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AAPM WG RO-ILS Recommended Curriculum on Quality Improvement and Incident Learning

Welcome to the AAPM WG RO-ILS Recommended Curriculum on Quality Improvement and Incident Learning! This curriculum represents an effort by the AAPM Working Group on RO-ILS: Radiation Oncology Incident Learning SystemŽ to create a Quality Improvement and Incident Learning module for Medical Physics and Radiation Oncology Residency Programs. It can be used alone or in conjunction with existing QI training.


The curriculum consists of 5 sections:
(1) Overview of quality and safety in radiotherapy
(2) Quality audit review
(3) Root cause analysis
(4) RO-ILS education review
(5) Incident Review (submission of 5 sample incident reviews)

The first four sections are described below. While we provide sample resources for training in quality improvement, we intend specific learning objectives to be determined by the individual program through explicit guidance and involvement of the program faculty. We intend that the program director and/or program faculty will review the curriculum with the resident to assess the achievement of learning objectives. The final section provides sample events and the opportunity to submit 5 sample incident reviews via a google form modeled after the RO-ILS incident learning system interface. This form is accessible using the link in the instructions below.


  1. Review and complete sections (1)-(4) described below with guidance from your program faculty.
  2. Access the “Incident Review” section of the curriculum by clicking here
  3. Follow the instructions in the form to review an incident and complete an incident review.
  4. Repeat step (3) for the remaining four incident reviews.
  5. Following your final review, attest that you have completed sections (1)-(4) and all five incident reviews and notify your program director that you have completed the curriculum.

Part 1 Section Details:

Section (1) - Overview of quality and safety in radiotherapy

Purpose: The resident should receive an overview of quality and safety in radiotherapy (e.g., quality and safety terminology and resources, quality management, radiotherapy incidents, incident reporting, etc.)
and become familiar with common practices and current initiatives in quality improvement and incident learning.

A few sample resources for programs without established training modules in quality and safety are listed below:

IAEA online e-certificate course on quality and safety

Safety is No Accident: A Framework for Quality Radiation Oncology and Care, sponsored by the American Society for Radiation Oncology

iTreatSafely “QA & Safety” series (NOTE: To access this link, please first visit https://i.treatsafely.org/ to create an account and log in. If you are not logged into your account, the link below will send you to the main iTreatSafely landing site.)

Pawlicki, Dunscombe, Mundt, and Scalliet (eds.) Quality and Safety in Radiotherapy. Boca Raton, FL: Taylor & Francis

“Quality and Safety in Radiation Oncology”. Ed. Dicker, Williams and Ford.

Section (2) - Quality audit review

Purpose: The resident should -

  1. review quality audits that have been performed in his/her clinic,
  2. become familiar with common quality audit procedures and practices,
  3. review credentialing and accreditation processes (see links below), and
  4. review specific departmental quality audit practices and resulting data.

These potentially include:

Section (3) - Root cause analysis

Purpose: The resident should be provided with an opportunity to perform a sample exercise in root cause analysis.

We recommend that the resident choose one event from their own clinic on which to perform root cause analysis. Guidance for the performance of root cause analysis can be found on the Center for Medicare and Medicaid Services website at:


and on the Veterans Administration National Center for Patient Safety website at:


Section (4) - RO-ILS education review

Purpose: The resident should be familiar with the RO-ILS aggregate reports and with departmental quality initiatives. We recommend that the resident review the most recent RO-ILS aggregate report (available at https://www.astro.org/Patient-Care-and-Research/Patient-Safety/RO-ILS/RO-ILS-Education), then attend one or more institutional departmental quality meeting(s) and present an event from this report to the committee.