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HR-Survey > 360-Degree Feedback > Competency Model > Achievement Skills

Achievement - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Achievement:
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:
Achievement, Performance, Clarity, Client Focus, Persuasion and Influence, Co-worker Development, Creativity, Self Management, Leadership, Company, Fiscal Management
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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Achievement

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Met required benchmarks for the position.
  1. Leverages smart risk-taking to innovate and create competitive advantages.
  1. Takes calculated risks.
  1. Completed training on the new equipment.
  1. Set high standards in their performance
What are your suggestions for how [Participant Name] can make improvements
in Achievement?

Performance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Effective in performing his/her job.
  1. Able to organize work.
  1. Effectively organizes resources and plans
  1. ...Produce Quality
  1. Sets a high standard for job performance.
What are your suggestions for how [Participant Name] can make improvements
in Performance?

Clarity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Avoids stating unclear or conflicting goals.
  1. Provides a clear vision for the future.
  1. Writes clear job descriptions for positions in the organization.
  1. Seeks to reduce ambiguity in messaging and documents.
  1. Avoids creating ambiguity or mixed messages.
What are your suggestions for how [Participant Name] can make improvements
in Clarity?

Client Focus

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Maintains strong relationships with clients.
  1. Delivers high quality products to the client.
  1. Is consistent in services provided to clients.
  1. Is aware of what the client wants to receive.
  1. Acts with integrity in all client interactions.
What are your suggestions for how [Participant Name] can make improvements
in Client Focus?

Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Engages in difficult conversations with honesty and respect, guided by core beliefs rather than tactical advantage.
  1. Develops a good rapport with others.
  1. Creates a compelling message that is persuasive.
  1. Able to influence others to meet certain goals.
  1. Sets the proper context for employees to make the best decisions.
What are your suggestions for how [Participant Name] can make improvements
in Persuasion and Influence?

Co-worker Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Takes immediate action on poor performance
  1. Provides ongoing feedback to co-workers on their development progress
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Works to identify root causes of performance problems
What are your suggestions for how [Participant Name] can make improvements
in Co-worker Development?

Creativity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Builds buffer time into schedules to allow for reflection and idea development.
  1. Finds creative ways to meet the needs of patients.
  1. Transforms learning into creative output.
  1. Engages with other departments to enhance creativity.
  1. Reframes problems in novel ways to unlock new solutions.
What are your suggestions for how [Participant Name] can make improvements
in Creativity?

Self Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Uses patience and self-control in working with customers and associates.
What are your suggestions for how [Participant Name] can make improvements
in Self Management?

Leadership

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Promotes a culture where everyone is expected to raise the bar for the group.
  1. Coaches employees about the significance of the Company within our industry.
  1. Challenges senior leadership respectfully when their decisions conflict with core values or long-term goals.
  1. Never divulges confidential information given by colleagues.
  1. Utilizes recognition, and non-monetary rewards, as well as financial compensation, to reward excellent performance
What are your suggestions for how [Participant Name] can make improvements
in Leadership?

Company

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Takes on new projects without compromising existing work.
  1. Can be trusted by colleagues to act with integrity.
  1. Encourages open dialogue and mutual support among team members.
  1. Builds strong partnerships with local organizations, schools, and nonprofits to advance shared goals.
  1. Impresses upon others the important aspects of [Company].
What are your suggestions for how [Participant Name] can make improvements
in Company?

Fiscal Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Monitors expenses and verifies the need for items purchased.
  1. Develops of the department's annual budget.
  1. Keeps excellent records for financial transparency.
  1. Effective in using Company's resources.
  1. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
What are your suggestions for how [Participant Name] can make improvements
in Fiscal Management?


  1. Strengths


  2. Areas for Development


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