SAMPLES OF RANKING/FEEDBACK FORMS
The resources listed below are intended as samples and may be adapted to meet style and use needs
INDIVIDUAL EVALUATION PROFILE SAMPLE MATRIX
Matrix with sample of focused interview questions. Provide each interviewer a sheet for each
candidate interviewed. Rate the candidate’s responses. Add additional comments. Compile data
for all interviewers
Candidate:
Interviewer:
Sample
Competency/
Skill
Sample Question
(Insert questions specific to the position.
These are examples only)
Customer Service
Describe your most challenging customer
experience. What happened? How did you
deal with it?
Describe a time when you received
inadequate direction for a project. How did
you proceed? What were the results? What
did you learn from the process?
How do you organize your performance
management function within the larger
demands of your position?
What will your achievements in this position
at St. Thomas look like in a year? How will
you measure your progress? Your
department’s progress?
Describe a time when a team function did
not work as well and proposed? Evaluate the
process and describe how you could have
directed the task at hand differently.
Communication
Organizational
Skills
Dedication
Teamwork
Integrity
Motivation
TOTAL SCORE
Describe a time you were faces with a
difficult professional decision. What were
the factors involved in the decision? How
did you determine the course you would
follow?
Describe your ideal position. Discuss the
process of meeting that goal and what you
need to achieve that goal in 5 years?
Rating Scale
3.-Exceptional
2-Competent
1-Needs
Development
Comments
CANDIDATE ASSESSMENT PROFILE SAMPLE MATRIX
The resource listed below is intended as a sample and may be adapted to meet style and use needs
Decision matrix that assesses required competencies and other professional behaviors revealed during a
formal interview.
Candidate:
Interviewer:
Enter the rating for each competency. Determine the weighted value by multiplying the rating times
the weighted percentage.
COMPETENCIES
EXAMPLE
Knowledge and experience in
(field)
Knowledge and experience in
(req’d skill)
Knowledge and experience in
(req’d skill)
Communication/
Interpersonal Relationships
Ability to manage and
negotiate change
Relationship with Staff/
Team-building
Collaborative approach with
key stakeholders
Commitment to customer
service
Overall weighted value and
recommendation for
(position)
RATING
SCALE
3.-Exceptional
2-Competent
1-Needs
Development
2
WEIGHT
OF
FACTORS
Determine
weighting of
factors to be
evaluated by
percentage
20%
100%
TOTAL
Multiply
rating
evaluation
times
percentage
.4
COMMENTS