Continual Learning - 360 Degree Feedback Survey Sample #8

Self-Assessment Instructions

You have been selected to complete a self-assessment questionnaire as part of a 360-degree feedback assessment. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

Respond to the assessment form based on your work experiences during the previous 12 months. Your responses will be merged with other people's feedback and presented to you in your on-going development. Comments from others will be shared anonymously, as written.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

Continual Learning	Agree	Unsure	Disagree	N/A
You share best practices with others and learn from others.
You build on your strengths while addressing your weaknesses.
You participate in regular training offered.
You are open to new ideas and concepts.
You take the initiative to learn new skills.
Cultural Awareness	Agree	Unsure	Disagree	N/A
You value the opinions of diverse groups and individual.
You treat others with dignity and respect.
You show respect in daily interactions
You encourage a work environment where individual differences are valued.
You recognize and value individual and cultural differences.
Clarity	Agree	Unsure	Disagree	N/A
You avoid creating ambiguity or mixed messages.
You adjust communication methods to the needs of the audience.
You clarify problems and your causes to help employees correct them.
You write clear job descriptions for positions in the organization.
You are clear about goals that need to be achieved.
Collaboration	Agree	Unsure	Disagree	N/A
You a trustworthy and credible partner.
You a dependable partner in the group.
You respect other group/team members.
You consult with other partners on issues.
You work cooperatively with others to solve problems.
Coaching	Agree	Unsure	Disagree	N/A
You develop the skills and capabilities of others.
You help employees to understand responsibilities, authority, and expectations.
You coach employees in how to strengthen knowledge and skills to improve work performance.
You provide clear, motivating, and constructive feedback.
You help employees to maintain high personal standards.
Partnering/Networking	Agree	Unsure	Disagree	N/A
You maintain infrastructure to support partnerships and networks.
You develop a sense of trust in subordinates so they can freely interact and share information with others.
You support and encourage relationships that are created by diverse team members.
You promote the understanding of how the department affects the organization overall.
You create the conditions for partnerships to grow and develop.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You seek and utilize mentors to help guide your professional development.
You are comfortable operating in an environment of uncertainty.
You are excellent at managing relationships with stakeholders.
You balance risks and rewards when making decisions.
You find unique ways to go around barriers to success.
Vision	Agree	Unsure	Disagree	N/A
You expresse the Company vision in a way that is easily understood and adopted by employees.
You understand the vision of the Company and promote it ahead of any self-interests.
You work to support the strategy of [Company]
You clearly articulate a vision for your work and inspires others to support it
You create a common vision for others.

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

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for [Participant Name Here]'s assessment.