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 .

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Continual Learning	Agree	Unsure	Disagree	N/A
You are curious about learning new things.
You set stretch learning goals that challenge existing capabilities and promote continuous improvement.
I set specific learning goals to build new skills and deepen professional knowledge over time.
You pursue self-improvement through continual learning.
I actively pursue training, courses, and development activities to strengthen skills and stay current.
Cultural Awareness	Agree	Unsure	Disagree	N/A
You understand how implicit biases can affect decisions, communication and productivity.
I seek to reduce obstacles in communication that might arise from cultural differences.
You are sensitive to the different cultural backgrounds of employees.
I promote continuous learning about customs, traditions, and workplace etiquette.
You foster a diverse workforce free from discrimination and harassment.
Clarity	Agree	Unsure	Disagree	N/A
You avoid stating unclear or conflicting goals.
You clarify problems and their causes to help employees correct them.
You are clear about goals that need to be achieved.
You seek to reduce ambiguity in messaging and documents.
You use appropriate grammar and tense in communications.
Collaboration	Agree	Unsure	Disagree	N/A
I am tactful, compassionate and sensitive to the needs of others.
You build strong interpersonal relationships for more effective collaboration.
You ensure relevant data is available to all committee members.
You encourage a diversity of opinions and ideas.
I contribute expertise, insights, and resources to accelerate solutions to problems.
Coaching	Agree	Unsure	Disagree	N/A
You help employees to find and correct your own errors
You coach and mentor employees to achieve excellence.
I foster exploration using open-ended questions to shift the focus from merely addressing immediate issues to uncover underlying challenges, opportunities, and motivations.
You ask questions that challenge assumptions.
You ask questions that lead to discovery, insight or action.
Partnering/Networking	Agree	Unsure	Disagree	N/A
You mediate disagreements by helping each party articulate their underlying interests.
You create value within the Company by building networks.
You host industry events or meetups to bring partners and networks together.
You collaborate with others to accomplish goals and objectives.
You form strategic partnerships and business alliances to expand opportunities.
Entrepreneurship	Agree	Unsure	Disagree	N/A
I create forward-looking offerings that enhance the department's competitive edge.
You help people see the potential in ideas that are still emerging or ambiguous.
You articulate a compelling vision of what could be achieved.
You take the initiative to complete tasks.
You provide confidence and reassurance during periods of transition.
Vision	Agree	Unsure	Disagree	N/A
I provide vision and strategies to the team.
I envision and articulate a clear path for the department's accelerated growth over the next year.
You use data, trends, and scenario plan to craft a vision grounded in evidence rather than intuition alone.
I recognize and reward behaviors that are consistent with the company's vision.
You cultivate an environment that embodies the department's vision.

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.