such as myopia, presbyopia, and astigmatism and correct them through appropriate lens selection; the neurophysiology module allows learners to navigate the visual pathways from the retina to the visual cortex and to simulate lesions, experiencing the corresponding visual field deficits. User authentication and interactive evaluation steps provide analytical feedback of the experience and learning process. A pilot group of medical students reported high usability, engagement and deeper understanding of the vision-related concepts, showing how the approach of SIGHT can support experiential learning in medical education.

BackgroundParticipating in research during medical school is supported by institutional programs and may influence subsequent professional development. ObjectiveWe aimed to describe the current status and heterogeneity of scholarly research programs for medical students in the United States, including expectations, support, and key structural features. MethodsWe conducted a cross-sectional web audit of official webpages for all accredited US MD- and DO-granting medical schools (search performed September 2024 to January 2025). Extracted variables included participation requirements, mentorship, timing and duration (overall and dedicated research time), expected scholarly outputs, funding sources, stipend information, and stated program goals. We compared Carnegie tier R1 (Very high research activity) versus other institutions, QS Top-50 versus other institutions, and MD versus DO schools using {chi}2/Fisher exact tests for 2x2 tables and exact trend or Freeman-Halton tests for multicategory variables. ResultsPrograms were identified for all 202 institutions. Funding was explicitly mentioned by 61.9% (125/202) of programs, 27.0% (51/189) were compulsory, 98.9% (188/190) reported faculty mentorship, and 91.0% (171/188) were exclusive for medical students. Program duration, dedicated time, expected outcomes, stipend reporting, funding sources, and stated goals varied widely. Carnegie R1 institutions had longer duration (P=.002) and tended to report external funding more often than other institutions (25/104, 24.0% vs 9/98, 9.2%; OR 3.13, 95% CI 1.38-7.10; P=.008). QS Top-50 institutions were more likely to require compulsory participation than other institutions (11/19, 57.9% vs 40/170, 23.5%; OR 4.47, 95% CI 1.68-11.87; P=.003). No significant differences were observed between MD and DO programs across most measured characteristics. ConclusionsScholarly research programs for medical students are ubiquitous across US medical schools but heterogeneous in structure, expectations, and support. Research-intensive and top-ranked institutions may have more external funding and sometimes may put together longer and compulsory programs Further evaluation of student experiences and outcomes is warranted.

BackgroundAmid persistent structural barriers and recent national policy changes, early-career physician-scientists face mounting challenges that threaten the sustainability of the biomedical research pipeline in the United States. MethodsWe surveyed early career physician-scientists collecting demographic data, career development support, distribution of clinical and research responsibilities, funding, and perceived career challenges. The survey was distributed by email to the department chairs at 110 institutions in the United States. ResultsA total of 175 surveys were completed. About half 50.8% (n=89) of respondents received a career development award, with 28.9% of respondents reporting limited institutional/departmental support. The most reported challenges were balancing clinical, research, and educational responsibilities (72.5%, n=127); balancing work and family responsibilities (48%, n= 84); limited funding opportunities (48%, n=84); and under-compensation (34.3%, n=60). About 57.7% (n=101) of respondents had considered leaving academic medicine within the next two years, and 83.2% (n=139) indicated a >50% likelihood of doing so within five years. The most frequently cited reasons for attrition were funding challenges (72%, n=126), under-compensation (42.3%, n=74), feeling unhappy or stressed (40.6%, n=71), and burnout (37.7%, n=66). Furthermore, 43.9% (n=76) of respondents reported considering relocation outside the United States for better academic working conditions, and 10.4% (n=18) had already been contacted by institutions abroad. ConclusionEarly-career physician-scientists face substantial structural and financial challenges, with limited institutional support, high rates of burnout, and widespread intent to leave academia. These findings underscore an urgent need for sustained investment, targeted retention strategies, and policy reforms to stabilize and strengthen the physician-scientist workforce in the United States.

Engagement is widely recognised as central to learning and academic achievement. Electrodermal activity (EDA) has emerged as an objective physiological indicator of engagement, as it measures sympathetic nervous system activation. However, the high cost of wearable EDA sensors has limited its widespread application. This study answers the call for affordable, high-temporal-resolution engagement measures by validating a video-based quantitative assessment method. Researchers collected 75 minutes of synchronised EDA and video data from 12 upper secondary students (aged 17-18) during regular instruction. Novel software was developed to analyse student movement and sound level for academically relevant content. The OpenPose AI model for pose estimation was also applied. This approach produced six distinct movement variables: two AI-based and four non-AI-based. Six linear models using varying movement variables and sound level were tested to predict tonic EDA levels. All models effectively predicted EDA levels, with non-AI-based movement metrics outperforming AI-based alternatives. The four non-AI-based movement models showed similar performance, indicating that compressed versions reduced computational time without sacrificing predictive power. These findings validate a novel, objective method for comparing engagement across learning activities on short timescales. This method is particularly useful for collaborative learning environments and enables controlling for movement and sound in quantitative classroom analyses.

