Credentialling
Know who is credentialled to do what.
Your team is credentialled today.
New technology, new staff, new workflows, and changes in protocol mean it will drift without a system to monitor it.
The risk
Competency is perishable.
AyniHealth, backed by: Pavord et al. AAPM Subcommittee on Competency Evaluation. J Appl Clin Med Phys. 2016;17(4):5804. PMC5690041.
Competencies involve the ongoing verification of the performance of a procedure. Board certification alone is not an end point or a certification of competency.1
Reset by the new planning system upgrade
New technique, credentialling not yet started for most of the team
Two staff overdue for annual review
On track, one clinician returning from extended leave
Which means credentialling is never done. It is a cycle. Every new technique restarts it. Every new starter joins it. Every audit tests it.
Most teams run that cycle in spreadsheets and inboxes. It holds until the audit is announced. Then the scramble starts.
The standard
The professional imperative.
AyniHealth was built by clinicians who have run these programmes. We know what the cycle costs a department, because we have carried it.
This is not an administrative preference. It is a professional standard endorsed by every major body in radiation oncology.
AAPM
Board certification alone is not an end point or a certification of competency. Whenever new technologies are implemented, the entire staff would be subject to the credentialling process.
ASTRO
Establishing and maintaining an adaptive program requires a team-based approach, appropriately trained and credentialled specialists, significant resources, specialised technology, and implementation time.
ESTRO
Online MR-guided radiotherapy adds the MR environment to daily practice, which might be a new experience for many centres. New issues and challenges need to be thoroughly explored before starting clinical treatments.
The plan
The Adaptive Credentialling Protocol.
A protocol your team can run today. Three steps. Built on the published evidence. The same structure your team already knows: Align. Implement. Sustain.
Align
Credential the task, not the title.
Break online adaptive into its workflow units, from patient setup to contour review to plan approval to delivery. Map every task to the roles that perform it: RT, physicist, oncologist. Baseline each person against their tasks.
Implement
Train and verify to the task.
Move each person up a defined competency ladder, from observed to supervised to independent to able to teach. Sign off each tier with evidence. Follow the published RTT adaptive pathway.
Each tier signed off with evidence, following the published RTT adaptive pathway.
Online adaptive
The most demanding credentialling environment in modern radiation oncology.
Online adaptive treatments, where plans are modified in real time with the patient on the treatment table, make clinical decisions in minutes. The competency required is task-specific, technology-specific, and cannot be assumed from general qualifications.
MR-Linac (Unity, ViewRay)
- Who needs credentialling
- Radiation oncologists, medical physicists, radiation therapists
- Key competency areas
- MR safety, online contouring, adaptive plan approval, image interpretation
- Reference
- ESTRO-ACROP 2021; AAPM TG 284; ACPSEM MRILWG 2023
CBCT adaptive (Ethos)
- Who needs credentialling
- Medical physicists, dosimetrists, radiation therapists
- Key competency areas
- Automated segmentation review, plan selection, workflow-specific QA
- Reference
- AAPM TGs 384 & 395 (in development); Shepherd et al. 2021
MR-guided SBRT
- Who needs credentialling
- Radiation oncologists, medical physicists
- Key competency areas
- Gating, real-time tracking, online plan adaptation, motion management
- Reference
- ASTRO ART Safety White Paper 2024; AAPM TG 100
Online adaptive (any platform)
- Who needs credentialling
- The full clinical team
- Key competency areas
- Role-specific competency maps, decision-support tool use, on-call protocols
- Reference
- Shepherd et al. TIPSRO 2021; Hogan et al. J Med Radiat Sci 2023
Offline adaptive
The on-ramp to online adaptive, and an unrecognised exposure.
Offline adaptive treatments, where replanning happens between fractions based on accumulated dose, volumetric imaging, or clinical response, require equally rigorous competency frameworks. Each step involves a different role, a different competency, and a different credentialling requirement. None can be assumed from the original treatment plan approval.
What offline adaptive involves
- Weekly or triggered replanning based on anatomical change
- Accumulated dose analysis and dose-volume constraint review
- Adapted volume delineation and peer review
- Plan comparison and approval workflows
- Clinical decision-making on when to adapt versus treat as planned
Who needs what
- Radiation oncologists: volume adaptation, clinical decision authority
- Medical physicists: dose accumulation, constraint review, plan QA
- Dosimetrists: adaptive planning, constraint optimisation
- Radiation therapists: imaging acquisition, workflow execution
Many departments are already running offline adaptive workflows without formal task-specific credentialling. This is an unrecognised compliance exposure, and one that accreditation bodies are increasingly scrutinising.
Beyond a single procedure
Competency tracking.
Clinical credentialling is not a one-time event. The literature is explicit: competencies require ongoing verification. AyniHealth Connect is built around that principle, tracking competency across every relevant dimension of a clinician’s role.
Annual Competency Review
All staff across all active procedures. Timed, documented, auditable.
Automated scheduling and renewal alerts. Records held permanently and retrievable on demand.
New Technology Introduction
Entire team re-credentialled when new equipment or treatment technique is introduced, per AAPM guidelines.
Implementation of a new treatment unit triggers a credentialling workflow for every affected role. No manual tracking.
Role-Based Competency Maps
Oncologist, physicist, dosimetrist, RTT, nursing. Each role has different competency requirements for the same procedure.
