California Medical Association (CMA) Standards
In 2021, the California Medical Association (CMA) announced new standards for Cultural Linguistic Competency (CLC) and Implicit Bias (IB) in CME. The goal of the standards is to support the role of accredited CME in advancing diversity, health equity, and inclusion in healthcare. These standards are relevant to ACCME-accredited, CMA-accredited, and jointly accredited providers located in California. CME providers must comply with California Assembly Bills 1195 and 241, as well as CMA standards, by incorporating elements that address cultural and linguistic competency and implicit bias into their continuing medical education activities.
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What is the CMA definition of Cultural & Linguistic Competency (CLC) and Implicit Bias (IB)?
Cultural Competency
CMA Definition: "The ability and readiness of health care providers and organizations to humbly and respectfully demonstrate, effectively communicate, and tailor delivery of care to patients with diverse values, beliefs, identities and behaviors, in order to meet social, cultural and linguistic needs as they relate to patient health."
What this means:
Cultural competency refers to the ability of healthcare professionals and organizations to effectively deliver care that meets the social, cultural, and linguistic needs of patients from diverse backgrounds. It involves an ongoing commitment to understanding, respecting, and responding to the unique values, beliefs, and practices of individuals and communities.
Culturally competent care requires more than just awareness, it includes the development of specific skills, behaviors, and systems that support equitable and respectful engagement across cultural differences. This includes:
- Acknowledging the impact of culture on health beliefs and behaviors
- Adapting communication styles and care approaches to meet patients’ cultural and linguistic needs
- Addressing biases and assumptions that may affect care delivery
- Creating inclusive environments that support trust, safety, and dignity for all patients
- By integrating cultural competency into practice, healthcare providers can help reduce disparities, improve patient satisfaction, and deliver more effective, person-centered care.
Linguistic Competency
What this means: Linguistic competency refers to the skills, knowledge, and resources that enable healthcare providers and organizations to communicate effectively with patients who speak different languages or have limited English proficiency. This includes not only the ability to use language appropriately but also ensuring that communication is clear, accurate, culturally sensitive, and accessible.
Linguistic competency helps to bridge language barriers, improve patient understanding, enhance trust, and ultimately promote better health outcomes by making sure patients fully comprehend their care and can express their needs. This includes access to qualified interpreters, translated materials, and communication strategies that are both culturally and linguistically appropriate. Linguistic competency ensures that patients fully understand their care and can make informed decisions, regardless of language barriers.
Key aspects include the use of qualified interpreters, translation of materials, training staff in cross-cultural communication, and providing services in patients’ preferred languages.
What is Implicit Bias?
Implicit Bias (IB)
CMA Definition: "The attitudes, stereotypes and feelings, either positive or negative, that affect our understanding, actions and decisions without conscious knowledge or control. Implicit bias is a universal phenomenon. When negative, implicit bias often contributes to unequal treatment and disparities in diagnosis, treatment decisions, levels of care and health care outcomes of people based on race, ethnicity, gender identity, sexual orientation, age, disability and other characteristics."
What this means: Implicit bias involves unconscious attitudes or stereotypes that can influence perceptions, actions, and decisions in ways that may disadvantage certain groups. These biases often operate without intentional awareness and can affect clinical judgment, patient interactions, and health outcomes. Addressing implicit bias requires ongoing reflection, training, and organizational accountability to foster more equitable and inclusive healthcare environments.
In healthcare, implicit bias can affect clinical decision-making, communication, and the quality of care provided to patients. It can contribute to health disparities by influencing diagnosis, treatment options, and patient-provider relationships. Addressing implicit bias involves increasing self-awareness, seeking feedback, engaging in ongoing education, and implementing strategies to reduce its impact in both individual behavior and institutional practices.
Explain Diversity Practices in Quality Healthcare
Diversity
CMA Definition: "Having many different forms, types or ideas; showing variety. Demographic diversity can mean a group composed of people of different genders, races/ethnicities, cultures, religions, physical abilities, sexual orientations or preferences, ages, etc."
What this means: The inclusion and representation of individuals from a wide range of backgrounds, identities, and experiences within the healthcare system. This includes differences in race, ethnicity, gender, gender identity, sexual orientation, age, ability, language, religion, socioeconomic status, and cultural background. A diverse healthcare environment values these differences and actively works to ensure that they are respected, understood, and reflected in the delivery of care.
Promoting diversity in healthcare is essential to providing equitable, patient-centered care. It helps address health disparities, improves patient outcomes, and strengthens trust between patients and providers. A diverse workforce also brings varied perspectives that enhance problem-solving, innovation, and cultural responsiveness in clinical practice, policy-making, and education.