Assess Yourself 2: Cultural Awareness Self-Assessment Form

Please give a qualitative evaluation of each of the ten factors by clicking the circle that represents the appropriate numerical score which in your judgment best represents your assessment of your performance on each factor. This is not an opportunity to assess your desires, wishes, hopes, dreams, or even your potential. 7 = outstanding (superb); 6 = excellent; 5 = very good; 4 = average (good); 3 = fair; 2 = poor; 1 = very minimal; 0 = no ability at all.

Once you have completed the 10 items, click CALCULATE.

  7 6 5 4 3 2 1 0
1. I listen to people from other cultures when they tell me how my culture affects them.
2. I realize that people from other cultures have fresh ideas and different points of view to bring to my life and to the workplace.
3. I give people from other cultures advice on how to succeed in my culture.
4. I give people my support even when other members of my culture reject them.
5. I realize that people outside of my culture could be offended by my behavior. I’ve asked people if I have offended them by things I have done or said and have apologized whenever necessary.
6. I realize that when I am stressed out I am likely to make myself and my culture right and another culture wrong.
7. I respect my superiors (boss, teacher, supervisor, group leader, etc) regardless of where he or she is from. I do not go over his or her head to talk to someone from my culture in order to try and get my way.
8. When I am in mixed company, I mix with everyone. I do not just stay with people from my culture, or only with people from the dominant culture.
9. I go out of my way to work with, recruit, select, train, and/or promote people from outside the dominant culture.
10. When people in my culture make jokes about or talk negatively about other cultural groups, I let them know that I don’t like it.

*Adapted from: [No author]. (n.d.). Cultural awareness self-assessment form 3. I CANS (Integrated Curriculum for Achieving Necessary Skills), Washington State Board for Community and Technical Colleges, Washington State Employment Security, Washington Workforce Training and Education Coordinating Board, Adult Basic and Literacy Educators, P.O. Box 42496, 711 Capitol Blvd., Olympia, WA 98504. Retrieved August 12, 2002, from