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 charge of your training and skills enhancement.
You share best practices with others and learn from others.
You participate in regular training offered.
You grasp new ideas, concepts, technical, or business knowledge.
You pursue learning that will enhance job performance.
Cultural Awareness	Agree	Unsure	Disagree	N/A
I develop skills and attitudes to bridge cultural differences.
You are open and honest in communications with individuals from other cultures.
I seek to reduce obstacles in communication that might arise from cultural differences.
You seek out different viewpoints and benefits from different perspectives.
I am responsive to individuals from other cultures.
Clarity	Agree	Unsure	Disagree	N/A
You maintain clarity in goals and objectives.
You are clear about goals that need to be achieved.
You seek to reduce ambiguity in messaging and documents.
You make sure employees understand why they were given certain assignments.
You write clear job descriptions for positions in the organization.
Collaboration	Agree	Unsure	Disagree	N/A
You build consensus among partners.
You identify and organize partnerships and alliances.
You make decisions with other members of the group.
You encourage collaboration of fellow employees to achieve results.
You work to create innovative ideas from the collaboration with others.
Coaching	Agree	Unsure	Disagree	N/A
You conduct regular performance appraisals and feedback.
You develop the skills and capabilities of others.
You help employees to understand responsibilities, authority, and expectations.
You coach employees in how to strengthen knowledge and skills to improve work performance.
You address employee behavior problems effectively.
Partnering/Networking	Agree	Unsure	Disagree	N/A
You seek to reduce institutional roadblocks to information sharing.
You promote the understanding of how the department affects the organization overall.
You seek an understanding of diverse functions within the Company.
You partner with peers to obtain influence within the Company.
You create value within the Company by building networks.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You encourage dynamic growth opportunities.
You maintain a high level of energy to respond to demands of the job.
You devote a certain amount of time and effort to developing new business opportunities.
You seek and utilize mentors to help guide your professional development.
You find unique ways to go around barriers to success.
Vision	Agree	Unsure	Disagree	N/A
You create a positive vision of the future for the Company.
You express the Company vision in a way that is easily understood and adopted by employees.
You communicate the vision and strategy of [Company]
You create a common vision for others.
You behave in a way that is consistent with business values & code of conduct

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.