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.

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. Communicates effectively with others.
  1. Attempts to persuade others rather than simply control them.
  1. Has excellent influencing/negotiating skills.
  1. Able to express own goals and needs.
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. Is creative and inspirational.
  1. Develops solutions to challenging problems.
  1. Creates a lot of new ideas.
  1. Inspires creativity in their team.
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. Ability to solve problems at root cause rather than at symptom level.
  1. Actively seeks the root cause of a problem.
  1. Works cooperatively with others to solve problems.
  1. Is a good problem solver and decision maker
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. Anticipates critical incidents in the department and takes steps to mitigate their effect.
  1. Takes advantage of changes to the current situation.
  1. Takes action to respond to dissatisfied customer.
  1. Takes responsibility for meeting performance standards.
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. Develops a strategy for implementing changes.
  1. Supports new initiatives for organizational changes to improve effectiveness.
  1. Adopts changes to set and example for others to follow.
  1. Works cooperatively with others to implement 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. Understands and is committed to implementing new technologies.
  1. Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
  1. Maximizes the use of new technology to deliver products and services.
  1. Proficient in the use of technical systems and processes.
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. Can be counted on to add value wherever they are involved.
  1. Demonstrates the analytical skills to do their job.
  1. Keeps themselves and others focused on constant improvement.
  1. Is planful and organized.
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 and implements a compliance data recordkeeping system.
  1. Works quickly to implement changes in regulations.
  1. Uses operational compliance reports to evaluate the effectiveness of internal processes.
  1. Interacts with auditors and regulators on a professional basis.
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. Takes care to maintain confidential information.
  1. Is trustworthy; is someone I can trust.
  1. Communicates an understanding of the other person's interests, needs and concerns.
  1. Builds and maintains the trust of others.
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. Observes employees at work to get better insight into the issues they are dealing with.
  1. Creates strategic plans to develop and promote organizational and area strengths, as well as to address weaknesses based on insight from surveys.
  1. Analyzes records and reports to obtain insight into potential issues and trends.
  1. Works with others to develop insights into the resources and actions required to produce desired results.
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. Delegates role to team members to accomplish goals.
  1. Develops plans to ensure the smooth operation of the supply chain.
  1. Closely follows the plan established for the department.
  1. Develops an effective plan to guide the project.
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.