Executive Burnout Self-Assessment Questionnaire

At the start and end of the Road Map to Resilience Burnout Resolution course.

Not just avoidance/recovery – strategic performance optimisation with precise, measurable outcomes.

Think of this initial quiz as your strategic reconnaissance mission into the intricate landscape of your professional burnout. It’s not just a questionnaire—it’s a precision diagnostic tool that maps the invisible fault lines of your current performance ecosystem. By capturing granular data about your stress responses, energy depletion, and psychological resilience, we’re creating a bespoke performance restoration blueprint. This isn’t about labeling you as “burned out,” but about giving you unprecedented insight into your own complex machinery—think of it as a high-resolution MRI for your professional well-being, revealing exactly where your systems are under strain and how we can strategically recalibrate for peak performance.

PART 1

Instructions: For each statement, please indicate how often you feel this way on a scale of 1 to 5: 1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, 5 = Always

No.StatementPre-course ScorePost-course Score
1I find it challenging to maintain the same level of enthusiasm for my work as I once did.____________
2I often feel a sense of detachment from my colleagues and clients.____________
3I question the significance of my professional achievements and their impact.____________
4I experience a persistent feeling of fatigue, even after adequate rest.____________
5I feel that the demands of my role exceed my capacity to meet them effectively.____________
6I find myself becoming increasingly cynical about the motives and actions of others in my professional sphere.____________
7I struggle to find meaning and purpose in my daily professional tasks.____________
8I feel that my professional responsibilities are encroaching on my personal life and well-being.____________
9I have difficulty empathizing with the challenges and concerns of my team members or clients.____________
10I lack the energy and motivation to pursue personal interests and hobbies outside of work.____________
  1. Calculating the Total Score:
    • To calculate the total score, sum the ratings for all 10 statements.
    • The total score can range from 10 (minimum burnout) to 50 (maximum burnout).
  2. Interpreting the Total Score:
    • 10-20: Low burnout. The participant is experiencing minimal symptoms of burnout.
    • 21-30: Moderate burnout. The participant is experiencing some symptoms of burnout but may still be managing well.
    • 31-40: High burnout. The participant is experiencing significant symptoms of burnout and may be struggling to cope.
    • 41-50: Severe burnout. The participant is experiencing severe symptoms of burnout and likely needs immediate intervention and support.
  3. Comparing Pre-course and Post-course Scores:
    • Administer the quiz before the course begins (pre-course) and again 2 weeks after the course is completed (post-course).
    • Calculate the total scores for both the pre-course and post-course quizzes.
    • The quiz serves as a dynamic effectiveness tracker for your transformation. By reassessing key metrics two weeks after the course, you create a real-time feedback loop: noticeable positive changes confirm the course’s impact and your strategic implementation, while minimal improvement signals the need for more in-depth personal intervention or more aggressive strategies. This isn’t about pass or fail, but about precise, data-driven personal optimisation—ensuring you’re not just consuming information, but actively rewiring your mind and increasing your resilience.

By following this detailed scoring method, you can gain a clear understanding of your burnout levels and the impact of your course.

PART 2

Insight-giving open-ended Questions

Open-ended questions are designed to gather more detailed and nuanced information than what can be obtained from scored questions alone. They allow you to express your thoughts, feelings, and experiences in your own words, providing rich qualitative data. Open-ended questions provide:

  1. Depth of Understanding: Open-ended questions provide deeper insights into your experiences and perceptions, which can be crucial for understanding the context and specific challenges you face.
  2. Personalisation: They allow you to share unique and personal experiences that might not be captured by standardised questions.
  3. Contextual Information: These questions can reveal the underlying reasons for your ratings on the scored questions, offering a more comprehensive view.
  4. Actionable Insights: The responses can guide the development of tailored interventions and strategies to address burnout more effectively.

Answer these 6 Open-Ended Questions before you start the course:

  1. Can you describe a recent situation at work where you felt particularly overwhelmed or disengaged? What factors contributed to this feeling?
    • Function: This question helps identify specific triggers and situations that contribute to feelings of overwhelm and disengagement. Understanding these factors can guide targeted interventions.
  2. How do you currently manage the balance between your professional responsibilities and your personal life? What strategies have you found effective, and what challenges do you still face?
    • Function: This question assesses your current strategies for work-life balance and identifies areas where you may need additional support or new strategies.
  3. In what ways do you believe your professional success has impacted your overall well-being and sense of fulfilment?
    • Function: This question explores the relationship between professional success and personal well-being, helping to understand how achievements align with or diverge from a sense of fulfilment.
  4. What are the primary sources of stress or burnout in your current role, and how do you typically address these issues?
    • Function: This question identifies the main stressors and current coping mechanisms, providing insights into what aspects of the role need attention and what strategies are already in place.
  5. Can you share an example of a time when you felt a strong sense of purpose and fulfilment in your work? What elements contributed to this experience?
    • Function: This question highlights positive experiences and the factors that contribute to a sense of purpose and fulfilment, which can be leveraged to enhance overall well-being.
  6. How do you envision your professional and personal life evolving in the next 5-10 years? What steps are you taking to align your current actions with this vision?
    • Function: This question encourages you to think about your long-term goals and the steps you are taking to achieve them, providing a forward-looking perspective on your professional and personal development.

“I am an experienced medical doctor (MBChB, MRCGP, NLP master pract cert, Transformational Life Coach dip, Counselling cert, Med Hyp Dip and EAGALA cert) with a special interest in stress management. I may have an impressive number of letters after my name, and I may have more than three decades of professional experience, but what qualifies me to excel at what I do is my intuitive understanding of my clients’ difficulties and my extensive personal experience of managing major life changes using strategies I developed over many years” Dr M Montagu – iNFINITE iMPACT

It’s time to kick exhaustion to the curb and finally ditch that terminally overwhelmed feeling, evict your inner critic, declutter your mind and take control of your life like a boss. You’re about to turn your life from a comedy of errors into a blockbuster success story (with a much better soundtrack). This two-day online course is designed for anyone facing a major life transition, needing to dramatically reduce stress, end exhaustion and overwhelm, and prevent or recover from burnout.

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