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.
| Work Settings | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Adult Acute Care |
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| Adult Outpatient |
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| Pediatric Acute Care |
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| Pediatric Outpatient |
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| Procedures | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Angio Studies |
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| Abdominal Aorta |
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| Abdomen |
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| Chest |
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| Circle of Willis |
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| Head without Contrast |
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| Lower Extremities |
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| Neck |
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| Pelvis |
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| Renal |
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| Subclavian |
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| Venogram Studies |
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| Carotid/Neck |
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| Renals |
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| Pelvis |
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| Upper Extremities |
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| Lower Extremities |
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| MR Studies |
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| Head/Neck |
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| Brain/Head w/wo Contrast |
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| Face w/wo Contrast |
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| Internal Auditory Canal w/wo Contrast |
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| Mandible w/wo Contrast |
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| Nasopharynx without Contrast |
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| Orbits w/wo Contrast |
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| Pituitary w/wo Contrast |
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| Soft Tissue Neck w/wo Contrast |
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| Sinuses w/wo Contrast |
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| TMJ w/wo Contrast |
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| Abdomen/Pelvis |
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| Abdomen w/wo Contrast |
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| Adrenals w/wo Contrast |
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| Buttock w/wo Contrast |
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| Cholangiogram |
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| Pelvis w/wo Contrast |
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| Prostate w/wo Contrast |
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| Renal w/wo Contrast |
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| Scrotum with Contrast |
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| Chest |
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| Brachial Plexus |
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| Breast w/wo Contrast |
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| Chest w/wo Contrast |
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| Myocardium w/wo Contrast |
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| Sternum w/wo Contrast |
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| Spine |
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| Cervical Spine w/wo Contrast |
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| Thoracic Spine w/wo Contrast |
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| Lumbar Spine w/wo Contrast |
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| Sacrum w/wo Contrast |
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| Upper Extremities |
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| Scapula w/wo Contrast |
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| Shoulder w/wo Contrast |
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| Arthrogram Shoulder |
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| Elbow w/wo Contrast |
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| Wrist w/wo Contrast |
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| Hand/Finger w/wo Contrast |
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| Lower Extremities |
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| Hip w/wo Contrast |
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| Knee without Contrast |
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| Ankle w/wo Contrast |
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| Foot w/wo Contrast |
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| MRI Scan Types | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Gradient Echo Imaging |
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| Multiplanar Reconstruction/MRA |
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| Spin Echo Images |
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| Surface Coils |
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| Extremity |
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| Head |
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| Neurovascular |
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| Shoulder |
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| Spine/Phase Array |
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| Torso |
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| T-1 Weighted Images |
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| Equipment | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Phillips |
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| Siemens |
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| Toshiba |
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| Hitachi |
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| General Electric |
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| Other: |
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| Age Specific Experience | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Newborn/Neonate (birth to 30 days) |
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| Infant (1 month to 1 year) |
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| Toddler (1 year to 3 years) |
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| Preschooler (3 years to 5 years) |
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| School Age Child (5 years to 12 years) |
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| Adolescents (12 years to 18 years) |
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| Young Adults (18 years to 39 years) |
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| Middle Adults (39 to 64 years) |
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| Geriatric Adults (65+ years) |
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| EMR | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Allscripts |
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| Aria |
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| Athena |
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| Canopy |
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| Cerner |
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| Epic |
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| Eclipsys |
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| Mckesson |
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| Meditech |
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| Other Computerized System |
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