M.D.-Ph.D. programs in the United States have traditionally followed a "2-n-2" curricular model, with the graduate phase occurring between the pre-clerkship and clerkship portions of medical training. While well established, this format can limit trainee autonomy in shaping their physician-scientist training trajectories. In response, some programs have introduced a "3-n-1" model, allowing students to complete clerkships before beginning Ph.D. training. Our institution implemented multiple flexible curricula in 2017. Understanding why trainees choose one pathway is important as programs consider implementing more adaptable training structures. To investigate these factors, we surveyed M.D.-Ph.D. students at our institution, which offers multiple flexible curricular alternatives, about contributions to their curricular decisions. Responses supported that trainees weigh considerations across medical education, scientific development, and integrated physician-scientist training domains. Although the traditional pathway was a popular option, most students pursued one of the flexible pathways. Our findings suggest that introducing flexibility in the timing of undergraduate medical education and graduate training can support diverse educational, logistical, and personal priorities while maintaining the rigor of physician-scientist training. Offering multiple pathways empowers trainees to design trajectories that best fit their needs. Continued longitudinal studies are needed to assess the long-term impacts of flexible curricula on physician-scientist career outcomes.

Despite questionable accuracy, subjective methods to categorize skin color are heavily relied upon in research and medicine. Objective skin color determination is expensive requiring specialized instrumentation and interpretation. We compare three subjective approaches, i) Fitzpatrick Skin Type Scale (FST), ii) Pantone SkinTone Guide (PST) and, iii) Monk Skin Tone Scale (MST), with objectively measured skin color from a spectrophotometer in 87 volunteers to understand the limitations of each method. In agreement with others, we show that the popular FST questionnaire correlates poorly with the objective approach. However, PST color swatches provide good correlation with spectrophotometer measurements. PST consists of 110+ swatches that are inexpensive and easy to use, however, similar to other reports, the volunteers found the number of swatches overwhelming and/or excessive. We found that the recently introduced MST is not representative of reality with only 3 of the 10 color groups representing our volunteers and published populations of volunteers. In future, we propose using 9 color swatches to split the spectrum of human skin color into 10 groupings (Nottingham Skin Categories - NSC) that are representative of the global population. This new approach would be easy to implement and inexpensive in research, healthcare and cosmetics settings, and maps directly to objective, quantitative, measures taken with a spectrophotometer. For the testing and development of new optical devices, NSC would provide increased comparability between studies and ensure studies are representative of local/global populations. In the clinic NSC would be useful for dermatology, photodynamic therapy and dosage assessment for topical medicine, for example.

ObjectivesEffective communication about genetics concepts is essential for collaborative anthropological genetics research. However, communication can be challenging because many ideas are abstract and may be especially unfamiliar to communities with limited access to formal education. Indeed, there are no widely adopted models for communicating such information, nor a clear understanding of the social factors that may shape participant engagement. Here, we conducted a qualitative and quantitative, community-driven study to understand how illustrations can be useful to support concept sharing with two Indigenous groups--the Orang Asli of Peninsular Malaysia and the Turkana of Kenya. MethodsWe used a two phase approach to create and evaluate how illustrations can bolster communication about genetics concepts. First, we created images illustrating answers to frequently asked questions about genetics, iteratively updating the illustrations based on participant feedback. Second, we conducted 92 interviews to evaluate the finalized illustrations effectiveness. Finally, we analyzed the interview data using thematic analyses, multivariable modeling, and multiple correspondence analyses to identify patterns in participant understanding and feedback, including age, sex, market integration, and schooling. ResultsParticipants reported high interest in genetics research (92%) and broadly positive perceptions of the illustrations. Familiar, locally-grounded imagery was preferred and associated with greater perceived clarity, while more technical illustrations were more frequently reported as confusing. Quantitative analyses showed strong internal consistency across measures of engagement and understanding, with modest variation by degree of market-integration, schooling, and sex. DiscussionOur findings demonstrate that community-specific visualizations, co-developed through iterative feedback, can effectively support engagement with genetics research in participant communities.

The experimental use of antibodies that have not been validated for context-specific use frequently misdirects biomedical research. Experimental results that derive from the use of inadequately validated antibodies are estimated to waste over $1 billion annually in the United States alone and to consume millions of animal and human biological samples in experiments whose conclusions may be unreliable. Community validation frameworks, reporting standards, and independent characterisation initiatives have made important progress, and multi-stakeholder coordination efforts are emerging. However, the research community lacks a formally developed, consensus-based action plan that specifies what each stakeholder group should do, by when, and with what priority. We conducted a modified Delphi study with international experts representing academic researchers, scientific publishers, research funders, antibody manufacturers, and institutional research leaders to develop actionable recommendations for improving antibody validation, selection, and reporting practices. Thirty-two participants rated 33 proposed actions on effectiveness and feasibility using 9-point scales, with consensus assessed using the RAND/UCLA Appropriateness Method. Over two rounds, the panel achieved consensus on 15 items as both effective and feasible for implementation by 2030. These spanned institutional actions (training in antibody validation, integration into research integrity frameworks, support for local expertise networks), funder actions (dedicated validation budgets, grant application requirements, endorsement of community reporting standards), publisher actions (complete antibody reporting packages, clear validation standards), manufacturer actions (assignment of unique identifiers at source), and cross-stakeholder coordination (a shared roadmap for improvement). An additional 15 items were rated as effective but with uncertain feasibility, reflecting a consistent pattern in which the panel agreed on the value of proposed interventions but expressed reservations about realistic implementation timelines. One item was rejected by the panel with concerns around effectiveness and feasibility. Participants described four interconnected barriers to progress: diffuse ownership of the problem across stakeholders; market dynamics that inadequately reward antibody quality; difficulty justifying investment when returns are distributed across the research system; and coordination challenges among actors with different incentive structures. These barriers are addressable through coordinated action, and the findings complement existing technical and data-sharing initiatives by providing the structured, stakeholder-endorsed policy framework needed to translate awareness of the problem into concrete practice and policy changes.

