Kingdom of Saudi Arabia ‫اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬
National Guard Health Affairs ‫اﻟﺸﺆون اﻟﺼﺤﻴﺔ ﻟﻠﺤﺮس اﻟﻮﻃﻨﻲ‬
Recruitment Services
 
 
 
IMPORTANT GUIDELINES IN FILLING-OUT THE SKILLS CHECKLIST FORM

Dear Applicants,

First of all, thank you for your interest to be part of National Guard Health Affairs’ workforce.

As the next step of moving forward on your application, please take your time in completing the attached Technical Skills
Checklist and rate yourself as honestly as possible. Your rating in the said checklist will not affect your application
positively or negatively, but will be used to identify the most suitable area which you will best fit in.

It is important that you will not overrate yourself as this Checklist will also serve as a reference in your probationary
evaluation (initial 90 days of employment) and demonstration of skills, as you have stated in this Clinical Checklist Form, is
expected. Inability to demonstrate the skills stated might result in termination of your employment during
probationary period.

Please use the below keys in rating your skills:

EXPERIENCE KEY (Patricia Benner’s Model of Nursing Skills Acquisition – “Novice to Expert”)
1 - Novice – no background experience related to this function
2 - Advanced Beginner – sufficient knowledge to understand the contextual nature of the function, able to perform
routine functions independently, requires assistance when setting priorities in complex situations
3 - Competent – views actions as part of an over-all plan, knows what aspects of current and contemplated situations
are most important, needs to gain speed and flexibility to be proficient
4 - Proficient – Perceives situations and functions as a whole, has knowledge of the typical events to expect in a given
situation and the appropriate responses, flexible in decision making
5 - Expert – enormous background and experience, can grasp situations intuitively, mastery in performance,
incorporates elements of innovation and creativity in clinical experience

FREQUENCY KEY:
1 – Never performed the skill
2 – At least once or twice a year
3 – At least once per month
4 – At least once per week
5 – At least daily

Nevertheless, you may provide additional information as needed to facilitate a more comprehensive review of your skills
and experience.

Please note that your signature below will signify that you have read and understood the importance of
honestly filling-out the attached Clinical Checklist Form; And, that you accept and acknowledge that
incorrect declaration of skills might result to termination of your employment during probationary period.

Name: Signature: Date:

Ms. Faiza Shafiq

Concerned Recruiter/Agency (Signature/Stamp): (On behalf of Alnajam) Date:

Guidelines in Filling‐out the Checklist Form