CRA: A Matter of Credibility & Recognition

Posted by

By Michael R. Hughes, CRA, FAHRA

August 2009 In order to address the matter of credibility and recognition of the CRA credential and program, I feel I should give you a little background on where the program came from, where it is now, and current plans for moving into the future.

The original funding for the development of “an advanced certification in radiology administration” was provided through a grant from Kodak. A business plan for the development of this certification was drafted in late 2000. A market analysis was performed prior to the plan’s development and indicated that 72% of those radiology administrators surveyed felt that an advanced certification program in radiology administration would be of value to them and to their organizations. The vision of the project was to “change the radiology profession through improved business practices.” The mission was to “establish an advanced certification program whose successful completion becomes the industry norm for imaging administrators.” The objectives of the advanced certification program were to 1) raise the business acumen of imaging administrators, 2) provide a standardized evaluation of imaging administrator’s performance, 3) enhance the status of imaging administrators in the healthcare community, and 4) ensure appropriate recognition of expertise as identified by the certification process. 

A Feasibility Team made up of AHRA & AHRAEF directors, officers, and members, along with AHRA’s legal counsel worked in concert with Knapp & Associates, a company specializing in designing certification programs, to review the potential models for advanced certification. According to Knapp & Associates, professional certification “certifies that an individual has demonstrated knowledge, skills, and/or abilities required to perform competently the responsibilities associated with a defined profession. The knowledge, skills, and/or abilities tested must be comprehensive—reflecting the full scope of the profession—and should be measured within the context of professional practice.”

The CRA program was developed, the credential was established, and the first CRA examination was given in July 2002. Castle Worldwide was contracted with to assure that the program followed generally accepted psychometric principles for practice analysis, test development, and validation. The RACC (Radiology Administration Certification Commission) was established as an autonomous entity to oversee the program. The guidelines followed during the development of the program and to date are those published by NOCA (the National Organization for Competency Assurance) and its accreditation body, NCCA (the National Commission for Certifying Agencies). NOCA is a membership organization created to provide a forum for all types of organizations interested in learning more about competency assessment, assurance, and certification. NCCA, an independent entity linked to NOCA, is responsible for setting the standards and approving certification programs for all professions and occupations. In other words, NCCA is a voluntary certification program for certifying organizations—a certifier of certifiers.

It is the RACC’s responsibility to oversee all aspects of the program, especially the credibility and integrity of the certification examination. Each CRA examination is developed in concert with Castle Worldwide. Test questions are developed and submitted by a group of “item writers,” all practicing CRAs, who either meet in person or provide input online. When the items (questions) are submitted, they must include a group of proposed answers, including the correct answer, along with a reference from which the question was developed and where the answer can be validated. These questions and answers are then “validated” by another group of practicing CRAs. The selected questions are then again reviewed for relevance and accuracy before being added to a test as experimental questions. Once these experimental questions have been used in a test, they are again evaluated before they are added to the pool of accepted questions to be used in scoring. Even after this process of validation, if a concern is raised about a question, it will be reviewed again by the RACC commissioners. Through these and other generally accepted psychometric procedures, we assure that the test is relevant and credible to the practice of imaging administration.

Since the initial test in 2002, the American Registry of Radiologic Technologists (ARRT) has granted 24 CEUs for passing the CRA examination. This is the same number of CEUs it gives for passing one of its own advanced certification examinations.

Since we implemented our current marketing plan in 2007, we have attended meetings of various professional organizations in imaging management/administration, healthcare administration, human resources management/administration, and imaging education. Through these efforts, we have attempted to raise the awareness and understanding of the CRA credential. As many of you have perhaps noticed either in your own searches, in articles, or from your colleagues, the phrases “CRA preferred” and “CRA required” are appearing in more and more job postings. A CRA requested that we give CEU credit towards CRA renewal for passing the ACHE (American College of Healthcare Executives) advanced certification test. After reviewing the areas evaluated in that test, the request was granted. Several other individual CRAs have identified other opportunities to spread awareness, acceptance, and recognition of the CRA program and are working with the RACC to expand the CRA’s recognition.

The RACC will soon be seeking accreditation by the NCCA. As I mentioned earlier, the NCCA accredits certifying bodies such as the RACC. I should note that virtually all medical certifying bodies are NCCA accredited, including the ARRT. We feel this is the next logical step toward broader recognition. 

Credibility and recognition go hand in hand. The RACC will seek to continue to assure the relevance, integrity, and credibility of the CRA credential. We will also continue to expand understanding and recognition of the CRA credential to other individuals and organizations. We urge all CRAs to assist us in these efforts in any way that you can. We are eager to work with all of you in this effort. It is through the actions and examples set by you, the individual CRA, that will ultimately bring long term success to the program.

Michael Hughes is Chair of the 2009 Radiology Administration Certification Commission (RACC). He lives in Acton, CA and can be reached at


  1. Michael, thanks for your leadership of the CRA as the Commission continues to enhance the credibility of the certification and drive growth. You have managed that dual task very nicely in my opinion. Kudos and congrats for a job well done. You’ve set the bar high for your successor, and you will leave the RACC in a better position because of your diligence and dedication. We could not ask for more, thank you. Sincerely, Roland

Post a Comment

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s