= Skills Checklist =

Operating Room Skills

Please rank the following skills on a scale of 1 to 4

1 = No theory and/or experience
2 = Limited experience
3 = Experienced/minimal support needed to perform
4 = Proficient

  • General Surgery

  • Laparoscopic Procedures

  • Gynecology

  • G.U. & Cysto

  • Orthopedic

  • Neurosurgery

  • Plastics

  • Eye

  • Ear, Nose & Throat

  • Thoracic

  • Endoscopy

  • Cardiovascular

  • Transplants

  • Equipment

  • Sterilization of Equipment

  • Miscellaneous

  • Experience with the Following Ages

  • Date Format: MM slash DD slash YYYY