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Hiring Interview Appointment

Personal Information

Please enter your full legal name as it appears on your Social Security Card. *

First

Last

Email *

Phone

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

Work settings

Ambulatory OR

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4

CVOR

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4

Pedi CVOR

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3
4

First Assist

1
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3
4

Pedi General OR

1
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3
4

Trauma

1
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3
4

BARIATRICS

Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

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4

Gastric bypass

1
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3
4

Gastric Sleeve

1
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3
4

Lap band

1
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4

Laparoscopic assisted cases

1
2
3
4

Scrub Bariatric Surgery

1
2
3
4

CARDIOVASCULAR

Abdominal Aortic Aneurysm repair

1
2
3
4

Atherectomy

1
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3
4

Atrial Septic defect (adult) repair

1
2
3
4

Aortic Valve Replacement

1
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3
4

Cardiomyoplasty

1
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3
4

Carotid endarterectomy

1
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3
4

Coronary Artery Bypass Graft

1
2
3
4

ECMO

1
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3
4

Endovascular Aneurysm Repair

1
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3
4

Femoral Cannulation

1
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4

Femoral popliteal bypass graft

1
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3
4

Intra-Aortic Balloon Pump

1
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4

Laparoscopic Cardiac Surgery

1
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3
4

Left Ventricular Assist device

1
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3
4

MAZE Procedure

1
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3
4

Mitral valve replacement

1
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4

PDA

1
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4

Pericardial window

1
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4

Permanent pacemaker insertion

1
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3
4

Robotic Assisted Cardiac Surgery

1
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3
4

TAVR (Transaortic Valve Replacement)

1
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3
4

TEVAR (Thoracic Endovascular Aortic Repair)

1
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3
4

Vein stripping

1
2
3
4

Ventricular aneurysm repair

1
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3
4

Scrub Cardiovascular Surgery

1
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3
4

THORACIC

VATS

1
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3
4

Lung resection- Thoracotomy

1
2
3
4

Mediastinoscopy

1
2
3
4

Robotic VATS

1
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3
4

Scrub Thoracic Surgery

1
2
3
4

EAR/NOSE/THROAT

Endoscopic SINUS procedures

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3
4

Direct Laparoscopic

1
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4

Septoplasty/Rhinoplasty

1
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3
4

Mastoidectomy/Tympanoplasty/Stapedectomy

1
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3
4

Radical neck dissection

1
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3
4

Tonsillectomy/adenoidectomy

1
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3
4

Tracheostomy

1
2
3
4

Scrub ENT Surgery

1
2
3
4

Robotic TORS

1
2
3
4

ENDOSCOPIC PROCEDURES

Bronchoscopy

1
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3
4

Colonoscopy

1
2
3
4

EGD

1
2
3
4

Peg tube placement/exchange

1
2
3
4

Sigmoidoscopy

1
2
3
4

GENERAL SURGERY

Appendectomy

1
2
3
4

Breast biopsy

1
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3
4

Cholecystectomy

1
2
3
4

Colon resection

1
2
3
4

Hernia repair inguinal/umbilical

1
2
3
4

Laparoscopic assisted procedures

1
2
3
4

Laparoscopic nissen fundoplication

1
2
3
4

Mastectomy

1
2
3
4

Robotic assisted procedures

1
2
3
4

Thyroidectomy partial/total

1
2
3
4

Whipple

1
2
3
4

Scrub General Surgery

1
2
3
4

Hepatic Surgery

1
2
3
4

GYNECOLOGY

Abdominal/ Vaginal hysterectomy

1
2
3
4

Anterior/Posterior repair

1
2
3
4

C-sections

1
2
3
4

Dilation & Curettage

1
2
3
4

Laparoscopic assisted gynecological procedures

1
2
3
4

Robotic assisted Gynecological procedures

1
2
3
4

Scrub Gynecology Surgery

1
2
3
4

NEUROLOGY

Hydrocephalus

1
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3
4

Increased Intracranial Pressure

1
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3
4

Intracranial Pressure Monitoring

1
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3
4

Intraventricular Hemorrhage

1
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3
4

Meningocele/Myelomeningocele

1
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3
4

Neonatal Abstinence Syndrome

1
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4

Reflexes for Gestational Age

1
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3
4

Seizure Disorders

1
2
3
4

Ventricular Peritoneal (VP) Shunts

1
2
3
4

Eye exams

1
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3
4

Retinopathy of Prematurity (ROP)

1
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3
4

Professional Topic and Skills

APGAR scoring

1
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3
4

Bereavement Care

1
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3
4

Charge Experience

1
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4

Developmental Care

1
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4

Interpretation and communication of lab values

1
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4

National Patient Safety Goals

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4

National Patient Safety Goals/Core Measures

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4

Pain assessment and management

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4

Patient/family teaching

1
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3
4

Phlebotomy

1
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4

Restraints/Use of Least Restrictive Device

1
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4

Skin Care

1
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4

Thermoregulation

1
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4

RESPIRATORY

Apnea Monitor

1
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3
4

Assist with Intubation/Extubation

1
2
3
4

Bronchopulmonary Dysplasia

1
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3
4

Bubble CPAP

1
2
3
4

Diaphragmatic Hernia

1
2
3
4

ECMO

1
2
3
4

Endotracheal Tube Suctioning

1
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3
4

High Flow Nasal Cannula (HFNC)

1
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3
4

High Frequency Ventilation

1
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3
4

Inhaled Nitric Oxide

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3
4

Interpretation of Blood Gases

1
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3
4

Management of Chest Tubes

1
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3
4

Meconium Aspiration

1
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3
4

Oral/nasal Suctioning

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3
4

Oscillators

1
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4

Oxygen Delivery Systems

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3
4

Persistent Pulmonary Hypertension

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4

Pneumonia

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4

Pneumothorax

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4

Respiratory Distress Syndrome

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4

RSV (Respiratory syncytial virus)

1
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4

Tracheostomy Management

1
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3
4

Vapotherm

1
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4

Ventilator management (AC/PC/SINMV/CPAP/BIPAP/PEEP)

1
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3
4

RENAL/GENITOURINARY

Circumcision

1
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3
4

Exchange Transfusion

1
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3
4

Genetic Disorders

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3
4

Hyperbilirubinemia

1
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3
4

Hypo/Hyperglycemia

1
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3
4

Malformations of GU Tract / Kidney

1
2
3
4

Renal Failure

1
2
3
4

COMPUTERIZED CHARTING

Allscripts

1
2
3
4

Cerner

1
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3
4

EPIC

1
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3
4

McKesson

1
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3
4

Meditech

1
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4

Centricity-Perinatal (CPN)

1
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3
4

Other:

1
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4

If other, please specify

Age specific competency

Neonate

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Infant

1
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4

Child

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4

Adolescent

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4

Young Adult

1
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4

Middle Adult

1
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3
4

Older Adult

1
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3
4

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