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 are open to new ideas and concepts.
You participate in regular training offered.
You take the initiative to learn new skills.
You build on your strengths while addressing your weaknesses.
You pursue professional development opportunities when they arise.
Cultural Awareness	Agree	Unsure	Disagree	N/A
I value the diverse perspectives from others.
You respect the views offered by individuals with different cultural backgrounds.
I am aware of differences in how individuals from other cultures greet one another.
You are curious and willing to ask questions about the cultural differences in the workplace.
I seek opportunities to learn about the other cultural backgrounds of colleagues.
Clarity	Agree	Unsure	Disagree	N/A
You clearly explains responsibilities to individuals.
You avoid stating unclear or conflicting goals.
You attend to the important details of a job or task.
You clearly explain the vision and goals of the company.
You are clear about goals that need to be achieved.
Collaboration	Agree	Unsure	Disagree	N/A
You create an environment that encourages information sharing.
You listen and attend to the ideas from others.
I use digital tools to support collaborative efforts in document creation?
You build and strengthen relationships to improve collaboration and leadership.
You ensure relevant data is available to all committee members.
Coaching	Agree	Unsure	Disagree	N/A
You address employee behavior problems effectively.
You conduct regular performance appraisals and feedback.
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.
Partnering/Networking	Agree	Unsure	Disagree	N/A
I organize team-building activities to strengthen bonds between colleagues.
I nurture partnerships with key individuals in the industry to stay on top of the latest trends and best practices.
I seek to increase exchanges of information with other companies/colleagues.
I understand the potential implications of the partnership.
You leverage core competencies of partners to the benefit of both parties.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You take the initiative to complete tasks.
You are comfortable operating in an environment of uncertainty.
You are able to adapt the department to changing business demands and climate.
You maintain a high level of energy to respond to demands of the job.
You understand the processes and various stages of business development.
Vision	Agree	Unsure	Disagree	N/A
You commit to undertaking the implementation of the strategic vision.
You facilitate employees' adoption of the organization vision.
You encourage employees to embrace the departmental vision.
You channel team activities towards the vision's core aspects.
You diagnose issues and envision solutions.

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.