This Survey Instrument is intended to be a Kirkpatrick level 3 evaluation designed to be used in a course titled "Giving and Receiving Feedback". It should be distributed approximately 4 weeks after the end of the class. Identify at least two issues that you believe are important in understanding the degree to which this tool will be effective for that purpose. Connect each point you make in writing this memo to content from the text.

the survey instrument is as follows:

Giving and Receiving Feedback

The most important element in the core skills development is the actual transfer of learning to the work place. Does this process improve our performance? One way to measure the impact of this process is to ask participants to do a self-evaluation. Please answer the questions below.

	Core Skills: Giving Feedback Receiving Feedback	I strongly Agree	I Agree	Not Sure	I Disagree	I Strongly Disagree
1	Since participating in the activities associated with giving and receiving feedback, I have become more aware of how I should perform these core skills.
2	Since participating in these activities, I have been more likely to identify situations in which I should use the standards we discussed relating to these core skills.
3	Since participating in these activities, I can remember at least one situation which I handled more effectively because of our study of the core skills, giving and receiving feedback.
4	Based on our study of giving and receiving feedback, I routinely perform more effectively in situations requiring the use of these skills.

Please use the space below (and on the back of this page) to provide additional feedback: