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 seek opportunities to grow in skills and knowledge.
You build on your strengths while addressing your weaknesses.
You pursue professional development opportunities when they arise.
You improve on your skill sets.
You pursue self-improvement through continual learning.
Cultural Awareness	Agree	Unsure	Disagree	N/A
I am an advocate for others with different cultural backgrounds.
You respect others regardless of age, race, gender, nationality, or disability.
I recognize individual and cultural differences.
You encourage a work environment where individual differences are valued.
I actively listen to other employees' stories about their culture.
Clarity	Agree	Unsure	Disagree	N/A
You clearly explain the vision and goals of the company.
You seek to reduce ambiguity in messaging and documents.
You are clear about the roles and duties of team members.
You make sure employees understand why they were given certain assignments.
You communicate with clarity and efficiency.
Collaboration	Agree	Unsure	Disagree	N/A
You display a high degree of trust and credibility.
I involve others in reaching a consensus during group activities.
I create a culture that encourages understanding and valuing diverse perspectives to effectively resolve conflicts.
You are comfortable working with employees from different departments/divisions.
I encourage team members to offer opinions and ideas.
Coaching	Agree	Unsure	Disagree	N/A
You coach employees in how to strengthen knowledge and skills to improve work performance.
You develop the skills and capabilities of others.
You help employees to understand responsibilities, authority, and expectations.
You help employees to maintain high personal standards.
You provide clear, motivating, and constructive feedback.
Partnering/Networking	Agree	Unsure	Disagree	N/A
I work in tandem with colleagues to pursue common goals and needs.
I reinforce the contacts with other organizations.
You facilitate communication with others in the company.
You establish collaborative business relationships to unlock and enhance growth opportunities.
I maintain communication channels with colleagues in the industry.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You are able to adapt the department to changing business demands and climate.
You take the initiative to complete tasks.
You have a strategic awareness on how to promote the organization.
You are excellent at managing relationships with stakeholders.
You encourage risk taking for developing potential business opportunities.
Vision	Agree	Unsure	Disagree	N/A
You create an ambitious and aspirational vision for the company.
You create a workplace culture that reflects the organizational vision.
You entrust team members with executing the vision.
You diagnose issues and envision solutions.
I am adept at identifying underlying problems within the organization and is capable of envisioning innovative and effective solutions to address these issues.

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.