Medicine and Nursing, Boards of; continuing education, bias reduction training.

The document status changed from a 'Senate Substitute' proposal to an 'Enacted Act' (Chapter 450), indicating the bill has passed all legislative stages and is now law.

The header information was updated to include the official chapter number and the approval date of April 8, 2026.

The formatting of the amended Code of Virginia section (§ 54.1-3011) was adjusted to reflect official statutory text, including the addition of section lettering (e.g., C. D., D. E.).

The document structure was altered to include page numbers, bill identifiers, and specific formatting styles typical of a House Substitute amendment, while the actual legal text and policy provisions were preserved without modification.

The specific content of the first required bias reduction training was changed to remove 'labor and delivery' from the list of covered periods and removed the explicit mention of 'conscious' bias, focusing only on 'unconscious racial bias'.

The specific mention of 'conscious racial bias' in the description of the first required training topic was removed.

The document header was changed from 'Enrolled' to 'House Bill Substitute' with updated dates and committee attribution, indicating a procedural revision rather than a substantive policy change.

The required training topic was broadened from 'unconscious racial bias' to include both 'unconscious and conscious racial bias' affecting care during pregnancy, labor, and the postpartum period.

Two new definitions were added to Section 4: 'Explicit bias' is defined as attitudes and beliefs on a conscious level, and 'Implicit bias' is defined as judgment or behavior resulting from subtle cognitive processes operating below conscious awareness.

The bill text was restructured from three sections to four sections to accommodate the new definitions, and the status changed from 'Introduced' to 'Enrolled' with formatting adjustments typical of final legislative text.