Problem Solving - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Problem Solving:
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.





Problem Solving

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Finds creative ways to get things done with limited resources.
  1. Effective in solving problems.
  1. Ability to solve problems at root cause rather than at symptom level.
  1. Generates alternative solutions to problems and challenges.
  1. Is a good problem solver and decision maker
Please feel free to provide any comments to help explain your answers?

Change Management

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
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Competency
  1. Effective in implementing new organizational vision and values.
  1. Able to get department employees to accept new changes.
  1. Is a leading force driving changes.
  1. Effective in dealing with ambiguous and challenging situations.
  1. Works cooperatively with others to implement changes.
Please feel free to provide any comments to help explain your answers?

Flexibility

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Competency
  1. Can handle changes without complaining.
  1. Implements changes as a result of having listened to employees
  1. Able to adapt to new situations.
  1. Encourages others to adopt new procedures.
  1. Open to the perspectives/viewpoints of others.
Please feel free to provide any comments to help explain your answers?

Creativity

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Competency
  1. Is creative.
  1. Is creative and inspirational.
  1. Inspires creativity in their team.
  1. Develops solutions to challenging problems.
  1. Conceives, implements and evaluates ideas.
Please feel free to provide any comments to help explain your answers?

Cultural Awareness

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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  1. Supports and mentors others that may have different cultural backgrounds.
  1. Avoids referring to stereotypes about others from different cultures.
  1. Values the opinions of diverse groups and individual.
  1. Recognizes and values individual and cultural differences.
  1. Values the diverse perspectives from others.
Please feel free to provide any comments to help explain your answers?

Supervisory Skills

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. Is aware of the unique strengths of each employee.
  1. Is able to motivate others through persuasion rather than coercion.
  1. Decides what supplies need to be purchased.
  1. Uses the team to its fullest capacity.
  1. Oversees employees to make sure their work is performed up to standard.
Please feel free to provide any comments to help explain your answers?

Performance

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. Shown significant improvement in job performance.
  1. Effective in performing his/her job.
  1. Effectively organizes resources and plans
  1. Works well in this position.
  1. Listens and responds to issues and problems
Please feel free to provide any comments to help explain your answers?

Objectives

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  1. Ability to establish realistic goals.
  1. Consistently provides me with timely feedback for improving my performance.
  1. Able to organize work.
  1. Assures [Company] principles are understood, employed & pursued.
  1. Communicates goals and objectives to employees.
Please feel free to provide any comments to help explain your answers?

Conflict Management

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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Competency
  1. Assists team members by helping them see the other point of view.
  1. Tries to understand others' point of view before making judgments
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Deals effectively with employee grievances.
  1. Clearly expresses expectations to others.
Please feel free to provide any comments to help explain your answers?

Planning

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
  1. Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
  1. Encourages others to follow the plan.
  1. Develops a strategic plan to reduce costs in the department.
  1. Accurately estimates the amount of materials/supplies needed for the project.
  1. Anticipates resources needed to successfully implement a plan or project.
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.