This document provides an evaluation form for self-development interviews. It contains 63 items assessing interpersonal skills, self-management skills, organizational skills, technical skills, and provides space for examples and ratings on a scale of 1 to 5. The goal is for individuals to evaluate themselves and have others evaluate them to gain feedback on strengths and areas for improvement.

1. 5. Provides corrective feedback about difficult,
Self-Development Interview Performance awkward touchy problems in a way that ensures
Evaluation Form the person understands the nature of the
Name of Interviewee___________________ problems and the importance of the problems.
Name of Interviewer___________________ (Most people either completely fail to discuss
Date____________ these problems or do so in such a cautious way
The most valuable way to use this form is to that the person never really gets the point. It
evaluate yourself and have someone else evaluate you takes a certain amount of bravery to be a
as part of a Self-Development Interview (SDI). So person's true friend and proactively discuss
find someone who knows you fairly well and set up an touchy but important subjects with that person.)
SDI. You’ll fill out one self-evaluation on yourself and Perfect 1 2 3 4 5 Needs much improvement
one on the person you're meeting with1. Example:
When possible, give at least one example for Example:
each category, especially with regard to the person Example:
you're meeting with. Don’t worry about being too 6. Responds socially appropriately to positive or
detailed in your examples, just try to think of a negative feedback (i.e. says thank you, without
situation where you saw the other person disagreement).
demonstrate or fail to demonstrate each skill. Your Perfect 1 2 3 4 5 Needs much improvement
examples will help the other person understand your Example:
ratings. Example:
You may not be able to rate every item. So Example:
feel free to skip any questions that don’t seem to 7. Reacts in a rational, as opposed to an emotional
apply to your situation. manner, when faced with problems. Controls
emotions effectively (e.g. does not cry or yell) in
Interpersonal Style and Skills
frustrating situations (i.e.. under extinction or
1. Gives corrective feedback when needed.
aversive conditions), in professional, school, and
Perfect 1 2 3 4 5 Needs much improvement
peer settings. Doesn't get hysterical; always uses
Example:
a cool, problem solving approach.
Example:
Perfect 1 2 3 4 5 Needs much improvement
Example:
Example:
2. Gives corrective feedback in appropriate
Example:
situations (not in the presence of others).
Example:
Perfect 1 2 3 4 5 Needs much improvement
8. Smiles.
Example:
Perfect 1 2 3 4 5 Needs much improvement
Example:
Example:
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3. Provides corrective feedback in a non-punitive
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style (i.e., specifies appropriate desired behavior,
9. Is pleasant in interactions (i.e., zero to low rate
is not critical of person).
negative comments, well mannered).
Perfect 1 2 3 4 5 Needs much improvement
Perfect 1 2 3 4 5 Needs much improvement
Example:
Example:
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4.
1
If you’re using this form with Procrastination, check the Procrastination
Self-management Objectives and Homework Assignment, first.

2. 10. Verbally reinforces2 appropriate behavior -with 15. Dresses appropriately for all situations. {It's
clients or students whom you are teaching. rare that people are dressed better than is
Perfect 1 2 3 4 5 Needs much improvement appropriate and often when they are dressed
Example: worse than is appropriate. It's hard to overdo
Example: lookin' good.)
Example: Perfect 1 2 3 4 5 Needs much improvement
11. Verbally reinforces appropriate behavior -with Example:
peers. Example:
Perfect 1 2 3 4 5 Needs much improvement Example:
Example: 16. Physical appearance
Example: Perfect 1 2 3 4 5 Needs much improvement
Example: Example:
12. Verbally reinforces appropriate behavior -with Example:
supervisors and professors.3 Example:
Perfect 1 2 3 4 5 Needs much improvement 17. Good personal hygiene. (This is even an issue in
Example: those big-time corporate offices.)
Example: Perfect 1 2 3 4 5 Needs much improvement
Example: Example:
13. Is enthusiastic.4 Example:
Perfect 1 2 3 4 5 Needs much improvement Example:
Example: 18. Talks clearly and in an organized and
Example: appropriately confident manner.
Example: Perfect 1 2 3 4 5 Needs much improvement
14. Example:
Example:
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19. Actively listens when spoken to (i.e., good eye
contact) where appropriate.
Perfect 1 2 3 4 5 Needs much improvement
Example:
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20. Speaks in respectful ways (i.e., voice inflections
are not condescending) -- with clients or with
2
Often we may just be talking about positive feedback here, because the
students whom you are teaching.
reinforcer is delivered too long after the behavior to reinforce the desired Perfect 1 2 3 4 5 Needs much improvement
behavior. In any case, there are a couple good reasons to make positive
Example:
comments about desirable behavior. The obvious performance-management
one is that it will increase the frequency of that behavior in the future. But Example:
the moralistic one is that if the person did something good, they deserve to Example:
get a little praise for it, you know, like maybe they busted their butt to do
it. 21. Speaks in respectful ways -- with peers.
Perfect 1 2 3 4 5 Needs much improvement
3
It’s really a two-way street; not only do you need support from your
supervisors and professors, but they also need it from you, amazing as that
may seem. A nice remark of appreciation or approval from a student can spin
Example:
me out for several days; such remarks are really what keeps me going. And a Example:
nice remark from a student makes me appreciate how sharp the student
really is.
Example:
4
Nothing like having enthusiastic people in the class, on the job, on the
team, and at home. That’s worth a lot. And it’s important to let your
enthusiasm show. For example, I had an excellent MA student who thought
one of my colleagues was just the most wonderful professor ever. But my
colleague thought she was a loser. Why? Because she sat in his lectures,
looking like she was bored to death with everything he was saying. So I told
him what she really thought. And I told her that her expression and body
language were giving the wrong impression. By the end of the semester, her
professor agreed that she was, in deed, as good a student as I had said.

