Skills Checklist

Congratulations on your decision to apply for a Travel position with Med Travelers! Before we can offer you an employment opportunity, an electronic skills assessment must be completed. From the skills checklist below, please locate the list that matches your specialty and complete the online form. Be sure to review your information thoroughly before clicking the submit button. Thank you!

Mammography Technologist Skills Checklist

*

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This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
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First Name*	Middle Name	Last Name*
E-Mail Address*	Phone Number*

 

1. No experience; requires education, training and supervision
2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent
4. Expert level; can teach/supervise others

 

WORK SETTING

1

2

3

4

 

Freestanding Clinic

 

Hospital

 

Mobile

 

Outpatient

 

Other Setting: Specify

 

PROCEDURES

1

2

3

4

 

Diagnostic Mammograms

 

Digital

 

Fine Needle Aspirations

 

Implants (Eklund view)

 

Magnification Views

 

Male Mammography

 

Needle Localizations

 

Post Radiation

 

Screening Mammograms

 

Specimen Radiography

 

Spot Compressions View

 

Stereotactic Biopsy

 

PROJECTIONS

1

2

3

4

 

Axillary Tail

 

Cranialcaudo

 

Lateromedial Oblique

 

Rolled

 

Tangential

 

Triangulation

 

PROFESSIONAL KNOWLEDGE AND SKILLS

1

2

3

4

 

Digital Quality Assurance Procedures

 

Infection Prevention

 

Isolation Precautions

 

National Patient Safety Goals

 

Teach Breast Self Exams (BSE)

 

Universal Protocol Procedures/Core Measures

 

AGE SPECIFIC/POPULATION-BASED CARE

1

2

3

4

 

Neonate/Infant

 

Toddler/Preschool

 

School Age

 

Adolescents

 

Young/Middle Adults

 

Older Adults/Geriatrics

 

EMR

1

2

3

4

 

Allscripts

 

GE

 

Bar Coding for Medication Administration

 

Cerner

 

Computer Physician Order Entry

 

Eclipsys

 

Epic

 

McKesson

 

Meditech

 

Other: Specify

 

Other: Specify

 

EMR Conversion

Yes

No

 

CERTIFICATIONS (Current at the time of completing this form)

 

BLS

Yes

No

 

ARRT

Yes

No

 

ARRT Certified Mammographer

Yes

No

 

MQSA

Yes

No

 

Other: Specify

Mammography Technologist Skills Checklist, version 4

You must agree with the statements at the bottom of the form before submitting your skills checklist.

Please read and agree to the statements below by marking the checkbox.

* I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.