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 take the initiative to learn new skills.
I view setbacks as opportunities to learn from.
You are open to new ideas and concepts.
You grasp new ideas, concepts, technical, or business knowledge.
You pursue self-improvement through continual learning.
Cultural Awareness	Agree	Unsure	Disagree	N/A
You communicate with others without the influence of racism.
You understand how implicit biases can affect decisions, communication and productivity.
I participate in cultural training sessions/classes.
You are sensitive to the similarities and differences that exist between cultures.
You support and mentor others that may have different cultural backgrounds.
Clarity	Agree	Unsure	Disagree	N/A
You clearly define work objectives for employees.
You avoid creating ambiguity or mixed messages.
You are clear about the roles and duties of team members.
You communicate with clarity and efficiency.
You make sure goals and objectives are clearly and thoroughly explained and understood.
Collaboration	Agree	Unsure	Disagree	N/A
You devote time and energy to empower the team to succeed.
I strengthen relationships with suppliers to improve contract and price negotiation terms.
I regularly seek feedback from employees on how to improve collaboration and act on their suggestions.
You encourage trust among committee members.
I create an environment where team members feel safe to express their ideas and concerns without fear of judgment.
Coaching	Agree	Unsure	Disagree	N/A
You provide clear, motivating, and constructive feedback.
You help employees to maintain high personal standards.
You conduct regular performance appraisals and feedback.
You address employee behavior problems effectively.
You help employees to understand responsibilities, authority, and expectations.
Partnering/Networking	Agree	Unsure	Disagree	N/A
You srive to cultivate and maintain a partnership based on trust and commitment in relationships.
I work in tandem with colleagues to pursue common goals and needs.
You balance the strategic interests of those involved to maintain alliances.
You effectively develop networks with colleagues that have shared interests.
You use informal networks to share information.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You find unique ways to go around barriers to success.
You are excellent at managing relationships with stakeholders.
You balance risks and rewards when making decisions.
You can work effectively in an environment of uncertainty.
You exhibit determination and passion in completion of goals.
Vision	Agree	Unsure	Disagree	N/A
You lead employees in new directions.
I establish the direction and strategy for the organization.
I am able to formulate and implement a vision for the future of the department.
I inspire individuals to achieve success by clearly communicating the organization's vision and motivating them to align their personal goals with this vision.
I encourage employees to prioritize activities that contribute to the 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.