Twelve service chiefs participated in PULSE 360° feedback surveys and coaching as part of a departmental leadership development activity. Changes in the means of both composite survey scores and individual behavioral item scores over time were evaluated with paired t tests. Agreement between self-rating and rating of others was evaluated with unpaired t tests. There was a nonsignificant change in overall behavioral performance (composite scores) for the physician leaders (n D 12) from baseline [mean (M) D 68.7, standard deviation (SD) D 16.9] to 1-year follow-up (M D 73.1, SD D 11.4), but the performance of four of the leaders with the lowest scores improved substantially. There was a significant improvement in ‘‘identifies mistakes respectfully’’ when comparing baseline to 1-year follow-up. Ten behaviors were identified as improvement opportunities and nine behaviors were identified as behavioral strengths at baseline. Surgeon leaders were in agreement with others’ ratings on 68% of behaviors, underestimated 20% of behaviors, and overestimated 13% of behaviors.