Continual Learning - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Continual Learning:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
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.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .

Continual Learning

Agree Unsure Disagree N/A
  1. You pursue self-improvement through continual learning.
  1. You seek opportunities to grow in skills and knowledge.
  1. You take the initiative to learn new skills.
  1. You participate in regular training offered.
  1. You build on your strengths while addressing your weaknesses.

Cultural Awareness

Agree Unsure Disagree N/A
  1. You show respect in daily interactions
  1. You maintain an inclusive work environment that maximizes the talents of others in achieving goals.
  1. You value the opinions of diverse groups and individual.
  1. You encourage a work environment where individual differences are valued.
  1. You treat others with dignity and respect.


Agree Unsure Disagree N/A
  1. You make sure goals and objectives are clearly and thoroughly explained and understood.
  1. You maintain clarity in goals and objectives.
  1. You communicate ideas and facts clearly and effectively in writing.
  1. You attend to the important details of a job or task.
  1. You avoid creating ambiguity or mixed messages.


Agree Unsure Disagree N/A
  1. You build consensus among partners.
  1. You a dependable partner in the group.
  1. You work with others to resolve issues facing the company.
  1. You a trustworthy and credible partner.
  1. You define shared goals with the committee members.


Agree Unsure Disagree N/A
  1. You coach employees in how to strengthen knowledge and skills to improve work performance.
  1. You develop the skills and capabilities of others.
  1. You provide clear, motivating, and constructive feedback.
  1. You conduct regular performance appraisals and feedback.
  1. You address employee behavior problems effectively.


Agree Unsure Disagree N/A
  1. You seek to reduce institutional roadblocks to information sharing.
  1. You support and encourage relationships that are created by diverse team members.
  1. You collaborate with others to accomplish goals and objectives.
  1. You seek an understanding of diverse functions within the Company.
  1. You create the conditions for partnerships to grow and develop.


Agree Unsure Disagree N/A
  1. You are excellent at managing relationships with stakeholders.
  1. You exhibit determination and passion in completion of goals.
  1. You find unique ways to go around barriers to success.
  1. You have a strategic awareness on how to promote the organization.
  1. You encourage risk taking for developing potential business opportunities.


Agree Unsure Disagree N/A
  1. You develop action plans to align your work with the goals of the organization
  1. You communicate a vision of where the Company needs to be in the future.
  1. You clearly articulate a vision for your work and inspires others to support it
  1. You demonstrate consistency between words and actions
  1. You behave in a way that is consistent with business values & code of conduct

  1. Overall, please rate the effectiveness of [Participant Name Here].

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.