The Royal Australian and New Zealand College Radiologists (RANZCR) continuing professional development programme incorporates audit with feedback as one important activity. The 2004 audit tool improves radiation oncologist practice quality; however, the instrument is designed to be regularly refined. To refine the 2004 audit tool and present the new instrument we incorporated comments and suggestions from: (i) the auditor and radiation oncologist from the single machine unit trial; (ii) members of RANZCR Post-Fellowship Education Committee; (iii) New South Wales Department of Health mandatory prescription requirements; and (iv) the International Atomic Energy Agency audit tool. In July 2006, the revised instrument was designed then endorsed by Post-Fellowship Education Committee. Important changes include: (i) combining criteria which separately scored documentation and correctness for similar items; (ii) scoring treatment schedule more explicitly; (iii) separating target volume coverage and critical structure dose; (iv) altering performance criteria scoring to be sensitive to peer review when no consensus can be reached; and (v) strengthening instructions for use and notes to improve comprehension and acceptance. The refined 2006 instrument should be more user-friendly while increasing its usefulness.