{"id":"https://openalex.org/W7225270206","doi":"https://doi.org/10.3389/fpubh.2026.1942514","title":"Governance, leadership and organisational capacity for decentralised medical training: insights from a South African medical school","display_name":"Governance, leadership and organisational capacity for decentralised medical training: insights from a South African medical school","publication_year":2026,"publication_date":"2026-11-04","ids":{"openalex":"https://openalex.org/W7225270206","doi":"https://doi.org/10.3389/fpubh.2026.1942514"},"language":"en","primary_location":{"id":"doi:10.3389/fpubh.2026.1942514","doi":"https://doi.org/10.3389/fpubh.2026.1942514","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1942514","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1942514/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1942514/pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5080916588","display_name":"Nonhlanhla Precious. Mqadi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I95023434","display_name":"University of KwaZulu-Natal","ror":"https://ror.org/04qzfn040","country_code":"ZA","type":"education","lineage":["https://openalex.org/I95023434"]}],"countries":["ZA"],"is_corresponding":false,"raw_author_name":"Nonhlanhla Precious Mqadi","raw_affiliation_strings":["Discipline of Public Governance, University of KwaZulu-Natal"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Discipline of Public Governance, University of KwaZulu-Natal","institution_ids":["https://openalex.org/I95023434"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5032472844","display_name":"Thokozani Ian Nzimakwe","orcid":"https://orcid.org/0000-0001-5817-9910","observed_orcids":["https://orcid.org/0000-0001-5817-9910"]},"institutions":[{"id":"https://openalex.org/I95023434","display_name":"University of KwaZulu-Natal","ror":"https://ror.org/04qzfn040","country_code":"ZA","type":"education","lineage":["https://openalex.org/I95023434"]}],"countries":["ZA"],"is_corresponding":false,"raw_author_name":"Thokozani Ian Nzimakwe","raw_affiliation_strings":["Discipline of Public Governance, University of KwaZulu-Natal"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Discipline of Public Governance, University of KwaZulu-Natal","institution_ids":["https://openalex.org/I95023434"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5007223970","display_name":"Reward Utete","orcid":"https://orcid.org/0000-0002-9086-1052","observed_orcids":["https://orcid.org/0000-0002-9086-1052","https://orcid.org/0009-0007-0685-8744"]},"institutions":[{"id":"https://openalex.org/I24027795","display_name":"University of Johannesburg","ror":"https://ror.org/04z6c2n17","country_code":"ZA","type":"education","lineage":["https://openalex.org/I24027795"]}],"countries":["ZA"],"is_corresponding":true,"raw_author_name":"Reward Utete","raw_affiliation_strings":["Department of Industrial Psychology and People Management, University of Johannesburg"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Industrial Psychology and People Management, University of Johannesburg","institution_ids":["https://openalex.org/I24027795"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5007223970"],"corresponding_institution_ids":["https://openalex.org/I24027795"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.91089699,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":null,"biblio":{"volume":"14","issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10254","display_name":"Innovations in Medical Education","score":0.8335000276565552,"subfield":{"id":"https://openalex.org/subfields/3304","display_name":"Education"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10254","display_name":"Innovations in Medical Education","score":0.8335000276565552,"subfield":{"id":"https://openalex.org/subfields/3304","display_name":"Education"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12413","display_name":"Health and Medical Education","score":0.16019999980926514,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13896","display_name":"Health Services Management and Policy","score":0.002199999988079071,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/medical-school-governance","display_name":"medical school