MAGNETIC RESONANCE

CLINICAL COMPETENCY ASSESSMENT

Internationally Educated Medical Radiation Technologists
Resonance
The following chart will be used to assess clinical competency in the practice of magnetic resonance. Procedures must have been done
independently, in a variety of settings, in a timely manner, with the achievement of diagnostic images. Employment in the practice of
magnetic resonance must have been within the past five (5) years.

To complete the following assessment form

• Indicate date each procedure was last performed
• Obtain verification by having supervisor initial each procedure / process performed
• Sign and date form
• Have clinical supervisor sign and date form
• If any of the procedures were not performed, mark them as N/A (not applicable)

PROCEDURES N/A Date last performed (MM/YY)

1. Musculoskeletal Imaging
Shoulder
Elbow
Wrist/Hand
Pelvis / Hip
Knee
Ankle / Foot
TMJ’s
Arthrogram Imaging
MRA/MRV Imaging
2. Head and Neck Imaging
Brain
Temporal lopes
Pituitary gland
Posterior fossa
Internal auditory canal/ Cranial Nerves
MRA/MRV of Head & Neck
Nasopharynx
Soft tissue neck
3. Spinal Imaging
Cervical Spine
Thoracic Spine
Lumbar Spine
Sacral/SI Joint
Complete Spine
Brachial Plexus
4. Abdominal Imaging
Liver
Biliary Tree/Gallbladder
Pancreas
Kidneys/Adrenal Glands
Other Abdominal Imaging
MRA/MRV of Abdomen
 PROCEDURES N/A Date last performed (MM/YY)
5. Thorax Imaging
Cardiac
MRA/MRV of Thorax
Breast
Chest Wall
6. Pelvic Imaging
Female Pelvis
Male- Pelvis
Other Pelvis
7. Quality Control
Confirm cryogen levels
Scan phantoms
Evaluate performance of RF coils
8. Patient Care
Obtain and assess vital signs
Prepare contrast media
Perform venipuncture / Administer contrast media
Maintain infection control practices
Complete procedural documentation for pre/during/post procedure care
Screen for contraindications
9. Post process & archive images
10. Practice MR safety procedures

Please attach a resume outlining your clinical experience, as well as all other supporting documents/evidence.

Validation of applicant:
I hereby certify that the above information is true and correct to the best of my knowledge

Applicant’s signature Date signed

Print name

Validation of clinical supervisor:

I hereby certify that the applicant has competently performed all procedures identified. I acknowledge that this information will be used by
(CAMRT or regulatory body) in the assessment of the applicant’s practice in magnetic resonance.

Supervisor’s signature Date signed

Print Name Name of facility Telephone number

Official stamp or seal of facility of employment; if not available, please staple here the supervisor’s card: