Strategic Insight- 360 Degree Feedback Survey Sample #3





Competencies Included:
Strategic Insight, Entrepreneurship, Global Perspective, Adaptability, Self Management, Emotional Intelligence, Achievement, Objectives, Safety, Recognition
Surveys Measuring Strategic Insight:
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)
Self-Assessment Instructions

Leadership at [Company] are participating in a 360-Degree Feedback assessment. As part of this process, you need to complete a self-assessment questionnaire form. Other employees, including your manager(s), peers, and direct reports will also evaluate you.

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.






Strategic Insight

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You formulate policies and strategies for addressing the Company's important challenges.
  1. I attend industry conferences to gain further insight into how other companies deal with similar issues.
  1. You identify potential problems before they become critical incidents.
  1. You anticipate business cycles and trends and makes adjustments in a timely manner.
  1. You analyze records and reports to obtain insight into potential issues and trends.
Please feel free to provide any comments to help explain your answers?

Entrepreneurship

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
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Exhibits this
Competency
  1. You identify problems that need solved.
  1. You have clarity of purpose in your actions.
  1. You risk your time, effort, and reputation toward the completion of goals.
  1. You balance risks and rewards when making decisions.
  1. You are able to adapt the department to changing business demands and climate.
Please feel free to provide any comments to help explain your answers?

Global Perspective

Does Not
Exhibit this
Competency
Seldom
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Competency
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Exhibits this
Competency
Usually
Exhibits this
Competency
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Exhibits this
Competency
  1. You form strong client relationships with international partners.
  1. You align personal vision with global strategies.
  1. You are able to work with individuals having different backgrounds and cultures.
  1. You develop both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.
  1. You create an environment where individual differences are valued and supported.
Please feel free to provide any comments to help explain your answers?

Adaptability

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You will stop what you are doing to help colleagues in need.
  1. You can adjust plans as needed based on changing conditions.
  1. You handle changes easily.
  1. You can take on new assignments.
  1. You are proactive and takes steps to prepare for changes in the workplace.
Please feel free to provide any comments to help explain your answers?

Self Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Exhibits this
Competency
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Exhibits this
Competency
  1. You analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. You do not allow own emotions to interfere with the performance of others.
  1. You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. You consciously control own negative emotions in order to keep team morale up.
  1. You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Please feel free to provide any comments to help explain your answers?

Emotional Intelligence

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You help to make decisions and solve problems using knowledge about how others will react in certain situations.
  1. You stay calm, composed and positive during difficult events.
  1. You are attentive to emotional cues and interprets others' feelings correctly.
  1. You are able to manage your own emotions.
  1. You think clearly and stays focused under pressure.
Please feel free to provide any comments to help explain your answers?

Achievement

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Competency
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Competency
  1. You schedule time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
  1. I can complete required training and certification.
  1. You strive to meet goals and objectives.
  1. You are flexible in adjusting priorities to meet the demands of changing situations.
  1. You complete work to given time frame and to budget
Please feel free to provide any comments to help explain your answers?

Objectives

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
  1. You set long-term and short-term goals.
  1. You establish goals and objectives.
  1. You are able to organize work.
  1. You work toward achieving established goals and objectives.
  1. You effectively organize resources and plans
Please feel free to provide any comments to help explain your answers?

Safety

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Competency
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Exhibits this
Competency
  1. You create accurate and effective measures of safety.
  1. You commit adequate resources toward safety measures.
  1. You are not afraid to question a potential safety issue observed in the workplace.
  1. You develop a culture of safety.
  1. You work to implement corrective safety measures.
Please feel free to provide any comments to help explain your answers?

Recognition

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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Exhibits this
Competency
  1. You recognize the abilities and skills of self and others
  1. You recognize individuals for a specific outstanding achievement.
  1. You say "thank you" to show appreciation for work of others.
  1. You find opportunities to recognize others.
  1. You compliment other people when they do good work
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.