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 pursue self-improvement through continual learning.
You take charge of your training and skills enhancement.
You improve on your skill sets.
You are open to new ideas and concepts.
I view setbacks as opportunities to learn from.
Cultural Awareness	Agree	Unsure	Disagree	N/A
I am an advocate for others with different cultural backgrounds.
You hire individuals with different cultural backgrounds for the department.
You seek feedback from employees of different backgrounds to improve team inclusivity.
You respect the views offered by individuals with different cultural backgrounds.
You are sensitive to the similarities and differences that exist between cultures.
Clarity	Agree	Unsure	Disagree	N/A
You write clear job descriptions for positions in the organization.
You check details thoroughly.
You clearly define work objectives for employees.
You communicate with clarity and efficiency.
You adjust communication methods to the needs of the audience.
Collaboration	Agree	Unsure	Disagree	N/A
You have the confidence and trust of other partners.
You work with other experts to solve problems.
I collaborate across departmental boundaries and finds common ground with a wide range of stakeholders.
You respect individual differences that contribute to solving problems.
I share knowledge, ideas and resources to achieve quicker success.
Coaching	Agree	Unsure	Disagree	N/A
You provide clear, motivating, and constructive feedback.
You listen to ideas and suggestions from others.
You ask questions to help employees see the situation in a new light.
I create a supportive environment where employees feel confident exploring new ideas and tackle challenges.
You develop the skills and capabilities of others.
Partnering/Networking	Agree	Unsure	Disagree	N/A
I collaborate effectively with team members to achieve shared objectives and meet collective needs.
I use networks of personal contacts to gain introductions to others who may have valuable information.
I successfully identify complementary and compatible strategic partners with colleagues in the industry.
I enter into licensing agreements to share intellectual property.
I engage in partnerships that produce significant results.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You can work effectively in an environment of uncertainty.
You take the initiative to complete tasks.
You encourage dynamic growth opportunities.
You maintain a high level of energy to respond to demands of the job.
You have a strategic awareness on how to promote the organization.
Vision	Agree	Unsure	Disagree	N/A
You lead with a growth-oriented mindset, driving innovation and expansion.
I committed to turning the strategic vision into reality by meticulously planning, coordinating, and overseeing the implementation of an action plan.
You chart a bold course for the department's rapid evolution and expansion.
I assign the vision implementation to team members.
You direct team efforts towards key elements of 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.