governance","score":0.7940000295639038},{"id":"https://openalex.org/keywords/transformational-leadership","display_name":"transformational leadership","score":0.8309999704360962},{"id":"https://openalex.org/keywords/servant-leadership","display_name":"servant leadership","score":1.0},{"id":"https://openalex.org/keywords/distributed-leadership","display_name":"distributed leadership","score":0.7749999761581421},{"id":"https://openalex.org/keywords/organizational-readiness","display_name":"organizational readiness","score":0.7789999842643738},{"id":"https://openalex.org/keywords/clinical-training-sites","display_name":"clinical training sites","score":0.5389999747276306},{"id":"https://openalex.org/keywords/health-workforce-shortage","display_name":"health workforce shortage","score":0.6320000290870667},{"id":"https://openalex.org/keywords/faculty-development","display_name":"faculty development","score":0.7170000076293945},{"id":"https://openalex.org/keywords/curriculum-change","display_name":"curriculum change","score":0.8199999928474426},{"id":"https://openalex.org/keywords/health-professions-education","display_name":"health professions education","score":0.7269999980926514},{"id":"https://openalex.org/keywords/south-africa","display_name":"South Africa","score":0.6140000224113464}],"concepts":[{"id":"https://openalex.org/C38775462","wikidata":"https://www.wikidata.org/wiki/Q1569376","display_name":"Transformational leadership","level":2,"score":0.640999972820282},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.44760000705718994},{"id":"https://openalex.org/C7225491","wikidata":"https://www.wikidata.org/wiki/Q2697537","display_name":"Leadership studies","level":3,"score":0.4327999949455261},{"id":"https://openalex.org/C509550671","wikidata":"https://www.wikidata.org/wiki/Q126945","display_name":"Medical education","level":1,"score":0.41909998655319214},{"id":"https://openalex.org/C2778717081","wikidata":"https://www.wikidata.org/wiki/Q22905839","display_name":"Distributed leadership","level":4,"score":0.41760000586509705},{"id":"https://openalex.org/C2776007630","wikidata":"https://www.wikidata.org/wiki/Q2798912","display_name":"Accountability","level":2,"score":0.4108999967575073},{"id":"https://openalex.org/C201305675","wikidata":"https://www.wikidata.org/wiki/Q852998","display_name":"Stakeholder","level":2,"score":0.4090999960899353},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.40630000829696655},{"id":"https://openalex.org/C2778061430","wikidata":"https://www.wikidata.org/wiki/Q188823","display_name":"Scholarship","level":2,"score":0.40139999985694885},{"id":"https://openalex.org/C2778139618","wikidata":"https://www.wikidata.org/wiki/Q13440398","display_name":"Workforce","level":2,"score":0.3903999924659729},{"id":"https://openalex.org/C47177190","wikidata":"https://www.wikidata.org/wiki/Q207137","display_name":"Curriculum","level":2,"score":0.3727000057697296},{"id":"https://openalex.org/C106399304","wikidata":"https://www.wikidata.org/wiki/Q868123","display_name":"Snowball sampling","level":2,"score":0.36959999799728394},{"id":"https://openalex.org/C2780271678","wikidata":"https://www.wikidata.org/wiki/Q6508669","display_name":"Leadership development","level":2,"score":0.35749998688697815},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.3499000072479248},{"id":"https://openalex.org/C2780984029","wikidata":"https://www.wikidata.org/wiki/Q2930198","display_name":"Stakeholder engagement","level":2,"score":0.34869998693466187},{"id":"https://openalex.org/C111366508","wikidata":"https://www.wikidata.org/wiki/Q5341291","display_name":"Educational leadership","level":2,"score":0.3409000039100647},{"id":"https://openalex.org/C39389867","wikidata":"https://www.wikidata.org/wiki/Q380767","display_name":"Corporate governance","level":2,"score":0.33970001339912415},{"id":"https://openalex.org/C66204764","wikidata":"https://www.wikidata.org/wiki/Q219416","display_name":"Sustainability","level":2,"score":0.3379000127315521},{"id":"https://openalex.org/C2779622097","wikidata":"https://www.wikidata.org/wiki/Q1417724","display_name":"Capacity building","level":2,"score":0.32850000262260437},{"id":"https://openalex.org/C85973986","wikidata":"https://www.wikidata.org/wiki/Q1091731","display_name":"Exploratory