Kinesiologist Skills Checklist

Requested by:

Requested by email:

Today's Date: * +

First Name: *

Last Name: *

Mobile Phone Number: *

Email Address: *

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GENERAL SKILLS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Supervisor experience	123
National Patient Safety Goals/Core Measures	123
Awareness of HCAHPS	123
Accurate patient identification	123
Demonstrates knowledge of anatomy	123
Use proper body mechanics	123
Use of transfer/lifting devices	123
Infection control	123
Universal precautions	123
Isolation precautions	123
Minimize fall risks	123
Crash cart	123
Defibrillator	123
Care of patient in restraints	123
Obtain Vital Signs	123
Patient /Family education	123
Ensures HIPAA compliance	123

GENERAL KNOWLEDGE AND UNDERSTANDING OF THE BODY SYSTEMS AND THEIR FUNCTIONS:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Musculoskeletal system	123
Cardiovascular system	123
Respiratory system	123
Nervous system	123
Electronic documentation	123

ASSESSMENT AND ANALYSIS:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Assessment of body movements	123
Identifying Dysfunctions and Imbalances	123
Functional Movement Assessment	123
Mobility Assessment	123
Stability Assessment	123
Flexibility Assessment	123
Gait Analysis	123
Motion Capture	123
Range of Motion (ROM) Assessment	123

EMR AND TECHNOLOGY:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Epic Computerized charting	123
Cerner	123
Meditech	123
McKesson	123
Other computerized charting platforms	123
Report generating	123
Fitness tracking devices	123
Motion analysis software	123

EXERCISE PRESCRIPTION:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Design, implement, and personalize exercise programs for individual needs	123
Individual exercise goal development	123
Strength Training	123
Endurance Training	123
Aerobic Exercise	123
Anerobic Exercise	123
Resistance Exercise	123
Flexibility Training	123

GENERAL KNOWLEDGE OF BIOMECHANICS:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Knowledge of biomechanical principles related to movement	123
Effects of forces on the body during activity and exercise	123
Movement assessment to prevent injury and enhance performance	123

INJURY PREVENTION AND REHABILITATION:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Surgical Rehabilitation Recovery	123
Muscle Injury Rehabilitation Recovery	123
Bone Injury Rehabilitation and Recovery	123
Joint Injury Rehabilitation and Recovery	123
Tendon and Ligament Rehabilitation and Recovery	123
Exercise development, planning, and implementation	123
Injury prevention strategies and techniques	123

NUTRITION AND LIFESTYLE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Calorie intake and planning	123
Protein Intake and planning	123
Relation of nutrition and physical performance	123
Relation of nutrition and effects on body systems	123

PROBLEM SOLVING, CRITICAL THINKING, ETHICAL, PROFESSIONAL CONDUCT, AND COMMUNICATION SKILLS:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Ability to identify and troubleshoot common issues that may arise	123
Decision-making ability based on protocols and guidelines	123
Maintain patient confidentiality and adhere to ethical standards	123
Follow professional codes of conduct	123
Patient/Family Communication	123
Healthcare Team Communication	123

TECHNOLOGY PROFICIENCY:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Interpretation of Related Research	123
Muscle Injury Rehabilitation Recovery	123
Bone Injury Rehabilitation and Recovery	123
Joint Injury Rehabilitation and Recovery	123
Tendon and Ligament Rehabilitation and Recovery	123
Exercise development, planning, and implementation	123
Injury prevention strategies and techniques	123

WORK SETTING:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Hospital	123
Outpatient	123
Home Health	123
Health Clinic	123
Fitness Center	123
University/College/High School	123
Long Term Care	123
Acute Rehabilitation	123

AGE-SPECIFIC EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Newborn / neonate (birth-30 days)	123
Infant (31 days-1 year)	123
Toddler (ages 2-3 years)	123
Preschool (ages 4-5 years)	123
School age (ages 6-12 years)	123
Adolescent (ages 13-21 years)	123
Young adult (ages 22-39 years)	123
Adult (ages 40-64 years)	123
Older adult (ages 65-79 years)	123
Elderly (ages 80+ years)	123

Attestation

ATTESTATION: *

I certify that the information provide above accurately reflects my experience in each of the clinical areas identified within the past three years.

If you agree with the Attestation above, please electronically sign your name. *