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Xray Tech
X-Ray Tech
Name
First
Last
Date
MM slash DD slash YYYY
Self-Assessment Rating Scale:
No Experience
Theory or observation only during the past 12 months
Limited Experience
Performed less than 12 times within the past 12 months and may need a review
Experienced
Performed at least once per month within the past 12 months and may need minimal assistance
Highly Skilled
Performed on at least a weekly basis over the past 12 months; proficient
Age
No Experience
Limited Experiene
Experienced
Highly Skilled
Newborn (birth - 30 days)
Infant (30 days - 1 year)
Toddler (1 - 3 years)
Preschooler (3 - 5 years)
School Age (5 - 12 years)
Adolescents (12 - 18 years)
Young Adults (18 - 39 years)
Middle Adults (39 - 64 years)
Older Adults (64+ years)
Elderly Adults (Over 79+ years)
General Skills
No Experience
Limited Experience
Experienced
Highly Skilled
Standard Precautions
Isolation Precautions
Pediatric Respiratory/ Cardiac Arrest
Adult Respiratory/ Cardiac Arrest
Work Setting
No Experience
Limited Experience
Experienced
Highly Skilled
Adult Acute Care
Adult Outpatient
Pediatric Acute Care
Pediatric Outpatient
Bedside/ Portable Procedures
ER/ Trauma
OR
Chest and Thorax
No Experience
Limited Experience
Experienced
Highly Skilled
Chest Routine
Chest SP
Ribs
Chest Lateral Decubitus
Sternum
Upper Airway (Soft-Tissue Neck)
Upper Extremity
No Experience
Limited Experience
Experienced
Highly Skilled
Thumb or Finger
Hand
Wrist
Forearm
Elbow
Humerus
Shoulder
Trauma
Clavicle
Scapula
AC Joints
Lower Extremity
No Experience
Limited Experience
Experienced
Highly Skilled
Toes
Foot
Ankle
Knee
Tibia-Fibula
Femur
Trauma
Patella
Calcaneus
Head
No Experience
Limited Experience
Experienced
Highly Skilled
Skull
Paranasal Sinuses
Facial Bones
Orbits
Zygomatic Arches
Nasal Bones
Mandible
TMJ
Spine and Pelvis
No Experience
Limited Experience
Experienced
Highly Skilled
Cervical Spine
Thoracic Spine
Lumbar Spine
Sacrum and/ or Coccyx
Cross-Table Lateral Spine
Pelvis
Hip
Cross-Table Lateral Hip
Sacroiliac Joints
Scoliosis Series
Abdomen
No Experience
Limited Experience
Experienced
Highly Skilled
Abdomen Supine (KUB)
Abdomen Upright
Abdomen Decubitus
Fluoroscopy Studies
No Experience
Limited Experience
Experienced
Highly Skilled
Upper GI Series, Single or Double Contrast
Contrast Enema, Single or Double Contrast
Small Bowel Series
Esophagus
Cystography/ Cystourethrography
ERCP
Myelography
Arthrography
Hysterosalpingography
Mobile Radiographic Studies
No Experience
Limited Experience
Experienced
Highly Skilled
Chest
Abdomen
Orthopedic
Equipment
No Experience
Limited Experience
Experienced
Highly Skilled
GE
Fuji
Siemens
Toshiba
Hitachi
Portables
C-Arm
Computerized Charting - EMR
No Experience
Limited Experience
Experienced
Highly Skilled
eClinicalworks
EPIC
McKesson
Care 360
Allscripts
Cerner
GE
Optum Insight
NextGen
Greenway
Computerized Charting - PACS
No Experience
Limited Experience
Experienced
Highly Skilled
Ambra Health
Sectra
Infinitt
IBM Merge
McKesson
Philips
FujiFilm
Impax
Centricity
Carestream Vue
Clarity
eRad PACS
Syngo
Signature
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