Analytical Skills - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to participate in a 360-assessment. As part of this process you will need to complete the self-assessment questionnaire below.

In responding to the questions below, think about your experiences over the last 12 months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others. A report will be shared with you at the conclusion of this project.

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. If you have any questions about the process please contact [Contact Person].

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

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Analytical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I examine patient orders to determine the proper dosage of medicines.
You identify discrepancies and inconsistencies in reports.
You are open minded and receptive to considering opposing evidence.
You present data in a format that makes comparisons easier.
You recognize patterns, draws logical conclusions, and makes recommendations for action.
Juggling Multiple Responsibilities	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You coordinate the work of a team by assigning tasks to other team members.
You are aware of the deadlines for specific tasks/assignments.
You begin tasks as soon as possible.
You recognize and respond to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
You prioritize tasks for efficiency.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You consistently strive to complete work on time or ahead of schedule.
I am prepared and on time for meetings and scheduled events.
You are personally invested in the success of the organization.
I review performance to determine areas for improvement.
I work diligently for the success of the team.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You recognize integrity as a core value of the organization.
You maintain strong relationships with others.
You are consistently open and honest with others.
I conduct performance evaluations based on standard and objective measures to maintain the integrity of the evaluation system.
You inspire others to perform at their best by fostering a culture of integrity and achievement within the organization.
Feedback	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I see feedback as an opportunity for growth.
I explore alternative perspectives or interpretations of feedback to broaden self-awareness.
You give full attention to the feedback provider.
I integrate feedback appropriately to support professional advancement, ensuring it is handled with integrity.
You link feedback directly to specific role expectations, KPIs, or project outcomes.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You implement changes to reduce the chances of critical incidents in the future.
You design risk response activities that are proportionate to the level of risk.
I recognize the potential impact of systemic risks.
I take steps to reduce the occurrence of the risk events.
I use risk management to be more effective in identifying and implementing projects.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You develop a culture of safety.
You support our company's safety programs.
You mitigate hazards and safety issues that arise.
You identify predictable hazards in the workplace.
You seek to reduce the likelihood of accidents.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I am a committed and reliable partner.
You build a strong rapport with co-workers.
You are able to work with individuals at all levels of the company.
I give constructive feedback on performance reviews.
You come across as credible, knowledgeable and sincere
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You let employees complete tasks according to their methods.
I give employees opportunities to demonstrate their skills.
You support the decisions of others.
I value the opinions of others.
You give employees input into the decision making process.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I maintain strategic focus by regularly reviewing the strategic plan and taking corrective actions as needed to stay on track.
You determine the best strategy for achieving elevated levels of performance.
I understand the importance of developing strategic capabilities.
I create innovative strategies.
I inspire employees to adopt the strategic plan.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I set manageable workloads across the team.
You allocate resources strategically to minimize downtime and maximize productivity.
You provide access to training, documentation, and expert support to help employees use resources effectively
You understand the "basics" as to how [Company] functions/operates.
I regularly engage with employees to understand what drives their satisfaction and well-being.

56. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
57. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
58. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
59. Additional comments, if any for [Participant Name Here]'s assessment.