Interpersonal Skills - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Interpersonal Skills:
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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Instructions

You have been asked to evaluate yourself as part of a 360-degree feedback process. Other employees, including your manager(s), peers, and direct reports will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance as a manager. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

If you are not able to respond to an item, leave it blank and go on to the next item.

Sample Result Document:
Sample Results
We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

Please ensure that your submission is made between . The survey will only be available during these dates.







Interpersonal Skills

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Creates diverse teams of individuals with different backgrounds, skills, and abilities.
  1. Is a highly respected individual in the company.
  1. Provides constructive feedback in a way that fosters acceptance and development.
  1. Considers the other individual's point of view.
  1. Expresses appreciation of other's work.
Please feel free to provide any comments to help explain your answers?

Adaptability

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Adjusts tactics and strategies.
  1. Accommodates changes as needed.
  1. Able to adapt to changes in technology and processes.
  1. Develops insights and applies innovative solutions to projects and problems.
  1. Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Please feel free to provide any comments to help explain your answers?

Continual Improvement

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Looks for ways to improve work processes and procedures.
  1. Promotes training and development opportunities to enhance job performance.
  1. Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
  1. Looks for ways to expand current job responsibilities.
  1. Looks for ways to expand and learn new job skills.
Please feel free to provide any comments to help explain your answers?

Quality

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Systematically and thoroughly inspects products for consistency in meeting specifications.
  1. Understands and uses established quality procedures/controls.
  1. Creates quality improvement programs and processes.
  1. Develops a quality manual to assist in troubleshooting issues and documenting the quality management system.
  1. Establishes timeframes for achieving suitable quality levels.
Please feel free to provide any comments to help explain your answers?

Innovation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Encourages a diverse range of ideas and perspectives to cultivate an environment where innovation thrives.
  1. Encourages a search for radical innovation opportunities to obtain major breakthroughs.
  1. Advocates for disruptive innovation to ensure the department remains agile and responsive to evolving market demands.
  1. Uses unconventional approaches to solve problems.
  1. Fine-tunes innovative strategies to maximize resource utilization and achieve desired outcomes.
Please feel free to provide any comments to help explain your answers?

Goals

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  1. Achieves goals.
  1. Makes sure that team members have a clear idea of our group's goals.
  1. Understands & contributes to development of strategic goals.
  1. Makes sure that I have a clear idea of our group's goals.
Please feel free to provide any comments to help explain your answers?

Commitment To Result

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Coordinates all department activities into a cohesive team effort.
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
  1. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Maintains persistence and dedication to achieving results.
  1. Encourages commitment in others to obtain results.
Please feel free to provide any comments to help explain your answers?

Technical

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Willingly shares information and expertise; sought out as resource by others
  1. Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
  1. Demonstrates mastery of the technical competencies required in his/her work.
  1. Seeks information from others as needed.
  1. Is knowledgeable of procedures or systems necessary for the job.
Please feel free to provide any comments to help explain your answers?

Responsible

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Acts as a resource without removing individual responsibility.
  1. Works in a way that makes others want to work with her/him.
  1. Is a person you can trust.
  1. Behavior is ethical and honest.
  1. Holds herself / himself accountable to goals / objectives
Please feel free to provide any comments to help explain your answers?

Coaching

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Helps employees to maintain high personal standards.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Provides clear, motivating, and constructive feedback.
  1. Addresses employee behavior problems effectively.
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Identifies areas of agreement and common ground.
  1. Influences attitudes, beliefs, and behaviors in a way that fosters resolution and cooperation.
  1. Works to settle conflicts in a manner that is acceptable for a long-term solution.
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Is open and honest to avoid misunderstandings.
Please feel free to provide any comments to help explain your answers?

Global Perspective

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Applies knowledge of overseas markets.
  1. Cooperates with others on a global scale.
  1. Engages in problem solving with individuals outside of the country.
  1. Builds working relationships with others across cultures.
  1. Aligns personal vision with global strategies.
Please feel free to provide any comments to help explain your answers?

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






  2. Strengths


  3. Areas for Development


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