Skills Checklist

This Skills Checklist is a self-evaluation to assess your recent experience in various clinical settings focusing on the past 2 years.

0 = No Experience
1 = Some Experience
2 = Intermittent Experience
3 = Experienced
4 = Very Experienced

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AGE OF PATIENTS CARED FOR

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Newborn/Neonate (birth to 30 days)
Infant (1 month to 1 year)
Toddler (1 year to 3 years)
Preschooler (3 years to 5 years)
School Age Child (5 years to 12 years)
Adolescents (12 years to 18 years)
Young Adults (18 years to 39 years)
Middle Adults (39 years to 64 years)
Older Adults (64+ years)

MRI SAFETY REQUIREMENTS

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Screening Patients, Personnel, & Non-Personnel for MRI Safe, Conditional, & Unsafe Devices & Objects
Identify MRI Safety Zones
Static Field (ex: Pojectiles)
Radiofrequency Field (ex: Thermal Loading, Coil Positioning, & Insulation)
Time-varying Gradient Magnetic Fields (ex: Induced Voltages, Auditory Considerations)
Communication & Monitoring Considerations (ex: Sedated Patients, Verbal & Visual Contact, Vital Signs)
Contrast Media Safety (Ex: NSF, Renal Function)
Other MRI Safety Considerations (Ex: Cryogen Safety, Fire, Medical Emergencies, Laser Alignment Lights)

GENERAL SKILLS

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Venipuncture/IV Placement
Identification of Patient
Safety Screening & Patient Education Regarding Procedure
Patient Care & Assessment
Preparation of Examination Room
Preparation and/or Administration of Contrast Media
Selection of Optimal Imaging Coil
Patient Positioning
Protocol Positioning
Parameter Selection
Image Display, Filming (If Applicable), Networking, & Archiving
Post-Processing
Documentation of Procedure & Patient Data
Patient Discharge with Post-Procedure Instructions
CDC Standard Precautions
MRI Safety Procedures & Precautions
Completion of Acquisition

Head and Neck

Rows	0	1	2	3	4
Brain
IAC
Orbit
Pituitary
Head MRA
Head MRV
Cranial Nerves
Posterior Fossa
Head Trauma
Face/ Soft Tissue Neck
Neck MRA

Spine

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Cervical
Thoracic
Lumbar
Sacrum/ Coccyx
Spinal Trauma
Brachial Plexus

Thorax

Rows	0	1	2	3	4
Chest
Thoracic MRA
Breast

Abdomen and Pelvis

Rows	0	1	2	3	4
Abdomen
Pancreas
Kidneys
Adrenals
MRCP
Abdominal MRA
Abdominal MRV
Male Pelvis
Female Pelvis

Musculoskeletal

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Elbow
Hand/ Wrist
Finger/ Thumb
TMJ
MR Arthrography
Hip/ Bony Pelvis
Ankle
Shoulder
Scapula
Sternum/ SC
Foot
Upper Extremity Long Bones
Lower Extremity Long Bones
Knee

Special Imaging Procedures

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Image Post-Processing (Ex: MIP, MPR, ADC Mapping, Subtraction)
Perfusion
Diffusion (Non-Brain)
CINE (Ex: CSF Flow Study)
Peripheral MRA (Iliac, Runoff)
Spectroscopy

Quality Control

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Signal to Noise
Center Frequency
Transmitter Gain or Attenuation
Geometric Accuracy
Scanners

EMR

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eClinicalworks
EPIC
McKesson
Care 360
Allscripts
Cerner
Optum Insight
NextGen
Greenway

PACS

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Ambra Health
Sectra
Infinitt
IBM Merge
McKesson
Philips
FujiFilm
Impax
Centricity
Carestream Vue
Clarity
eRad PACS
Syngo

EQUIPMENT

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Telerad
Nighthawk
Power Injectors

GE Signa

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1.5T Magnet Strength
3T Magnet Strength

Siemens

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1.5T Magnet Strength
3T Magnet Strength

Hitachi

Rows	0	1	2	3	4
1.5T Magnet Strength
3T Magnet Strength

Philips

Rows	0	1	2	3	4
1.5T Magnet Strength
3T Magnet Strength

Position Category

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Total Years of Experience

First Name

Last Name

Social Security #

Date of Birth

Email

Phone

Attestation

I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified, particularly within the last 2 years. I hereby authorize Alliant Personnel Resources (The Company) to collect, store, and release any information that I have provided in this Skills Checklist and/or any other documentation and information they have collected or that I have submitted in any form to its parent company(s), its subsidiaries, or other subcontractors/its service providers as it deems necessary in its business operations as well as to individuals and companies in relation to consideration of employment as a Healthcare Professional with those companies and individuals. I acknowledge that The Company will take precaution and care to protect my personal information that is collected/stored/shared but cannot guarantee permanent data security and I release The Company from all related liability for damages or punitive liability.

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Skills Checklist - MRI