The purpose of this Supplemental Questionnaire is to determine if you meet the minimum qualifications of a 2310 Surgical Procedures Technician, and to determine your knowledge, skills, and abilities in job-related areas that have been identified as critical for satisfactory performance in this specialty.
Responses to supplemental questionnaire items must be supported by the information provided in the body of your application (i.e. education and training/employment record section) in order to receive appropriate credit, and are subject to verification. Verification of experience, licensure, and possession of valid certifications/certificates may be collected at any time during or after the selection process.
Instructions: Please answer all applicable questions by choosing the best response that matches your education, experience, certifications, licenses, and/or by providing the information requested.
Part One: Education & Experience Qualifications
Instructions for Questions #1 - #3: Please answer the question by choosing the best response that matches your education, experience, certifications, and licenses.
1.
Do you possess a certificate of graduation/diploma from a school of surgical technology accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP)?
As a reminder, all trainings, certificates, and/or licenses, etc. must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the trainings, certificates, and/or licenses you are about to describe in the "Professional Licenses, Certifications, or Registrations" section of your application, you will not receive credit for this certificate. If you are copying an old application, please take the time to update your "Professional Licenses, Certifications, or Registrations" before submitting your application.
Yes
No
2.
Have you completed a surgical technology training in an accredited community college, the military service, or an accredited nursing education program?
As a reminder, all trainings, certificates, and/or licenses, etc. must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the trainings, certificates, and/or licenses you are about to describe in the "Professional Licenses, Certifications, or Registrations" section of your application, you will not receive credit for this training. If you are copying an old application, please take the time to update your "Professional Licenses, Certifications, or Registrations" before submitting your application.
Yes
No
3.
How much verifiable full-time equivalent work experience do you have performing scrub duties in an acute care hospital providing elective and emergency surgery, within the last five (5) years? (Full-time experience is equivalent to 40 hours per week.)
As a reminder, all work experiences must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the experience you are about to describe in the "Employment Record" section of your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update your work experience before submitting your application.
I have NO verifiable experience.
I have some verifiable experience, but less than 1 year (<1,999 hours) of verifiable experience.
At least 1 year but less than 2 years (2,000 to 3,999 hours) of verifiable experience.
At least 2 years but less than 3 years (4,000 to 5,999 hours) of verifiable experience.
3 years or more (6,000 hours or more) of verifiable experience.
Part Two: Supplemental Questionnaire
Instruction for Questions #4 - #7:
All applicants are required to complete the supplemental questionnaire as part of the online application process. The questionnaire will be used to assess each candidate’s possession of the minimum qualifications and their knowledge, skills and abilities as it pertains to the position.
Responses to items on the supplemental questionnaire must be supported by the information provided on the application. This information is subject to verification. Please be sure to include all relevant education and experience in the work history and education sections of the application. Resumes are not used or reviewed to determine whether you meet the minimum qualifications or to determine your score/rank. A resume should not be submitted to substitute for a completed application. If you write "see resume" on the application, or on the supplemental questionnaire, your application may be rejected.
If you experience technical difficulties, make note of any error messages and contact the analyst before the filing deadline. Responses should be consistent with the information on your employment application and are subject to verification.
By continuing, you hereby certify that you are the author of the information supplied in this supplemental questionnaire. You understand that any false or incorrect statements may result in your disqualification or dismissal from employment with the San Francisco Department of Public Health and City and County of San Francisco. You also understand and agree that the information provided is subject to verification.
4.
Based on your work experience, excluding instrument sets, describe the most complicated piece of medical equipment you have mastered. (Please be detailed in your response.)
Describe what made the piece of equipment complicated.
Explain how you learned to troubleshoot the equipment.
What resources did you use to learn the equipment/troubleshooting?
As a reminder, all work experiences must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the experience you are about to describe in the "Employment Record" section of your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update your work experience before submitting your application.
5.
Based on your work experience, describe a time when you had a break in sterile technique. What did you do to remedy the situation? (Please be detailed in your response.)
As a reminder, all work experiences must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the experience you are about to describe in the "Employment Record" section of your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update your work experience before submitting your application.
6.
Describe your work experience setting up a sterile back table for an exploratory laparotomy. Include the instruments that were required for your case and any special considerations you made based on the procedure. (Please be detailed in your response.)
As a reminder, all work experiences must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the experience you are about to describe in the "Employment Record" section of your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update your work experience before submitting your application.
7.
Based on your work experience, describe a time when you had a disagreement with your co-worker regarding operating room procedures. (Please be detailed in your response.)
How did you resolve the disagreement?
How did you maintain a working relationship with your co-worker?
As a reminder, all work experiences must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the experience you are about to describe in the "Employment Record" section of your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update your work experience before submitting your application.
CERTIFICATION: By checking this box, I hereby certify that I am the author of the information supplied in this supplemental questionnaire. I understand that any false or incorrect statements may result in my disqualification or dismissal from employment with the San Francisco Department of Public Health and City and County of San Francisco. I also understand and agree that the information provided is subject to verification.
Department of Human Resources