Problem Solving - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

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)

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 comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

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.

Problem Solving

  • Effective in solving problems.
  • Able to balance the needs of different people in a solution to a problem.
  • Works cooperatively with others to solve problems.
  • Identifies and assesses all potential responses to a problem.
  • Ability to develop innovative solutions to problems.
If [Participant Name] were to make improvements in Problem Solving, what are your suggestions for how he/she can improve this?


  • Implements and facilitates controls and processes that maintain the integrity of the organization.
  • Keeps supervisor informed of recent events.
  • Takes responsibility for results.
  • Defines roles, rights, and responsibilities of the team.
  • Creates a consistent process for prioritizing work.
If [Participant Name] were to make improvements in Accountability, what are your suggestions for how he/she can improve this?

Cultural Awareness

  • Values the opinions of diverse groups and individual.
  • Encourages a work environment where individual differences are valued.
  • Respects others regardless of age, race, gender, nationality, or disability.
  • Fosters a diverse workforce free from discrimination and harassment.
  • Treats others with dignity and respect.
If [Participant Name] were to make improvements in Cultural Awareness, what are your suggestions for how he/she can improve this?

Project Management

  • Organizes, plans, and directs resources to accomplish the goals and objectives.
  • Defines project outcomes based on customer requirements.
  • Inspires others to accomplish goals and objectives.
  • Develops action items, workplans, timelines, and criteria for projects.
  • Works with customers and clients to assess their needs and define project parameters.
If [Participant Name] were to make improvements in Project Management, what are your suggestions for how he/she can improve this?


  • Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
  • Systematically works to improve the organization
  • Completes work to a high technical standard
  • Set high standards in their performance
  • Accepts setbacks and challenges as improvement opportunities
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?
Overall, please rate the effectiveness of [Participant Name Here].


Areas for Development

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