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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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
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.
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Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Listens actively to opposing viewpoints and responds with thoughtful counterarguments rather than defensiveness.
  1. Leverages industry insights and benchmarks to support persuasive arguments and strategic recommendations.
  1. Uses values-based language to inspire alignment and a shared sense of purpose among team members.
  1. Stands firm on principles, even when under pressure to compromise for short-term gain.
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. Creates an atmosphere where creative energy thrives.
  1. Translates creative concepts into actionable plans and deliverables.
  1. Introduces creative practices that elevate team collaboration and morale.
  1. Reflects on past outcomes to inform more creative future decisions.
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. Develops and implements clear guidelines and protocols for handling tasks.
  1. Involves the department in the problem-solving process to foster a sense of collective responsibility and investment in the outcome.
  1. Weighs the pros and cons of proposed solutions.
  1. Effective problem-solver
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. Creates innovative products and services.
  1. Is proactive in addressing the needs of the department.
  1. Pursues goals with action to achieve success.
  1. Identifies opportunities for improvement before there is a problem.
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 aware of changes in the work environment.
  1. Helps employees overcome opposition to change.
  1. Able to get department employees to accept new changes.
  1. Plans and initiates effective departmental and organizational changes.
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. Supports technical training and development of employees.
  1. Uses technology in decision making and problem solving.
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Adopts the implementation of new technology into the workplace.
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. Takes a lot of pride in their work.
  1. Is planful and organized.
  1. Produces high quality work.
  1. Can be counted on to add value wherever they are involved.
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. Develops the appropriate incentives (or disincentives) for regulatory compliance.
  1. Develops and implements appropriate reporting channels.
  1. Trains and coordinates activies of compliance officers.
  1. Establishes protocols for secure data transmission between departments and external regulators.
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. Demonstrates congruence between statements and actions.
  1. Builds and maintains the trust of others.
  1. Takes ownership, delivers on commitments
  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. Identifies potential problems before they become critical incidents.
  1. Pursues strategic alliances with valued partners.
  1. Educates team members on emerging trends and their implications for current projects or goals.
  1. Recognizes when strategic plans are no longer relevant due to environmental or organizational changes.
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. Assigns the right tasks to the right people and holds them accountable.
  1. Efficiently manages deadlines.
  1. Is able to follow the plan set in place.
  1. Adjusts plans as needed according to situational/strategic changes.
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.