3. 22. Speaks in respectful ways -- with supervisors and 29. Appears appropriately receptive to others’ values
professors.5 and viewpoints.
Perfect 1 2 3 4 5 Needs much improvement Perfect 1 2 3 4 5 Needs much improvement
Example: Example:
Example: Example:
Example: Example:
23. Shows interest in people's activities outside the 30. Acts in a cooperative, selfless manner that
system (i.e., asks questions about and makes supports the overall system goals rather than a
positive comments about other people's outside competitive manner that interferes with
interests and activities) -- with clients or with achieving overall system goals.
students whom you are teaching.67 Perfect 1 2 3 4 5 Needs much improvement
Perfect 1 2 3 4 5 Needs much improvement Example:
Example: Example:
Example: Example:
Example: 31. Collaborates well with other members when
24. Shows interest in people's activities outside the working on joint projects.
system (i.e.. asks questions etc.)-with peers. Perfect 1 2 3 4 5 Needs much improvement
Perfect 1 2 3 4 5 Needs much improvement Example:
Example: Example:
Example: Example:
Example: 32. Is properly assertive in asking, (i.e., makes
25. Shows interest in people's activities outside the requests appropriately, e.g., asks for help, when
system (i.e.. asks questions etc.)-with supervisors needed, without aggression)-with clients or
and professors. students whom you are teaching.
Perfect 1 2 3 4 5 Needs much improvement Perfect 1 2 3 4 5 Needs much improvement
Example: Example:
Example: Example:
Example: Example:
26. Does not dominate discussions at meetings and 33. Is properly assertive in asking-with peers.
seminars (i.e. speaks during no more than the Perfect 1 2 3 4 5 Needs much improvement
appropriate share of meeting time). Example:
Perfect 1 2 3 4 5 Needs much improvement Example:
Example: Example:
Example: 34. Is properly assertive in asking-with supervisors
Example: and professors.
27. Carries a reasonable share of the discussion in Perfect 1 2 3 4 5 Needs much improvement
meetings and seminars (doesn't just sit there Example:
listening). Example:
Perfect 1 2 3 4 5 Needs much improvement Example:
Example:
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28.
5
Some people kiss the butts of their supervisors and kick the butts of their
subordinates. Neither behavior is cool.
6
Don’t confuse this item with a later one about actually participating in
outside activities.
7
People really do appreciate your interest in them as people, and not just as
clients, students, professors, or supervisors.

4. 35. Is properly assertive in declining (i.e., declines 38. Doesn't whine.
inappropriate requests without hesitation and Perfect 1 2 3 4 5 Needs much improvement
without aggression, e.g., doesn't agree to do Example:
things that can't be done)-with clients or Example:
students whom you are teaching. Example:
Perfect 1 2 3 4 5 Needs much improvement 39. On the other hand, raise each problem and
Example: disconnect in a non-whiny, problem-solving
Example: manner, even if you don't have a solution at the
Example: time.
Is properly assertive in declining-with peers. Perfect 1 2 3 4 5 Needs much improvement
Perfect 1 2 3 4 5 Needs much improvement Example:
Example: Example:
Example: Example:
Example: 40. Has a confident style, not an unconfident,
36. Is properly assertive in declining-with supervisors uncertain, equivocating, apologetic style.
and professors.8 Perfect 1 2 3 4 5 Needs much improvement
Perfect 1 2 3 4 5 Needs much improvement Example:
Example: Example:
Example: Example:
Example: 41. Public relations: positively influences others
outside of the system.
Perfect 1 2 3 4 5 Needs much improvement
Example:
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42. Does not act in a way that might be viewed as
sexist, racist, or discriminatory in use of
language, humor, job assignments, or
interpersonal interactions.
Perfect 1 2 3 4 5 Needs much improvement
Example:
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43. Does not make jokes that are derogatory to
others or that might hurt the feelings of others.
Perfect 1 2 3 4 5 Needs much improvement
Example:
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37.
8
This assertiveness business is a tricky issue. The truth is, a supervisee or
employee who does what ever is asked and many things that aren’t even
thought of by the supervisor, employer, or professor will be much more
highly evaluated and appreciated, and, therefore, will probably be much more
successful, at least according to what I’ve seen. But there’s a price, like loss
of sleep when you do those all nighters to accommodate unreasonable
requests. But to be really successful, you must never show the boss the
price tag, like, “I stayed up all night to do this for you”; instead, you just
smile and say, “No problem; my pleasure.” Really.

