Continual Learning - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Continual Learning:
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.

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.





Continual Learning

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You build onto your strengths.
  1. You set relevant learning objectives and goals.
  1. You grasp new ideas, concepts, technical, or business knowledge.
  1. You take charge of your training and skills enhancement.
  1. You build on your strengths while addressing your weaknesses.
Please feel free to provide any comments to help explain your answers?

Communication Skills

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You are an effective communicator
  1. You organize ideas clearly.
  1. You create reports that are clear and persuasive.
  1. You deal with difficult situations calmly and confidently.
  1. You support communication systems recently implemented.
Please feel free to provide any comments to help explain your answers?

Attitude

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You show by your actions that you trust in the positive intentions of others.
  1. You are approachable and easy to talk to.
  1. You display persistence in pursuing goals despite obstacles and setbacks.
  1. You appreciate the efforts of others.
  1. You contribute to a positive and fun work environment.
Please feel free to provide any comments to help explain your answers?

Managing Performance

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You monitor performance on a regular basis.
  1. I am consistent in clearly communicating job requirements.
  1. I provide additional responsibilities for employees that exceed performance standards.
  1. I make sure employees understand what is expected of them.
  1. I increase responsibilities for high performing individuals.
Please feel free to provide any comments to help explain your answers?

Project Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. I understand what software tools are available to be used to manage the project.
  1. I add the necessary time buffers to avoid the project getting behind schedule.
  1. You accurately determine the number of staff needed for the project.
  1. You work with both internal and external individuals to facilitate the project.
  1. You monitor timelines and milestones to ensure set benchmarks are met.
Please feel free to provide any comments to help explain your answers?

Delegation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You delegate tasks, responsibilities, and accountability as appropriate.
  1. You communicate expected/desired outcomes.
  1. You clearly define tasks for employees.
  1. You assign tasks to subordinates for completion.
  1. You assign tasks to create learning opportunities for the employees.
Please feel free to provide any comments to help explain your answers?

Goals

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You set high expectations and goals; encourages others to support the organization.
  1. You make sure that I have a clear idea of our group's goals.
  1. You keep abreast of current developments pertaining to the job
  1. You achieve established goals.
  1. You understand and contribute to development of strategic goals.
Please feel free to provide any comments to help explain your answers?

Managing Risk

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You implement changes to reduce the chances of critical incidents in the future.
  1. You improve process safety where possible.
  1. You create informative guides regarding potential risks and risky behaviors.
  1. You seek to retain the best and brightest employees.
  1. You are able to perceive the risks of different work tasks and activities.
Please feel free to provide any comments to help explain your answers?

Safety

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You develop a sustainable safety culture.
  1. You create accurate and effective measures of safety.
  1. You keep accurate safety records.
  1. You identify predictable hazards in the workplace.
  1. You are committed to safety in the workplace.
Please feel free to provide any comments to help explain your answers?

Negotiation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You leverage relationships with others to achieve goals.
  1. You are able to adapt to changing situations.
  1. You establish clear communications to avoid misunderstandings.
  1. You are able to clearly express thoughts and concerns.
  1. You are able to decline bad ideas to avoid making poor decisions.
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.