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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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
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:
Continual Learning, Communication Skills, Attitude, Managing Performance, Project Management, Delegation, Goals, Managing Risk, Safety, Negotiation
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.



Edit this Survey
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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 pursue professional development opportunities when they arise.
  1. You expand your educational and future learning opportunities.
  1. You are introspective and aware of your own learning needs.
  1. I view setbacks as opportunities to learn from.
  1. You set relevant learning objectives and goals.
Please feel free to provide any comments to help explain your answers?

Communication Skills

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
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Competency
  1. You deliver messages with personal energy, enthusiasm, and conviction.
  1. You review any "action steps" resulting from meetings or conversations before concluding to ensure clarity and that plans will be executed
  1. You deliver clear and concise instructions.
  1. You are an effective communicator
  1. I effectively engage with everyone from the CEO to external partners.
Please feel free to provide any comments to help explain your answers?

Attitude

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
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Competency
  1. You contribute to a positive work environment.
  1. You visibly support and encourages diversity in style and background.
  1. You are pleasant and gracious to work with.
  1. You build open and trusting relationships.
  1. You are genuinely concerned about others in the department.
Please feel free to provide any comments to help explain your answers?

Managing Performance

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
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  1. You acknowledge employee contributions that support the bottom line.
  1. You monitor performance on a regular basis.
  1. You recognize team members when they contribute significantly to the team.
  1. I administer the performance rewards program in a fair and equitable manner.
  1. I link qualitative objectives to quantitative key results.
Please feel free to provide any comments to help explain your answers?

Project Management

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Competency
  1. You formulate the schedule for the project phases, resoures usage, and benchmarks.
  1. You identify potential risks to completing the project on time.
  1. You respond quickly and appropriately to unforeseen problems.
  1. You coordinate timelines, events and tasks with various sub-groups within the project.
  1. You regularly review project performance and goals.
Please feel free to provide any comments to help explain your answers?

Delegation

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
Usually
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Competency
Always
Exhibits this
Competency
  1. You set clear and reasonable expectations for others and follow through on their progress.
  1. You assign goals and objectives as needed.
  1. You select appropriate individuals to complete tasks.
  1. You delegate tasks, responsibilities, and accountability as appropriate to the level of employee.
  1. You encourage and empower others to use initiative in achieving goals and objectives.
Please feel free to provide any comments to help explain your answers?

Goals

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. You seek projects in areas outside immediate responsibilities.
  1. You set challenging stretch goals
  1. You make sure that I have a clear idea of our group's goals.
  1. You set short and long term goals for self without being pushed.
  1. You establish and document goals and objectives.
Please feel free to provide any comments to help explain your answers?

Managing Risk

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
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Exhibits this
Competency
  1. You are aware of process safety management.
  1. I accept risks as needed.
  1. You effectively manage risk for the department.
  1. I design risk management activities that support the success of the company.
  1. I establish the context for risk management activities.
Please feel free to provide any comments to help explain your answers?

Safety

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Exhibits this
Competency
  1. You encourage others to work safely.
  1. You point out behaviors in others that may be unsafe.
  1. You mitigate hazards and safety issues that arise.
  1. You perform work safely.
  1. You keep accurate safety records.
Please feel free to provide any comments to help explain your answers?

Negotiation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
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Competency
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Competency
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Competency
  1. You are able to adapt to dynamic situations created by new information or unexpected challenges.
  1. You are aware of the needs of the other party.
  1. I keep a firm grasp on the issues and priorities.
  1. You base arguments on objective standards or criteria, such as market value, legal standards, or expert opinions.
  1. You are able to adapt to changing situations.
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.