Role-Modeling Character Virtues in Surgical Teaching: An Exploratory Qualitative Study of Attending Surgeons

Background: Character virtues expressed by attending surgeons during teaching may shape residents’ professional identity, psychological safety, and learning behaviors. However, virtue-based teaching is rarely described in concrete, practice-level terms within surgical training. Methods: We conducted semi-structured interviews with a purposive sample of 10 attending surgeons from 7 institutions who had prior exposure to frameworks of learner flourishing. Interviews were recorded, transcribed, de-identified, and analyzed using cross-case thematic analysis. Initial coding was informed by flourishing frameworks and then refined inductively to capture specific teaching behaviors and contextual examples. Results: Six virtues consistently emerged as central to effective surgical teaching: temperance, courage, humanity, justice, wisdom, and transcendence. Participants described how these virtues were enacted through everyday practices, including balancing autonomy with guidance, modeling humility and help-seeking, giving residents space to struggle safely, prioritizing honest communication, mentoring equitably, and affirming trainees’ contributions. Across narratives, virtue role-modeling functioned as an organizing “through-line” connecting technical coaching with relational practices that sustain a growth-oriented learning environment. Conclusions: Attending surgeons described character virtues not as abstract ideals but as observable behaviors embedded in operative coaching, rounds, and feedback. Making these virtues explicit may offer a practical approach to humanizing surgical training while strengthening professional formation.