Presenting the Inner Triangle Outer Diamond (ITOD) Framework of Educational Ecosystems and Its Applications to the Integration of Educational Technologies and Innovations.

Educators are leveraging technologies and innovations, including artificial intelligence (AI), to support learners and deliver quality medical education. Many of these initiatives have reportedly yielded positive impacts. There have also been publications and reports highlighting the success of educational technologies (EdTech) and innovations, as well as their potential to not only enhance the outcomes of educational programs but also define the future of medical education and practice. Proponents of EdTech and innovations argue that the significant introduction of EdTech and innovations into programs can enhance learners' experiences, improve programme outcomes, and prepare learners for a future of work and practice expected to be significantly shaped by technologies and innovation. However, it is equally important to address the unintended consequences of poor technology application, particularly when approaches to introducing and deploying EdTech and innovations are not properly grounded in learning theories and pedagogical principles or are improperly integrated into the educational ecosystem. A major issue associated with improper deployment and poor integration of educational technologies and innovations is heterogeneity, in addition to other reported contextual challenges and limitations. This underscores the need to approach the introduction, deployment, and integration of EdTech and innovation from an ecosystem perspective, providing medical educators and other stakeholders with a comprehensive view of what constitutes the ecosystem supporting medical education. Such an approach ensures the optimization of technologies and innovations through systems thinking. The inner triangle outer diamond (ITOD) framework, therefore, represents an approach that is both comprehensive and relatable for medical educators. This model aims to guide the integration of technologies and innovations in a way that aligns with the broader goals of medical education.