research","level":2,"score":0.32710000872612},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.3179999887943268},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.3172999918460846},{"id":"https://openalex.org/C67126808","wikidata":"https://www.wikidata.org/wiki/Q2912387","display_name":"Servant leadership","level":3,"score":0.3172000050544739},{"id":"https://openalex.org/C2779968149","wikidata":"https://www.wikidata.org/wiki/Q8034851","display_name":"Workforce development","level":3,"score":0.3138999938964844},{"id":"https://openalex.org/C207195186","wikidata":"https://www.wikidata.org/wiki/Q846002","display_name":"Neuroleadership","level":4,"score":0.2962999939918518},{"id":"https://openalex.org/C107645774","wikidata":"https://www.wikidata.org/wiki/Q5467169","display_name":"Human resources","level":2,"score":0.28940001130104065},{"id":"https://openalex.org/C88251983","wikidata":"https://www.wikidata.org/wiki/Q7489549","display_name":"Shared leadership","level":3,"score":0.289000004529953},{"id":"https://openalex.org/C51067260","wikidata":"https://www.wikidata.org/wiki/Q828812","display_name":"Professional development","level":2,"score":0.28679999709129333},{"id":"https://openalex.org/C68489960","wikidata":"https://www.wikidata.org/wiki/Q2370659","display_name":"Transactional leadership","level":2,"score":0.2854999899864197},{"id":"https://openalex.org/C197386563","wikidata":"https://www.wikidata.org/wiki/Q6508686","display_name":"Leadership style","level":2,"score":0.27959999442100525},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.274399995803833},{"id":"https://openalex.org/C56739046","wikidata":"https://www.wikidata.org/wiki/Q192060","display_name":"Knowledge management","level":1,"score":0.27000001072883606},{"id":"https://openalex.org/C2778456998","wikidata":"https://www.wikidata.org/wiki/Q25339345","display_name":"Instructional leadership","level":3,"score":0.265500009059906},{"id":"https://openalex.org/C100363876","wikidata":"https://www.wikidata.org/wiki/Q690661","display_name":"Nonprobability sampling","level":3,"score":0.2653000056743622},{"id":"https://openalex.org/C74196892","wikidata":"https://www.wikidata.org/wiki/Q7781188","display_name":"Thematic analysis","level":3,"score":0.25949999690055847},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.2581999897956848},{"id":"https://openalex.org/C148609458","wikidata":"https://www.wikidata.org/wiki/Q7021281","display_name":"Nexus (standard)","level":2,"score":0.25609999895095825},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.2522999942302704}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3389/fpubh.2026.1942514","doi":"https://doi.org/10.3389/fpubh.2026.1942514","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1942514","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1942514/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3389/fpubh.2026.1942514","doi":"https://doi.org/10.3389/fpubh.2026.1942514","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1942514","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1942514/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Quality education","score":0.9235000014305115,"id":"https://metadata.un.org/sdg/4"},{"display_name":"Good health and well-being","score":0.5683000087738037,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225270206.pdf","grobid_xml":"https://content.openalex.org/works/W7225270206.grobid-xml"},"referenced_works_count":39,"referenced_works":["https://openalex.org/W600039702","https://openalex.org/W1969512867","https://openalex.org/W1981665776","https://openalex.org/W1996600674","https://openalex.org/W2050028148","https://openalex.org/W2069213946","https://openalex.org/W2103899250","https://openalex.org/W2118443906","https://openalex.org/W2136165894","https://openalex.org/W2140376514","https://openalex.org/W2144606486","https://openalex.org/W2170052663","https://openalex.org/W2399464288","https://openalex.org/W2513325771","https://openalex.org/W2612201902","https://openalex.org/W2760301011","https://openalex.org/W2767289697","https://openalex.org/W2789736709","https://openalex.org/W2793862966","https://openalex.org/W2802008805","https://openalex.org/W2883498355","https://openalex.org/W2