Medical Technologist Skills Checklist One program to handle all talent management needs from acquisition to development Personal Information This field is hidden when viewing the formOverall ScoreOut of 4Name(Required) First Middle Last Last 4 Digits of Social Security NumberEmail(Required) This field is hidden when viewing the formDate MM slash DD slash YYYY Proficiency Scale1 – No Experience 2 – Need Training 3 – Able to perform with supervision 4 – Able to perform independentlyBlood BankComponent Preparation(Required) 1 2 3 4 Special Blood Typing(Required) 1 2 3 4 Procedures(Required) 1 2 3 4 Patient Identification(Required) 1 2 3 4 Emergency Release(Required) 1 2 3 4 Freezing Blood(Required) 1 2 3 4 Antibody Identification(Required) 1 2 3 4 Antibody Titer(Required) 1 2 3 4 Blood Irradiation(Required) 1 2 3 4 Cold Agglutinins(Required) 1 2 3 4 Direct Coombs Test(Required) 1 2 3 4 Indirect Coombs Test(Required) 1 2 3 4 Cross Match(Required) 1 2 3 4 Donor Unit Collections(Required) 1 2 3 4 Immediate Spin Cross Match(Required) 1 2 3 4 Plasmapheresis(Required) 1 2 3 4 Rhogam(Required) 1 2 3 4 Kell, Kidd, Duffy, RH HR, MNS, Lewis, P(Required) 1 2 3 4 InstrumentationAutomated Instrumentation(Required) 1 2 3 4 Crystal Identification(Required) 1 2 3 4 Semen Analysis(Required) 1 2 3 4 Macroscopic UA(Required) 1 2 3 4 Microscopic UA(Required) 1 2 3 4 HematologyBody Fluid Count(Required) 1 2 3 4 Bleeding Time(Required) 1 2 3 4 Lee-White Clotting Time(Required) 1 2 3 4 Differential(Required) 1 2 3 4 Eosinophil Count(Required) 1 2 3 4 Factor Assays(Required) 1 2 3 4 Fibrinogen(Required) 1 2 3 4 Fibrin Split Products/FDB(Required) 1 2 3 4 Platelet Aggregation(Required) 1 2 3 4 Platelet Count(Required) 1 2 3 4 PT and PTT(Required) 1 2 3 4 Reticulocyte(Required) 1 2 3 4 Sedimentation Rate(Required) 1 2 3 4 Sicle Cell Prep(Required) 1 2 3 4 PAS, Peroxidase, Leukocyte, Aldaline, Phosphatase(Required) 1 2 3 4 Thrombin Time(Required) 1 2 3 4 Fetal Hemoglobin(Required) 1 2 3 4 ChemistryAcetone Analysis(Required) 1 2 3 4 Atomic Absorption(Required) 1 2 3 4 Thin Layer Chromatography(Required) 1 2 3 4 Gas Chromatography(Required) 1 2 3 4 CSF/Body Fluid Drug Monitoring(Required) 1 2 3 4 CSF/Body Fluid Electrolytes(Required) 1 2 3 4 Electrophoresis(Required) 1 2 3 4 Immunoelectrophoresis(Required) 1 2 3 4 Osmolality(Required) 1 2 3 4 Stool Analysis(Required) 1 2 3 4 Instrumentation Used - Blood Gas(Required) 1 2 3 4 Instrumentation Used - Main Chemistry Unit(Required) 1 2 3 4 Serology/ImmunologyHemagglutination Inhibition(Required) 1 2 3 4 Pregnancy Testing(Required) 1 2 3 4 Meningitis Screen(Required) 1 2 3 4 Body Fluids(Required) 1 2 3 4 Rubella Serology(Required) 1 2 3 4 ANA(Required) 1 2 3 4 ASO Titer(Required) 1 2 3 4 C3, C4, Total Complement(Required) 1 2 3 4 Febrile Agglutinations(Required) 1 2 3 4 FTA-ABS(Required) 1 2 3 4 LE Cell Prep(Required) 1 2 3 4 Monostat(Required) 1 2 3 4 Radial