Persuasion and Influence - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Persuasion and Influence:
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 selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the questions below, think about your experiences working with this employee over the last twelve months and the goals they were asked to achieve. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be discussed with the employee to foster growth and on-going development.

Competencies Included:
Persuasion and Influence, Creativity, Problem Solving, Action, Change Management, Technology Use/Management, Excellence, Regulatory/Compliance, Trustworthy, Strategic Insight, Planning
Sample Result Document:
Sample Results
Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

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


Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Persuades others to consider alternative points of view.
  1. Develops a good rapport with others.
  1. Able to express own goals and needs.
  1. Seeks to obtain consensus or compromise.
What are your suggestions for how [Participant Name] can make improvements
in Persuasion and Influence?

Creativity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Inspires creativity in their team.
  1. Conceives, implements and evaluates ideas.
  1. Develops solutions to challenging problems.
  1. Is creative.
What are your suggestions for how [Participant Name] can make improvements
in Creativity?

Problem Solving

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Identifies fresh approaches and shows a willingness to question traditional assumptions.
  1. Ability to develop innovative solutions to problems.
  1. Makes judgments based upon relevant information.
  1. Ability to solve problems at root cause rather than at symptom level.
What are your suggestions for how [Participant Name] can make improvements
in Problem Solving?

Action

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Sets high standards for themselves and others.
  1. Is ambitious when working on the project.
  1. Effectively makes decisions
  1. Works across organizational lines and boundaries to attain goals.
What are your suggestions for how [Participant Name] can make improvements
in Action?

Change Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Is an inspiration for others to accept the recent changes.
  1. Facilitates change with minimal resistance.
  1. Assists others in understanding changes to the organization.
  1. Effective in dealing with ambiguous and challenging situations.
What are your suggestions for how [Participant Name] can make improvements
in Change Management?

Technology Use/Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Supports employee training and development initiatives regarding implementation of technology.
  1. Proficient in the use of technical systems and processes.
  1. Supports technical training and development of employees.
What are your suggestions for how [Participant Name] can make improvements
in Technology Use/Management?

Excellence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Takes a lot of pride in their work.
  1. Demonstrates the analytical skills to do their job.
  1. Keeps themselves and others focused on constant improvement.
What are your suggestions for how [Participant Name] can make improvements
in Excellence?

Regulatory/Compliance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Complies with regulatory requirements for the state.
  1. Offers training to employees to ensure they are complying with regulations.
  1. Creates documents and reports as needed to maintain compliance with regulations.
  1. Ensures regulations are followed as required.
What are your suggestions for how [Participant Name] can make improvements
in Regulatory/Compliance?

Trustworthy

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Consistently keeps commitments.
  1. Takes care to maintain confidential information.
  1. Works in a way that makes others want to work with her/him.
  1. Delivers on promises made.
What are your suggestions for how [Participant Name] can make improvements
in Trustworthy?

Strategic Insight

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Lets employees know how their roles contribute toward the achievement of strategic company objectives.
  1. Adjusts strategic plans based on insights gathered from different points of view.
  1. Pursues strategic alliances with valued partners.
  1. Formulates policies and strategies for addressing the Company's important challenges.
What are your suggestions for how [Participant Name] can make improvements
in Strategic Insight?

Planning

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Able to stay organized and focused using excellent planning skills.
  1. Initiates the planning process by defining the scope of the project.
  1. Makes strategic and tactical decisions to guide the logistics process.
  1. Plans for how to allocate time to specific activities.
What are your suggestions for how [Participant Name] can make improvements
in Planning?


  1. Strengths


  2. Areas for Development


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