Radiology Technologist Skills Checklist
   NAME  
   Email-Id
   DATE    
I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

Instructions:

This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

 
Proficiency Scale: 1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

 
Rating Stars (Click)
SETTING 1
2
3
4
Adult Inpatient
ER/Trauma
Adult Outpatient
Pediatric Inpatient
Pediatric Outpatient
Rating Stars (Click)
Procedures 1
2
3
4
Chest Studies
Abdominal Studies
Foreign Body/Soft Tissue Studies
Specimen Radiography
Rating Stars (Click)
Extremities 1
2
3
4
Upper
Lower
Pelvis Obls/Judet Views
Pelvis SI Joints
Pelvis Sacrum/Coccyx
Rating Stars (Click)
Spine 1
2
3
4
Cervical Spine-Obls/Flexion/Extension
Thoracic Spine-Swimmers View
Lumbar Spine-Obls/Flexion. Extension
Rating Stars (Click)
Head 1
2
3
4
Facial Bones
Mandible
Rating Stars (Click)
Head (cont.) 1
2
3
4
Mastoids
Orbits
Sinus Series
TMJ
Skull Series
Rating Stars (Click)
Tomography 1
2
3
4
Renal
TMJ
Spine
Rating Stars (Click)
Flouroscopy/Contrast Studies 1
2
3
4
Barium Swallow/Esophagram
Modified Barium Swallow/Protocol Swallow
Swallow Studies with Videotaping
Upper GI Series-Single Contrast
Upper GI Series-Air Contrast
Small Bowel Follow Through
Rating Stars (Click)
Enema Studies 1
2
3
4
Barium Enema-Single Contrast
Water Soluble Contrast Enema (e.g. Hypaque)
Barium Enema-Air Contrast
Lower GI Studies thru Colostomy
Rating Stars (Click)
Cystography 1
2
3
4
Cystogram
Voiding Cystogram
Rating Stars (Click)
Cystography (cont.) 1
2
3
4
Urethrography
Rating Stars (Click)
Contrast Injection Studies 1
2
3
4
IVP
IVP with Tomograms
Rating Stars (Click)
Myelograms 1
2
3
4
Cervical Spine
Thoracic Spine
Lumbar Spine
Rating Stars (Click)
Mobile C-Arm Flouroscopy 1
2
3
4
Broncoscopy with Fluoro Guidance
Bedside Line and Tube Placement
Rating Stars (Click)
OR Cases 1
2
3
4
Sterile Procedures in OR
Spine Work
Operative Cholangiography
Hip Studies
Extremity Studies
Cystography
Retrograde Urography
Rating Stars (Click)
Patient Safety 1
2
3
4
National Patient Safety Goals
Computerized Charting
Rating Stars (Click)
Age Specific Practice Criteria 1
2
3
4
Newborn/neonate (birth-30 days)
Infant (30 days-1 year)
Toddler (1-3 years)
Preschooler (3-5 years)
School age children (5-12 years)
Adolescents (12-18 years)
Young adults (18-39 years)
Middle adults (39-64 years)
Older adults (64+)