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

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.

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.

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.

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.