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)
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
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Competency
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Competency
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Competency
  1. Is a role model for others demonstrating the importance of interpersonal skills.
  1. Assists employees that need help.
  1. Gives constructive feedback on performance reviews.
  1. Honesty and integrity are core tenets of interpersonal relationships.
  1. Adapts management style to meet the needs of the individual or situation.
Please feel free to provide any comments to help explain your answers?

Adaptability

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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  1. Adjusts to new plans and procedures.
  1. Responsive to the needs of others.
  1. Adapts to new environments.
  1. Can take on new assignments.
  1. Accommodates changes as needed.
Please feel free to provide any comments to help explain your answers?

Continual Improvement

Does Not
Exhibit this
Competency
Seldom
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Competency
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  1. Encourages an employee culture of continuous improvement to seek out better ways of doing things.
  1. Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
  1. Open to the suggestions from others.
  1. Analyzes processes to determine areas for improvement.
  1. Looks for ways to improve work processes and procedures.
Please feel free to provide any comments to help explain your answers?

Quality

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
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  1. Reflects on what is working and what could be improved.
  1. Analyze what occurred and re-adjusts accordingly when goals are not met.
  1. Always strives to produce the highest quality work products.
  1. Encourages others to achieve high quality standards.
  1. Encourages others to produce the highest quality work products.
Please feel free to provide any comments to help explain your answers?

Innovation

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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  1. Finds creative ways to get things done with limited resources.
  1. Challenges current procedures to develop other alternatives.
  1. Analyzes current procedures and identifies opportunities for improvement.
  1. Offers constructive improvements to existing systems.
  1. Creates a safe environment for idea-sharing.
Please feel free to provide any comments to help explain your answers?

Goals

Does Not
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Competency
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  1. Achieves established goals.
  1. Understands & contributes to development of strategic goals.
  1. Establishes and documents goals and objectives.
  1. Achieves goals.
  1. Makes sure that team members 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
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Competency
Seldom
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Competency
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  1. Creates a sense of urgency among the store team members to complete activities, which drive sales.
  1. Committed to the team.
  1. Able to focus on a task even when working alone.
  1. Maintains persistence and dedication to achieving results.
  1. Coordinates all department activities into a cohesive team effort.
Please feel free to provide any comments to help explain your answers?

Technical

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. Willingly shares information and expertise; sought out as resource by others
  1. Is knowledgeable of procedures or systems necessary for the job.
  1. Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
  1. Seeks information from others as needed.
  1. Willingly shares his/her technical expertise; sought out as resource by others
Please feel free to provide any comments to help explain your answers?

Responsible

Does Not
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Competency
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Competency
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  1. Sets high personal standards of performance.
  1. Acts as a resource without removing individual responsibility.
  1. Responsible for setting the vision of the department.
  1. Sets a good example
  1. Is a person you can trust.
Please feel free to provide any comments to help explain your answers?

Coaching

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Competency
Seldom
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Competency
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  1. Addresses employee behavior problems effectively.
  1. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Helps employees to maintain high personal standards.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Provides clear, motivating, and constructive feedback.
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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  1. Clearly expresses expectations to others.
  1. Tries to understand others' point of view before making judgments
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Identifies and takes steps to prevent potential confrontations.
  1. Deals effectively with employee grievances.
Please feel free to provide any comments to help explain your answers?

Global Perspective

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
  1. Is aware of the culture, behaviors, identities and beliefs of others.
  1. Builds working relationships with others across cultures.
  1. Creates an environment where individual differences are valued and supported.
  1. Excellent communication skills to conduct effective business with individuals from different cultures and/or countries.
  1. Analyzes global issues/problems that are having a large impact on the Company.
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.