Immuno Diffusion(Required) 1 2 3 4 Rhumatoid Factor(Required) 1 2 3 4 RPR(Required) 1 2 3 4 PhlebotomyBasic Safety Guidelines: gloves and goggles(Required) 1 2 3 4 Communication Skills(Required) 1 2 3 4 Ability to Write Procedures(Required) 1 2 3 4 Masks(Required) 1 2 3 4 Use of Balance (weighing)(Required) 1 2 3 4 Anticoagulants - Knowledge of Tube Types and Uses(Required) 1 2 3 4 Calculation for Solution Prep: Molarity and Molality(Required) 1 2 3 4 Finger Stick(Required) 1 2 3 4 Heel Stik(Required) 1 2 3 4 M.L.A.(Required) 1 2 3 4 Operatoin of Centrifuge(Required) 1 2 3 4 Pediatric(Required) 1 2 3 4 Pipetting(Required) 1 2 3 4 To Contain(Required) 1 2 3 4 To Deliver(Required) 1 2 3 4 Venipuncture(Required) 1 2 3 4 Volumetric(Required) 1 2 3 4 Microbiology/VirologyBlood Culture(Required) 1 2 3 4 Cell Culture(Required) 1 2 3 4 Aerobic Culture(Required) 1 2 3 4 Anaereobic Culture(Required) 1 2 3 4 Anaereobic Identification(Required) 1 2 3 4 Mycobacteria Culture(Required) 1 2 3 4 Sensitivities(Required) 1 2 3 4 Virus Identification(Required) 1 2 3 4 Virus Isolation(Required) 1 2 3 4 Acid Fast Stain (Fluorescent)(Required) 1 2 3 4 Acid Fast Stain (Kinyoun)(Required) 1 2 3 4 C Difficili Assay(Required) 1 2 3 4 Concentration Techniques(Required) 1 2 3 4 Culture Plating(Required) 1 2 3 4 Darkfield(Required) 1 2 3 4 Gram Stain(Required) 1 2 3 4 Identification(Required) 1 2 3 4 India Ink(Required) 1 2 3 4 KOH Prep(Required) 1 2 3 4 M.I.C(Required) 1 2 3 4 Chlamydia Culture(Required) 1 2 3 4 Malarial Examination(Required) 1 2 3 4 Occult Blood(Required) 1 2 3 4 Organism Identification (Aerobic)(Required) 1 2 3 4 OVA and Parasite Concentration(Required) 1 2 3 4 Ova and Parasite Identification: Trichone(Required) 1 2 3 4 West Mount - Mobility(Required) 1 2 3 4 Wet Mount(Required) 1 2 3 4 RIAData Reduction(Required) 1 2 3 4 Curves/Regression(Required) 1 2 3 4 Counters(Required) 1 2 3 4 Background Counts(Required) 1 2 3 4 Scintillation Counter(Required) 1 2 3 4 Hormone Testing(Required) 1 2 3 4 Radiation Safety Techniques(Required) 1 2 3 4 Instrumentation/Gamma Counters(Required) 1 2 3 4 B12/Folates(Required) 1 2 3 4 Hepatitis(Required) 1 2 3 4 Thyroid Testing(Required) 1 2 3 4 Tumor Markers(Required) 1 2 3 4 EMRAllscripts(Required) 1 2 3 4 Cerner(Required) 1 2 3 4 Epic(Required) 1 2 3 4 HomeCare Home Base(Required) 1 2 3 4 McKesson(Required) 1 2 3 4 Mediatech(Required) 1 2 3 4 Other Computerized Documentation SystemAuthorizationsLegal Consent(Required) I agree to the terms and conditions.Consumer Disclosure Regarding Conducting Business Electronically, Signing Documents Electronically, and Receiving Electronic Notices and Disclosures Please read the information below, carefully, as it concerns your rights. eSignatures are an efficient way to execute an agreement with the same legal force and effect of a handwritten or “wet ink” signature. 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