The transition to higher education is characterized by increased academic demands and psychosocial stress, which may negatively affect cognitive functioning and student well-being. Executive functions (working memory, inhibitory control, and cognitive flexibility) are critical for academic adaptation and can be enhanced through structured interventions. Physical exercise, mind-body practices, and cognitive training have demonstrated potential benefits for executive functioning and stress reduction; however, few randomized controlled trials have directly compared interventions with different physical and cognitive demands in university students, particularly in Latin America. In addition, most studies have relied on self-report measures and physiological stress biomarkers such as salivary cortisol. This protocol describes a three-arm, parallel-group randomized controlled trial designed to evaluate the effects of a 12-week intervention on executive functions and stress in first-year university students. The study will recruit 120 first-year health-science students aged 18-25 years. Participants will be randomly assigned (1:1:1), using block randomization stratified by sex, to one of three interventions delivered twice weekly (24 sessions of 60 minutes): (1) moderate-to-vigorous motor-cognitive dual-task exercise (DT); (2) low-to-moderate intensity Tai Chi (TC); or (3) supervised digital cognitive stimulation (CS) using structured graphomotor tasks. Primary outcomes include executive functions assessed through standardized neuropsychological measures. Secondary outcomes include stress will be evaluated using the Academic Stress Inventory, Depression Anxiety Stress Scales and salivary cortisol collected in the morning using passive drool and analyzed by competitive ELISA.Other outcomes include physical activity levels, anthropometric and body composition measures, and handgrip strength. Data will be analyzed following an intention-to-treat approach using repeated-measures models, with multiple imputation for missing data. The study has received institutional ethics and biosafety approval. Trial registration: ClinicalTrials.gov Identifier: NCT07443904.

Peer reviewers provide a critical service to NIH by evaluating the scientific and technical merit of grant applications. While the tangible rewards for this service are limited, many reviewers feel review service makes them better applicants, improving their grant competitiveness. However, empirical evidence for this claim is limited. This study evaluates relationships between early career peer review service and subsequent application behavior and funding outcomes. Using NIH administrative data, applicants who served as Early Career Reviewers (ECRs) during the 2020 - 2021 council years were compared to a matched group of ECR-eligible applicants who had not served as reviewers (n=1,120 per group). To address non-random selection of ECRs, propensity score matching was used to balance groups on research field, demographics, productivity, career stage, and institutional resources. Outcomes, assessed over a three-year follow-up period, included submission volume, peer review scores, and funding outcomes for R01 and R01-equivalent applications. ECRs submitted more applications, were more likely to have their applications discussed, and were more likely to receive a high review score than matched controls. They were also more likely to receive R01 funding. While peer review scores do not solely determine award outcomes, these findings indicate that peer review service among ECRs is associated with improved grant application outcomes.

Background: Black patients and individuals with low socioeconomic status (SES) face significant disparities in accessing curative therapies for hepatocellular carcinoma (HCC), including liver transplantation. This study aimed to develop provider-co-created intervention prototypes in response to patient-identified barriers and recommendations. Methods: A human-centered design session with hepatology and transplant providers at a large academic medical center was conducted. Prior to the session, participants were presented with barriers and preliminary solutions identified through an earlier human-centered design session with Black and low-SES patients. Using structured ideation methods, including brainwriting, challenge mapping, and concept voting, providers co-created intervention prototypes. Final concepts were synthesized from patient insights, provider input, and design methods using affinity diagramming and concept modeling. Results: Nine providers participated in the session. They focused on three key areas for intervention: inefficiencies in transplant pre-evaluation, inadequate social support, and information overload. Solutions included: (1) a structured triage pathway to standardize referrals and reduce delays; (2) a peer navigator model to guide patients through the transplant process; and (3) a multimodal transplant education roadmap to improve comprehension and engagement. These prototypes addressed both patient- and system-level barriers. Conclusions: Protypes developed through provider-led design, grounded in patient-identified barriers and co-created ideas, can yield actionable, scalable strategies to advance equity in HCC care. Future work will refine these prototypes through patient feedback and pilot them in clinical settings.