Communication - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Communication:
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

You have been asked to complete a self-assessment questionnaire form (shown below). You will also receive feedback from others such as your peers, direct reports and manager. Feedback is an important part of our company's leadership development process and this survey is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the questions below, think about your experiences as an employee over the last twelve months and the goals you were asked to achieve. 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 become part of the assessment process to foster your growth and on-going development.

Competencies Included:
Communication Skills, Continual Improvement, Attitude, Analytical, Juggling Multiple Responsibilities, Collaboration, Trustworthy, Vision
Sample Result Document:
Sample Results
Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

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


Communication Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You communicate goals of project, resources required, resources available, etc. to the team
  1. You use effective non-verbal communication (e.g., eye contact, nodding, gestures, etc.)
  1. I clarify problems logically, simplifying complex matters into digestible parts.
  1. You are an effective and motivating communicator.
  1. You convey priorities with right sense of urgency and importance.
What are your suggestions for how you can make improvements
in Communication Skills?

Continual Improvement

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You investigate the root causes of problems.
  1. You look for ways to improve work processes and procedures.
  1. You evaluate the effectiveness of improvements.
  1. You pursue efforts to improve by seeking feedback from others.
  1. You identify opportunities to improve workflow processes through the better use of technology.
What are your suggestions for how you can make improvements
in Continual Improvement?

Attitude

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You visibly support and encourages diversity in style and background.
  1. You treat all people fairly and with respect.
  1. You display persistence in pursuing goals despite obstacles and setbacks.
  1. You work to eliminate unnecessary work or barriers that get in others' way.
  1. You enjoy working in the department
What are your suggestions for how you can make improvements
in Attitude?

Analytical

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You identifiy opportunities for progress and innovation.
  1. You perform checks on data accuracy and quality.
  1. You determine averages and trends in the data.
  1. You look for trends in the data.
  1. You prioritize various actions to be taken when solving a problem.
What are your suggestions for how you can make improvements
in Analytical?

Juggling Multiple Responsibilities

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You observe, analyze, and respond to merchandise needs while serving customers and accomplishing operational tasks.
  1. You can switch focus between tasks as needed.
  1. You delegate tasks to others when needed.
  1. You prioritize tasks for efficiency.
  1. You determine which tasks are critical and which tasks are optional.
What are your suggestions for how you can make improvements
in Juggling Multiple Responsibilities?

Collaboration

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I collaborate with others to resolve conflicts constructively.
  1. I involve others in reaching a consensus during group activities.
  1. I give consideration to the innovative ideas presented by others.
  1. You encourage working together to achieve shared goals.
  1. You are honest with others.
What are your suggestions for how you can make improvements
in Collaboration?

Trustworthy

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You seek to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. You demonstrate congruence between statements and actions.
  1. You work in a way that makes others want to work with you.
  1. You communicate an understanding of the other person's interests, needs and concerns.
  1. You demonstrate a sense of responsibility and commitment to public trust.
What are your suggestions for how you can make improvements
in Trustworthy?

Vision

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You align subordinates' work with the vision's critical priorities.
  1. You are able to diagnose issues and problems and to create a vision for their solutions.
  1. You develop a vision that is a catalyst for innovation and change.
  1. You pinpoint challenges and devises strategies.
  1. You communicate the vision effectively across the organization to motivate and guide employees.
What are your suggestions for how you can make improvements
in Vision?


  1. Strengths


  2. Areas for Development


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