884862593","https://openalex.org/W2887563597","https://openalex.org/W2900799024","https://openalex.org/W2913884000","https://openalex.org/W2917141922","https://openalex.org/W3081264413","https://openalex.org/W4200055165","https://openalex.org/W4200258011","https://openalex.org/W4213230142","https://openalex.org/W4214816821","https://openalex.org/W4220663647","https://openalex.org/W4223508755","https://openalex.org/W4234580964","https://openalex.org/W4390109941","https://openalex.org/W4391678396","https://openalex.org/W4401026626","https://openalex.org/W4413529652","https://openalex.org/W4417150778"],"related_works":["https://openalex.org/W2760301011","https://openalex.org/W4252825071","https://openalex.org/W3142409077","https://openalex.org/W2767289697","https://openalex.org/W2766298784","https://openalex.org/W4416292644","https://openalex.org/W2340089278","https://openalex.org/W4251572956","https://openalex.org/W4220786819","https://openalex.org/W2785003319"],"abstract_inverted_index":{"Introduction":[0],"Decentralised":[1],"medical":[2,69,75,131,191,242],"training":[3,15,70,100,132,192,243],"has":[4,31],"become":[5],"a":[6,72,92,174,194],"strategic":[7],"approach":[8],"for":[9,40,150,234],"strengthening":[10],"primary":[11],"healthcare,":[12],"expanding":[13],"clinical":[14,99,182],"capacity":[16],"and":[17,36,49,61,94,105,114,141,159,164,206,219,226,236,244,248],"addressing":[18],"health":[19,251],"workforce":[20],"shortages":[21],"in":[22,102,254],"South":[23,73],"Africa.":[24],"Despite":[25],"its":[26,41],"growing":[27],"adoption,":[28],"limited":[29],"research":[30,81],"examined":[32],"the":[33,56,148,165,179,199,246],"governance,":[34,136,203],"leadership":[35,59,205,220],"organisational":[37,196],"conditions":[38],"required":[39],"successful":[42],"implementation.":[43],"Guided":[44],"by":[45,214],"Transformational":[46,224],"Leadership":[47,51,225],"Theory":[48],"Servant":[50,227],"Theory,":[52],"this":[53],"study":[54,210],"explores":[55],"governance":[57,218],"structures,":[58],"practices":[60],"institutional":[62,207],"readiness":[63,170],"necessary":[64],"to":[65,111,239],"support":[66],"sustainable":[67,157],"decentralised":[68,130,190,241],"within":[71],"African":[74],"school.":[76],"Methods":[77],"An":[78],"exploratory":[79],"qualitative":[80],"design":[82],"was":[83,171],"adopted":[84],"employing":[85],"semi-structured":[86],"interviews":[87],"with":[88],"16":[89],"participants":[90,113],"from":[91],"university":[93],"affiliated":[95],"Department":[96,166],"of":[97,129,167,181,201,250],"Health":[98],"sites":[101],"KwaZulu-Natal.":[103],"Purposive":[104],"snowball":[106],"sampling":[107],"techniques":[108],"were":[109,116],"used":[110],"recruit":[112],"data":[115],"analysed":[117],"thematically":[118],"using":[119],"NVivo":[120],"12.":[121],"Results":[122],"The":[123,144,186,209,229],"findings":[124,187,230],"demonstrate":[125,188],"that":[126,189,222],"effective":[127,202],"implementation":[128],"depends":[133],"on":[134],"collaborative":[135],"transparent":[137],"communication,":[138],"stakeholder":[139],"engagement":[140],"distributed":[142],"leadership.":[143],"results":[145],"further":[146],"highlighted":[147],"need":[149],"curriculum":[151],"transformation,":[152],"faculty":[153],"development,":[154],"adequate":[155],"infrastructure,":[156],"funding":[158],"strong":[160],"partnerships":[161],"between":[162],"universities":[163,235],"Health.":[168],"Organisational":[169],"perceived":[172],"as":[173],"multidimensional":[175],"construct":[176],"extending":[177],"beyond":[178],"expansion":[180],"placement":[183],"sites.":[184],"Discussion":[185],"is":[193],"complex":[195],"transformation":[197],"requiring":[198],"integration":[200],"adaptive":[204],"capacity.":[208],"extends":[211],"existing":[212],"scholarship":[213],"proposing":[215],"an":[216],"integrated":[217],"framework":[221],"combines":[223],"Leadership.":[228],"offer":[231],"practical":[232],"guidance":[233],"policymakers":[237],"seeking":[238],"strengthen":[240],"improve":[245],"responsiveness":[247],"sustainability":[249],"professions":[252],"education":[253],"resource-constrained":[255],"settings.":[256]},"counts_by_year":[],"updated_date":"2026-11-06T12:05:46.655746","created_date":"2026-11-05T00:00:00"}
