Change Management - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Change Management:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
Self-Assessment Instructions

Leadership at [Company] are participating in a 360-Degree Feedback assessment. As part of this process, you need to complete a self-assessment questionnaire form. Other employees, including your manager(s), peers, and direct reports will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance as a manager. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

If you are not able to respond to an item, leave it blank and go on to the next item.

Competencies Included:
Change Management, Objectives, Flexibility, Creativity, Cultural Awareness, Performance, Interpersonal Skills, Conflict Management, Planning
Sample Result Document:
Sample Results
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.

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




Change Management

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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  1. You support new initiatives for organizational changes to improve effectiveness.
  1. You work cooperatively with others to implement changes.
  1. I facilitate change with minimal resistance.
  1. I develop plans for following through on the changes.
  1. You address organizational and departmental resistance to changes.
Please feel free to provide any comments to help explain your answers?

Objectives

Does Not
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  1. You establish goals and objectives.
  1. You set long-term and short-term goals.
  1. You encourage others to take on greater responsibility.
  1. You are able to organize work.
  1. You assure [Company] principles are understood, employed & pursued.
Please feel free to provide any comments to help explain your answers?

Flexibility

Does Not
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  1. You are effective in incorporating new ideas.
  1. You implement changes as a result of having listened to employees
  1. You are able to adapt to new situations.
  1. You are willing to try new ideas.
  1. You are open to the perspectives/viewpoints of others.
Please feel free to provide any comments to help explain your answers?

Creativity

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  1. You are creative.
  1. You are creative and inspirational.
  1. You conceive, implement and evaluate ideas.
  1. You inspire creativity in your team.
  1. You add value to the department/organization.
Please feel free to provide any comments to help explain your answers?

Cultural Awareness

Does Not
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Competency
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  1. I develop skills and attitudes to bridge cultural differences.
  1. You are willing to work with employees who have different cultural backgrounds.
  1. I value the diverse perspectives from others.
  1. I interact effectively with people from different cultural backgrounds.
  1. I seek clarification to avoid misunderstandings.
Please feel free to provide any comments to help explain your answers?

Performance

Does Not
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Competency
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  1. You work well in this position.
  1. You work effectively in the department.
  1. You are effective in performing your job.
  1. You have great overall performance
  1. You shown significant improvement in job performance.
Please feel free to provide any comments to help explain your answers?

Interpersonal Skills

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  1. I value the input from coworkers.
  1. You value the opinions of others.
  1. I demonstrate a high degree of ethics and integrity in the workplace.
  1. I assist employees that need help.
  1. You understand the core issues of conversations.
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
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  1. You discuss conflict situations with supervisor.
  1. You help employees to think through alternative ways to resolve conflict situations.
  1. You try to understand others' point of view before making judgments
  1. You deal effectively with employee grievances.
  1. You assist team members by helping them see the other point of view.
Please feel free to provide any comments to help explain your answers?

Planning

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  1. You set the appropriate sequence of tasks to efficiently achieve the goal.
  1. You understand the process for developing strategic plans for the organization.
  1. You make plans and follows through.
  1. I develop plans used to accomplish urgent or critical tasks.
  1. I divide complex tasks into smaller steps to measure progress toward a goal.
Please feel free to provide any comments to help explain your answers?

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






  2. Strengths


  3. Areas for Development


  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.