SELF EVALUATION
HISTOLOGY
SKILLS PROFICIENCY CHECKLIST
| Print this form and fax or mail: Fax to: (505) 797-3822 Mail to: 5150 San Francisco RD NE, Albuquerque, NM 87109 |
Last Name:
First Name:
Middle Initial:
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Years Experience |
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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 = |
H ighly Proficient.Extensively experienced; able to supervise and/or train others. |
SE = |
Some Experience. |
|
| VE = |
Very Experienced. |
NE = | No Experience. | |
| EX = |
Experienced. |
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| GENERAL PROCEDURES: | HP | VE | EX | SE | NE | SPECIAL STAINS: | HP | VE | EX | SE | NE | |
| Embedding | Giemsa | |||||||||||
| Cutting 2-5 microns | Methenamine Silver | |||||||||||
| Coverslipping | Masson’s Trichrome | |||||||||||
| Routine Staining H+E | Oil Red O | |||||||||||
| Iron | ||||||||||||
| OTHER PROCEDURES: | Alcian Blue | |||||||||||
| Microwave Staining | Verhoeff’s Elastic | |||||||||||
| Frozen Sections | PAS | |||||||||||
| Cytospins | AFB | |||||||||||
| Autostainer | Crystal Violet | |||||||||||
| Auto Coverslipper | Brown-Hopp’s Modification | |||||||||||
| Immunohistochemistry | of Gram Stain | |||||||||||
| CAP Inspections | Gomoris Retic | |||||||||||
| Other: | Fontanna-Masson for Melanin | |||||||||||
| Other: | and Argentaffin Granules | |||||||||||
| LIST OTHER AREAS OF SPECIALTY AND EXPERIENCE: | ||||||||||||
Submitted by: Date:
Phone / Email:
© Rapid Temps, Inc., rev Feb-2000
