ADEX Medical Staffing - MRI Tech Skills Checklist

MRI Tech Skills Checklist

This assessment is for determining your experience in the below outlined clinical areas. This checklist will not be used as a determining factor in accepting your application for employment with ADEX Medical Staffing, LLC.

Proficency Scale:

1 = No Experience - Theory only

2 = Limited Experience - Infrequent

3 = Moderate Experience - Able to perform independently

4 = Proficient - Able to perform proficiently and instruct

Frequency Scale:

1 = Never Observed

2 = Less than 6 times a year

3 = 1 or 2 Times a Month

4 = Daily or Weekly

Personal Information
Name:
Email:
City:
Country:
State/Region:

	Proficiency				Frequency
Settings	1	2	3	4	1	2	3	4
Adult Acute Care
Adult Outpatient
Pediatric Acute Care
Pediatric Outpatient

	Proficiency				Frequency
Angio Studies	1	2	3	4	1	2	3	4
Abdominal Aorta
Abdomen
Chest
Circle of Willis
Head w-w/o Contrast
Lower Extremities
Neck
Pelvis
Renal
Subclavian

	Proficiency				Frequency
Venogram Studies	1	2	3	4	1	2	3	4
Carotid/Neck
Renals
Pelvis
Upper Extremities
Lower Extremities

	Proficiency				Frequency
MR Studies	1	2	3	4	1	2	3	4
Head/Neck
Brain/Head w-w/o Contrast
Face w-w/o Contrast
Internal Auditory Canal w-w/o Contrast
Mandible w-w/o Contrast
Nasopharynx w-w/o Contrast
Orbits w-w/o Contrast
Pituitary w-w/o Contrast
Soft Tissue Neck w-w/o Contrast
Sinuses w-w/o Contrast
TMJ w-w/o Contrast

	Proficiency				Frequency
Abdomen/Pelvis	1	2	3	4	1	2	3	4
Abdomen/Pelvis
Abdomen w-/w/o Contrast
Adrenals w-w/o Contrast
Buttock w-w/o Contrast
Cholangiogram
Pelvis w-w/o Contrast
Prostate w-w/o Contrast
Renal w-w/o Contrast
Scrotum with Contrast

	Proficiency				Frequency
Chest	1	2	3	4	1	2	3	4
Brachial Plexus
Breast w-w/o Contrast
Chest w-w/o Contrast
Myocardium w-w/o Contrast
Sternum w-w/o Contrast

	Proficiency				Frequency
Spine	1	2	3	4	1	2	3	4
Cervical Spine w-w/o Contrast
Thoracic Spine w-w/o Contrast
Lumbar Spine w-w/o Contrast
Sacrum w-w/o Contrast

	Proficiency				Frequency
Upper Extremities	1	2	3	4	1	2	3	4
Scapula w-w/o Contrast
Shoulder w-w/o Contrast
Arthrogram Shoulder
Elbow w-w/o Contrast
Wrist w-w/o Contrast
Hand/Finger w-w/o Contrast

	Proficiency				Frequency
Lower Extremities	1	2	3	4	1	2	3	4
Hip w-w/o Contrast
Knee w-w/o Contrast
Ankle w-w/o Contrast
Foot w-w/o Contrast

	Proficiency				Frequency
MRI Scan Types	1	2	3	4	1	2	3	4
Gradient Echo Imaging
Multiplanar Reconstruction/MRA
Spin Echo Images

	Proficiency				Frequency
Miscellaneous	1	2	3	4	1	2	3	4
National Patient Safety Goals
Computerized Charting

	Proficiency				Frequency
Surface Coils	1	2	3	4	1	2	3	4
Extremity
Head
Neurovascular
Shoulder
Spine/Phase Array
Torso

	Proficiency				Frequency
Images	1	2	3	4	1	2	3	4
T-1 weighted
T-2 weighted
Inversion Recovery
Fat Supression

	Proficiency				Frequency
Related Skills	1	2	3	4	1	2	3	4
Venipuncture
Contrast Administration
Scanning Patient with Conscious Sedation
Scanning Patient with Anesthesia

	Proficiency				Frequency
Age Specific Skills	1	2	3	4	1	2	3	4
Newborn (birth-30 days)
Adolescents (12 - 18 years)
Infant (30 days - 1 year)
Young Adults (18 - 39 years)
Toddler (1 - 3 years)
Middle Adults (39 - 64 years)
Preschooler (3 - 5 years)
Older Adults (64+ years)
School Age (5 - 12 years)

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The information represented above is true and correct to the best of my knowledge. I authorize ADEX Medical Staffing, LLC to share this skills checklist with its clients.
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Form Reviewed by ADEX Clinician - 11/16/2010