Email *

Full Name *

Assessment Instructions

Self-Rating Scale
Rate each statement on a scale of 1 to 10, with 10 being the best.
🔷

A note on your ratings:

This assessment is your check-up—a way to diagnose where you are today and identify opportunities to grow.

Be honest and curious about your responses.

8 to 10: This is a strong area for you, reflecting how you show up consistently, just about all the time, even under pressure.
5 to 7: You’re doing well here but have room to improve your consistency. Sometimes yes, sometimes no.
1 to 4: This area needs attention, but it’s an opportunity for growth.

Self Mastery

1 - I stay calm and composed under pressure, even during high-stakes situations (like a critical patient case or staff conflict). *

2 - I feel confident leading discussions with colleagues, executives, or external stakeholders—even when I’m not the expert on the topic. *

3 - I understand how my personal assumptions or biases might affect my decisions in patient care, team management, or organizational strategy. *

4 - I recognize my triggers (like staff frustrations or operational delays) and manage them effectively so they don’t impact my leadership. *

5 - I don’t take it personally when others are upset or stressed, and I maintain focus on solutions instead of reactions. *

6 - I seek out and implement meaningful feedback from peers, team members, and mentors to understand how I can improve. *

SELF MASTERY PILLAR TOTAL *

Role Mastery

7 - I adapt quickly when healthcare regulations, policies, or procedures change unexpectedly. *

8 - I prioritize my time and focus on the most important tasks to achieve patient care, team, and organizational goals. *

9 - I know the skills and leadership behaviors I need to grow in my role or advance to the next level. *

10 - I collaborate effectively with other departments, such as clinical staff, operations, or administration, to improve outcomes. *

11 - I’m skilled at influencing decisions within my organization to advocate for my team, patients, and priorities. *

ROLE MASTERY PILLAR TOTAL *

Goal Mastery

12 - I’m clear on my organization’s vision, mission, and goals, and I can confidently articulate how my team contributes to them. *

13 - My decisions and actions align with long-term strategic objectives, including patient care excellence and operational success. *

14 - I regularly seek input from key stakeholders to ensure alignment with organizational and departmental goals. *

15 - When challenges arise (like budget cuts or staffing shortages), I adjust plans and keep my team focused on solutions. *

16 - I actively pursue opportunities to learn and grow, such as leadership training, certifications, or mentoring. *

17 - My career choices and development are intentional and focused on my goals. *

18 - I have a written career plan or professional development roadmap that informs my daily and weekly actions. *

GOAL MASTERY PILLAR TOTAL *

Do you supervise or lead a team? *

Yes

Team Mastery

19 - My team understands the organization’s priorities and knows why their work matters to patients and outcomes. *

20 - Every team member knows what success looks like in their role and how their performance is measured. *

21 - My team members are aware of their key growth areas and have actionable plans to improve. *

22 - Everyone on my team understands how their role supports the broader goals of the department and organization. *

23 - My team works together to address challenges, with open communication and shared accountability. *

24 - I actively coach and mentor my team to help them grow their skills, confidence, and leadership abilities. *

TEAM MASTERY PILLAR TOTAL *

You Scores

Self-Mastery Total Score: *

Role-Mastery Total Score: *

Goal-Mastery Total Score: *

Team Mastery Total Score: *