SELF EVALUATION
CT SKILLS PROFICIENCY CHECKLIST

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     Last Name: 
    First Name: 
Middle Initial: 
Years Experience: yrs.

DIRECTIONS: Place an x in the box that best describes your level of proficiency for each of the skills presented.

LEVELS OF PROFICIENCY KEY:

HP =

Highly Proficient.
Extensively experienced; able to supervise and/or train others.

 SE =

Some Experience.
Need review and assistance or supervision.
VE =

Very Experienced.
Can perform well without assistance or supervision.

 NE = No Experience.
EX =

Experienced.
Competent; can perform independently; may need initial review or supervision.
ROUTINE STUDIES: HP VE EX SE NE
Brain with Contrast
Brain without Contrast
TMJ’s
Temporal Bones
Orbits
Sinuses
Sella
Facial Bones
Neck (ST)
Larynx
Chest
Pulmonary Embolism
Abdomen  
Liver  
Renal  
Hemangioma  
Pancreas  
Pelvis  
Calculus  
Upper Extremities  
Lower Extremities  
Cervical Spine  
Thoracic Spine  
Lumbar Spine  
HARDWARE: HP VE EX SE NE
GE
Hilight Advantage
Highspeed Advantage
Pro Speed
CT/I
Light Speed CT/I
Siemens
Picker
Toshiba
PRESSURE INJECTORS: HP VE EX SE NE  
Medrad  
L/F  
Venipuncture  
SPECIAL PROCEDURES: HP VE EX SE NE  
Biopsy Procedures  
Angio  
Stereotactic Brain  
Bone Marrow Density   
Submitted by:      Date:

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