Clinical Competency Checklist

Clinical Competency Checklist — Form Fields

This healthcare template includes 6 fields. Documents clinical staff competency assessments across key skills and procedures. Used by nurse managers and clinical educators during annual reviews and onboarding. Free to customize and use on ZenBuild.

• Staff Member Name (text, required)
• Position / Role (text, required)
• Evaluator Name (text, required)
• Competency area being assessed (dropdown selection, required) — options: Medication administration, IV insertion and management, Wound care, Patient assessment, Emergency response, Documentation standards
• Overall competency rating (multiple choice, required) — options: Competent — performed independently, Developing — requires occasional guidance, Not yet competent — requires supervision
• Evaluator comments and recommendations (long text, optional)