Multi-rater Forms, Rights Waived

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11/03/2015
Oregon State University Extension Service
Suggestions for Collecting Input from Multi-Raters – Rights Waived
Incorporating input from multi-raters is one of the best methods for reducing rater error in
performance evaluations. The 360-feedback model is a structured process for assessing
employee performance based on information from multiple sources. Those sources may
include peers, clientele, office colleagues, community collaborators and other supervisors
(program leaders and department heads). Research on employee satisfaction shows that
employees say multi-source feedback gives a fairer and better picture of performance, is
perceived as more accurate and honest, and creates more reliability in the data.
The number of multi-raters contacted annually may vary for each faculty member and situation,
but should include enough names for a diverse review of performance. In most cases seven to
eight contacts will provide an accurate representation. The multi-raters should include
individuals who are familiar with the faculty member’s Extension teaching, scholarship and/or
leadership, and may include:
 Peers
 Clientele
 Office Colleagues
 Community Collaborators
 Program Leaders and/or Department Heads
Input may be collected via a form, a telephone conversation, or in a person-to-person
interview. In each case, if the information collected is used for performance evaluation,
confidentiality cannot be guaranteed. By legal counsel’s interpretation of state statutes, the
employee may request review of and receive access to any input provided for their annual
performance review. The supervisor shall have the employee sign the “Extension Performance
Evaluation – Waiver of Access” form choosing if they do, or not waive their right. Sample cover
letter and input forms are attached for immediate supervisors and faculty to adapt and/or
adopt as appropriate.
One last suggestion, providing a copy of the faculty member’s position description will assist
the rater in understanding the range of responsibilities and the expectations of the job. This
small step will greatly improve the quality and accuracy of the input.
SAMPLE COVER LETTER
Dear _____________,
As someone who is familiar with the work of
, county Extension
employee, would you be willing to provide your evaluation of
Extension
program and leadership abilities? For your convenience, an evaluation form is enclosed for you
to complete and return to me by ________ in the accompanying stamped envelope. Also
included for your review and consideration is a copy of ______ position description.
It is my intent to summarize the evaluation input from all those who respond to my request and
share that summary with
. This employee has waived their legal right to
request review and receive access to any input provided for their annual performance review.
Your evaluation form will be kept confidential.
Thank you for your time and effort in assisting with this important task.
Sincerely,
Enclosures
SAMPLE INPUT FORM FOR VOLUNTEERS,
PROGRAM PARTICIPANTS AND COMMUNITY PARTNERS
Performance Evaluation Form
Employee’s name: ________________________
Please respond to the following statements. Check only one response or provide a brief
statement as requested.
1. In what capacity have you observed the employee’s performance during the past year?
2. Have you participated in a workshop or seminar presented by the employee?
_____Yes
_____No
If yes, how would you rate the employee’s communication/teaching skills? Check only one
response on the rating scales.
_____ Extraordinary Performance
_____ Strong and Positive Performance
_____ Positive Performance, but some improvement is needed
_____ Unsatisfactory Performance
3a. In your opinion, what was the employee’s most significant accomplishment in the past year?
3b. How is this accomplishment of significance to you, the county, the region, or the state?
4. As you’ve interacted with the employee as a volunteer, program participant or community
partner, how would you describe the employee’s ability to engender trust and respect?
SAMPLE INPUT FORM FOR VOLUNTEERS, PROGRAM PARTICIPANTS AND COMMUNITY PARTNERS (Rights Waived) – Page 1 of 2
5. Describe how the employee promotes a positive, professional image of Extension and Oregon
State University?
6. In your opinion, what are the employee’s personal strengths as an Extension educator and
community leader?
7. Do you have suggestions for ways in which the employee can become more effective as an
educator and community leader?
8. Based on overall effectiveness, please rate the employee’s job performance as an
Extension educator. Check only one response on the rating scale.
_____ Extraordinary Performance
_____ Strong and Positive Performance
_____ Positive Performance, but some improvement is needed
_____ Unsatisfactory Performance
7. Are there additional comments you’d like to make?
To comply with state statutes, we must ask you to sign the evaluation form. Please return the form in the
enclosed envelope by February 08. Thank you for your time and effort to assist with the performance evaluation.
______________________________________
Signature
______________
Date
This employee has waived their legal right to review and receive access to any input provided for their annual
performance review. Your evaluation form will be kept confidential.
SAMPLE INPUT FORM FOR VOLUNTEERS, PROGRAM PARTICIPANTS AND COMMUNITY PARTNERS (Rights Waived) – Page 2 of 2
SAMPLE INPUT FOR PEERS, OFFICE
COLLEAGUES, AND OTHERS
Performance Evaluation Form
Employee’s Name: ___________________________________
Period of Evaluation is From: _____________
To: _____________
Please return completed survey to ____________________ by (date) after providing a brief
response to the specifics requested below.
1. In what capacity have you observed the faculty member’s performance during the
evaluation period noted above? Please be specific.
2. What is your appraisal of the faculty member’s overall effectiveness of OSU Extension’s
(name of position)? Please provide examples if appropriate.
3. What do you see as the faculty member’s greatest strengths or assets as they apply to
his/her job duties and effectiveness in the job? Please provide examples if appropriate.
4. What do you see a major weaknesses or areas of specific concern in the faculty member’s
work or job effectiveness? Please provide examples if appropriate.
5. What is your appraisal of the faculty member’s knowledge and expertise in (area of
person’s) and in OSU & (your program’s) policies and procedures in particular? Please
provide examples if appropriate.
SAMPLE INPUT FOR PEERS, OFFICE COLLEAGUES, AND OTHERS (Rights Waived) – Page 1 of 2
6. If you received training or instruction in (area of person’s), how would you rate the quality,
quantity and usefulness of the information received?
7. This faculty member plays a significant role in providing service to (your program) customerbase. Please provide your assessment of responsiveness, professionalism, courtesy,
timeliness and accuracy of information provided and service received. Please provide
examples if appropriate.
8. Based on overall effectiveness, please rate the employee’s job performance as (title)?
_____ Extraordinary Performance
_____ Strong & Positive Performance
_____ Positive Performance but some improvement needed
_____ Unsatisfactory Performance
To comply with state statues, we must ask that you sign the evaluation form. Please return the
form in the enclosed envelope by February 08. Thank you for your time and effort to assist
with this evaluation.
______________________________________
Signature
______________
Date
This employee has waived their legal right to review and receive access to any input provided for their annual
performance review. Your evaluation form will be kept confidential.
SAMPLE INPUT FOR PEERS, OFFICE COLLEAGUES, AND OTHERS (Rights Waived) – Page 2 of 2
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