Mediation- 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

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Management Team

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Mediation	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Paraphrases and summarizes key points to confirm understanding and reduce misinterpretation.
Synthesizes diverse inputs into a coherent understanding of the dispute's structure and drivers.
Determines what documents are to be exchanged with each side.
Identifies acceptable trade-offs and concessions from the parties.
Summarizes key points from private sessions (with permission) to ensure transparency and shared understanding.
Uses neutral language when summarizing private conversations to protect party identity and intent.
Selects appropriate mediation format (joint sessions, shuttle diplomacy, caucus-heavy) based on case complexity and sensitivity.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Attends to the important details of a job or task.
Communicates with clarity and efficiency.
Clearly explains responsibilities to individuals.
Clarifies problems and their causes to help employees correct them.
Avoids stating unclear or conflicting goals.
Avoids creating ambiguity or mixed messages.
Uses appropriate grammar and tense in communications.
Communication Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Delivers messages with personal energy, enthusiasm, and conviction.
Shares important information with others.
Tailors oral communications to the intended audience.
Keeps the supervisor informed about achievements and milestones.
Delivers difficult messages to co-workers in an appropriate manner
Uses correct spelling, grammar and punctuation.
Takes steps to prevent interruptions when important issues are being discussed
Action	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is the first to volunteer for assignments.
Takes charge without being asked.
Drives and mobilizes others progress toward goals.
Takes action when opportunities arise.
Takes action when necessary.
Takes steps to prepare for the start of the project.
Gladly accepts new challenges and works on them with urgency.
Integrity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Prioritizes ethical behavior over immediate gains ensuring that actions align with values and the best interests of all stakeholders.
Earns the trust of employees, clients, and stakeholders by consistently demonstrating a high degree of integrity.
Is transparent about capabilities and timelines when making promises.
Is willing to address any shortcomings.
Works towards developing an environment built upon trust
Can be trusted by others all the time and in every circumstance.
Follows ethical standards and principles, regardless of the situation.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Responds thoughtfully to culturally influenced communication styles and preferences.
Is aware of differences in how individuals from other cultures greet one another.
Hires individuals with different cultural backgrounds for the department.
Participates in or facilitates cultural sensitivity training for self and team.
Develops skills and attitudes to bridge cultural differences.
Encourages a work environment where individual differences are valued.
Is aware of the similarities and differences among and between cultural groups.
Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works effectively in the department.
Effective in performing his/her job.
Able to organize work.
Listens and responds to issues and problems
Has great overall performance
Effectively organizes resources and plans
...Produce Quality
Technology Use/Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Applies complex rules and regulations to maintain optimal system performance.
Proficient in the use of technical systems and processes.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Supports technical training and development of employees.
Uses technology in decision making and problem solving.
Supports employee training and development initiatives regarding implementation of technology.
Adopts the implementation of new technology into the workplace.
Collaboration	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Shares skills and time to help the team thrive.
Develops networks and builds alliances across departments.
Encourages open communication to support a collaborative environment.
Guides team members to reconcile their differences and collaborate effectively.
Encourages open dialog and sharing of information among team members.
Contributes resources and knowledge to help the team achieve its goals.
Respects other group/team members.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Recognizes and rewards people based on their job performance.
Leverages the use of recognition to obtain maximum impact.
Creates clear links between recognition and HR driven incentive systems.
Acknowledges and appreciates the worth of employees.
Facilitates and supports the recognition programs within the department.
Ensures that the rewards are 'rewarding'.
Expresses genuine appreciation for the employee's work by mentioning the work that the employee has completed and how it has impacted the organization.

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

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
72. Strengths
    
    
    
73. Areas for Development
    
    
    
74. Please give any final comments or suggestions for [Participant Name Here]'s assessment.