5. 48. Timely (reliable): completes tasks by the
Self-management skills deadline.
44. Through performance management, adjusts
Perfect 1 2 3 4 5 Needs much improvement
behavior problems at an acceptable rate when
Example:
corrective feedback is provided or through the
Example:
use of performance contracting (fast enough so
Example:
that the system is not threatened by the speed
49. Makes measurable progress on long-term projects
of observable, through gradual improvement). In
without constant reminders.
other words, when you find out that you have a
Perfect 1 2 3 4 5 Needs much improvement
problem in your performance, do you fix it
Example:
quickly.
Example:
Perfect 1 2 3 4 5 Needs much improvement
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50. Low absenteeism.
Example:
Perfect 1 2 3 4 5 Needs much improvement
Example:
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45. Quality: produces a good product with good
Example:
results.
Example:
Perfect 1 2 3 4 5 Needs much improvement
Is on time for appointments and meetings.
Example:
Perfect 1 2 3 4 5 Needs much improvement
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46. Quantity (responsible): volunteers for
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assignments when needed without over extending
51. Is well organized in daily work.
oneself.
Perfect 1 2 3 4 5 Needs much improvement
Perfect 1 2 3 4 5 Needs much improvement
Example:
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52. Puts tasks or assignments in writing that for
which responsibility has been assumed.
Perfect 1 2 3 4 5 Needs much improvement
Example:
Example:
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53. Puts tasks or assignments in writing that have
been assigned to subordinates.
Perfect 1 2 3 4 5 Needs much improvement
Example:
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47.

6. Organizational skills and values Technical skills
54. Shows a strong commitment to the organization. 59. Appropriate speaking skills: good grammar.
Perfect 1 2 3 4 5 Needs much improvement Perfect 1 2 3 4 5 Needs much improvement
Example: Example:
Example: Example:
Example: Example:
55. Is proactive. 60. Appropriate speaking skills: loudness, enunciation,
Perfect 1 2 3 4 5 Needs much improvement confidence.
Example: Perfect 1 2 3 4 5 Needs much improvement
Example: Example:
Example: Example:
56. Makes positive comments about the system and 61. Appropriate speaking skills: articulate.
the overall organizational goal. (Articulate, can mean two things: The first is
Perfect 1 2 3 4 5 Needs much improvement clear, correct, precise pronunciation; but that's
Example: not the way we mean it here, we have that
Example: covered with enunciation, earlier. The second is
Example: exact, precise use of words and sentences, so
57. Does not criticize the system when talking that you say exactly what you mean, so that you
without an effective counter proposal for a can express yourself clearly; that's the articulate
change within the system. that we're using here.)
Perfect 1 2 3 4 5 Needs much improvement Perfect 1 2 3 4 5 Needs much improvement
Example: Example:
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58. Positive community member: participates actively 62. Appropriate speaking skills: fluent. (Fluent means
in the curricular and extracurricular activities of without pausing, stammering, or starting over.)
the organization. Perfect 1 2 3 4 5 Needs much improvement
Perfect 1 2 3 4 5 Needs much improvement Example:
Example: Example:
Example: Example:
Example: 63. Appropriate writing skills: i.e. grammar. spelling,
organization.
Perfect 1 2 3 4 5 Needs much improvement
Example:
Example:
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64. Systems-analysis skills: Able to effectively
detect, analyze, and clearly specify problems
within the system and then suggest and
implement good solutions.
Perfect 1 2 3 4 5 Needs much improvement
Example:
Example:
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65.

7. 66. High quality behavior-analytic skills.
Perfect 1 2 3 4 5 Needs much improvement
Timelines
Now that you've filled out the entire
Example:
checklist, assume that you only have a 50-minute hour
Example:
to complete the two interviews. No way you're going
Example:
to do 71 x 2 items. So, in advance, clearly circle the
Other issues numbers of 5 of the positive items you'd like to
Add other items that merit discussion. discuss and 5 of the negative ones. Then allow
67. yourself a maximum of 10 minutes on the 5 positive
68. items and 10 minutes on the 5 negative items. If you
69. have time left over, then you can discuss more of
them. That leaves you 5 minutes to review the areas
Greatest Areas of Strength most in need of improvement and discuss
(from the preceding list) performance-management interventions.
70. Strength:
71. Strength:
72. Strength:
Areas That Most Need Improvement
(from the preceding list)
For each area of improvement, write what the
problem is and design a performance-management
intervention to improve that problem. To design the
intervention, just fill in the target behavior
(behavior); how you will keep track of, or record, the
behavior (recording); and what new consequences
you’ll put on the behavior (consequences).
73. Problem:
Performance-Management Intervention
Behavior:
Recording:
Consequences:
74. Problem:
Performance-Management Intervention
Behavior:
Recording:
Consequences:
75. Problem:
Performance-Management Intervention
Behavior:
Recording:
Consequences: