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Continual Learning - 360 Degree Feedback Survey Sample #5





360-Degree Assessment Survey

Questionnaires Measuring Continual Improvement:
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)
Dear Employee:

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

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 by .

Thank you for your participation in the survey.

Management Team



Continual Improvement

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Looks for ways to expand current job responsibilities.
  1. Promotes training and development opportunities to enhance job performance.
  1. Looks for ways to expand and learn new job skills.
  1. Encourages an employee culture of continuous improvement to seek out better ways of doing things.
  1. Looks for ways to improve work processes and procedures.


Professional Development

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Encourages employees to take courses relevant to their job.
  1. Seeks opportunities for professional development.
  1. Seeks opportunities for continuous learning.
  1. Contributing fully to the extent of their skills
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge


Initiative

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Takes action without being asked.
  1. Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Takes the initiative to change the direction or course of events.
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.


Technical

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Willingly shares information and expertise; sought out as resource by others
  1. Knows how to produce high quality products/work.
  1. Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
  1. Willingly shares his/her technical expertise; sought out as resource by others
  1. Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices


Managing Risk

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Responds appropriately to unexplained or unanticipated events.
  1. Avoids maintaining the status quo (or standard operating procedures) when addressing new and influential situations.
  1. Rewards innovative experiments to try new ideas.
  1. Maintains open communication with other departments.
  1. Recognizes that small changes may snowball into major events.


Teamwork

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Builds relationships across boundaries and with key stakeholders by developing informal and formal networks.
  1. Communicates well with team members.
  1. Effective team player
  1. Identifies and resolves conflicts within the team to increase team effectiveness
  1. Coaches team members to work toward a common goal.



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






  2. Strengths


  3. Areas for Development


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