Role-specific competency pathways configured per department. Each clinician tracks against their own map.
Scope of Practice Tracking
Evidence that staff are only performing tasks they are credentialled to perform. Critical for medico-legal protection.
Credentialling records linked to treatment assignments. Scheduling grounded in verified capability, not assumptions.
CPD and MOC Alignment
Continuing professional development aligned to maintenance of certification requirements.
CPD activities logged inside Connect. Completion tracked against role requirements and certification renewal dates.
New Staff Onboarding
New clinicians must demonstrate competency before performing procedures independently, not just complete training.
Structured onboarding pathways with milestone tracking. Supervisor sign-off required at each stage. Probationary credentialling until independence is verified.
Post-Absence Revalidation
Staff returning after extended leave may require competency revalidation before resuming full scope of practice.
Automated flagging when a clinician’s practice gap exceeds a defined threshold. Revalidation pathway triggered automatically.
The protocol is simple. Keeping it running is the hard part.
Schedules slip. Spreadsheets go stale. Evidence scatters across systems. Without a system, every audit starts from zero.
That is what AyniHealth does. The protocol, live and auditable.
The resolution
The protocol, as two products.
Both are in build. Individuals can start on the platform today; departments should talk to us about a pilot.
The protocol as a live worklist.
Every task, every role, every tier. Tracked as your team works. New technology triggers the credentialling workflow automatically.
The competency behind the protocol.
A guided reading and viewing pathway tied to each workflow unit, so every sign-off is built on the published evidence.
Sold through the Exchange. Fees apply.
Clinical credentialling should not live in a spreadsheet or across multiple systems. AyniHealth gives your team a single, auditable record of staff credentialling, competency, and readiness updated as training and assessments are completed.
When accreditation comes around, you are ready. When a procedure is updated or introduced, whether online adaptive, offline adaptive, or any new technique, you know exactly who can perform it and who needs extra time to get there. When a new staff member joins, their onboarding starts from a clear picture of where they are and what they need.
- Auditable credentialling records for every clinician, every procedure, every system
- Task-specific competency tracking for online and offline adaptive RT
- Role-based competency maps across all clinical roles
- Automated alerts when credentials are due for renewal
- Instant visibility for department heads, educators, and compliance teams
- Scheduling grounded in verified capability, not assumptions or seniority
- New technology introduction triggers automatic credentialling workflows
- Post-absence revalidation pathways built in
- CPD and maintenance of certification tracking aligned to role requirements
- Built for radiation oncology. Works for any clinical setting.
When accreditation comes, the evidence is already there.
References
Sources: Pavord et al., AAPM Subcommittee on Competency Evaluation, J Appl Clin Med Phys, 2016 · ASTRO Adaptive Radiation Therapy Safety White Paper, IJROBP, 2024 · Corradini et al., ESTRO-ACROP MR-Linac Recommendations, Radiother Oncol, 2021 · Shepherd et al., RTT oART Credentialling Pathway, Tech Innov Patient Support Radiat Oncol, 2021
- 1.Pavord L, Bellezza S, Christodouleas JP, et al. A report from the AAPM Subcommittee on Guidelines for Competency Evaluation for Clinical Medical Physicists in Radiation Oncology. Journal of Applied Clinical Medical Physics. 2016;17(4):5804. doi:10.1120/jacmp.v17i4.5804
- 2.Huq MS, Fraass BA, Dunscombe PB, et al. The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management. Medical Physics. 2016;43(7):4209. doi:10.1118/1.4947547
- 3.Quality and Safety Considerations for Adaptive Radiation Therapy: An ASTRO White Paper. International Journal of Radiation Oncology, Biology, Physics. 2024. doi:10.1016/j.ijrobp.2024.03474
- 4.Corradini S, Alongi F, Andratschke N, et al. ESTRO-ACROP recommendations on the clinical implementation of hybrid MR-linac systems in radiation oncology. Radiotherapy and Oncology. 2021;159:146-154. doi:10.1016/j.radonc.2021.03.025
- 5.An ESTRO-ACROP guideline on quality assurance and medical physics commissioning of online MRI guided radiotherapy systems based on a consensus expert opinion. Radiotherapy and Oncology. 2023;181:109504. doi:10.1016/j.radonc.2023.109504
- 6.Shepherd M, Graham S, Ward A, et al. Pathway for radiation therapists online advanced adapter training and credentialing. Technical Innovations and Patient Support in Radiation Oncology. 2021;20:54-60. doi:10.1016/j.tipsro.2021.11.001
- 7.Shepherd M, Joyce E, Williams B, et al. Training for tomorrow: Establishing a worldwide curriculum in online adaptive radiation therapy. Technical Innovations and Patient Support in Radiation Oncology. 2025;33:100304. doi:10.1016/j.tipsro.2025.100304
- 8.Hogan L, Jameson M, Crawford D, et al. Old dogs, new tricks: MR-Linac training and credentialing of radiation oncologists, radiation therapists and medical physicists. Journal of Medical Radiation Sciences. 2023;70:99-106.
- 9.ACPSEM Magnetic Resonance Imaging Linac Working Group. ACPSEM position paper on ROMP scope of practice and staffing levels for magnetic resonance linear accelerators. Physics and Engineering Sciences in Medicine. 2023;46:521-527.