Culture Diagnostic — Short Assessment & Action Worksheet

A short interactive diagnostic that measures psychological safety, feedback norms, and inclusion. The form collects 10 quick scale responses, provides a clear scoring and interpretation guide, and includes an action worksheet to capture three experiments with owners, metrics, and timeboxes.

Interactive Tool

Culture Diagnostic — Short Assessment & Action Worksheet

This short diagnostic helps teams surface the most important culture gaps that block learning and performance. It takes 5–10 minutes. Answer each statement based on how the team is doing today. Use the scoring guidance below to interpret results and then capture up to three small experiments with owners and measurable signals so issues get real attention.

How scoring works

  1. Each item is scored 1 (Strongly disagree) to 5 (Strongly agree).
  2. Compute an average score across all items (or across domains shown in the guide). Lower average scores highlight the strongest gaps.
  3. Prioritize the lowest-scoring areas for experiments. Aim for small, time-boxed changes you can evaluate with a simple metric.

Quick interpretation

  • 4.0–5.0: Healthy—keep reinforcing and scale what works.
  • 3.0–3.9: Mixed—some practices exist but are inconsistent.
  • 1.0–2.9: Concerning—issues are likely blocking speaking up, learning, or inclusion.

Action coaching tip

Don't treat this as a one-off survey. Use the action worksheet below: pick owner(s), pick a clear signal/metric, run a short experiment (2–6 weeks), review results, and iterate.

Comfort speaking up without fear of ridicule or retaliation.
1.0 10.0
Mistakes are discussed constructively to improve systems, not to blame individuals.
1.0 10.0
Feedback is specific, actionable, and occurs close to events.
1.0 10.0
Feedback leads to visible changes or agreed experiments.
1.0 10.0
Active listening and acknowledgement are common.
1.0 10.0
Diverse voices are invited and respected.
1.0 10.0
Different experiences and expertise are actively solicited.
1.0 10.0
Accountability focuses on shared agreements and improvement, not punishment.
1.0 10.0
There is a simple, visible way to record and act on lessons learned.
1.0 10.0
Leaders demonstrate curiosity, admit uncertainty, and encourage challenge.
1.0 10.0
Record specific incidents or patterns that explain your scores.
A short name for the experiment (e.g., 'Weekly safe-fail huddle').
Who will run this experiment?
How will you measure progress? (e.g., # of issues raised, survey change)
Suggested 2–6 weeks. Record start and end dates or duration.
Another prioritized experiment.
Who will run this experiment?
How will you measure progress?
Suggested 2–6 weeks.
Third experiment (optional).
Who will run this experiment?
How will you measure progress?
Suggested 2–6 weeks.
One sentence: what will you do next and when?
Selecting yes can help make experiments visible and invite support.
You can explore this tool now. Sign in or create an account to save your responses and return to them later.
Make this tool part of your work

Save a personal copy, bring it to your team, or tailor the questions and workflow to fit what you are hungry to improve.

Member customization and team collaboration are coming soon.

Discussion

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