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In the middle of a classroom, where the tables have been pushed to the sides and the chairs placed in a circle, sit a series of blankets. They include the traditional flags of the Haudenosaunee and Mohawk nations, but others have been prepared by school children. As the participants arrive, they are greeted by the facilitators – Dawn Maracle and Zoë Aarden – who over the next two hours will lead the group through an exercise that reveals the history of Indigenous Peoples in Canada.

Known as the , the program is an interactive way to convey truth, understanding, respect and reconciliation among Indigenous and non-Indigenous people. Over the course of the exercise, participants watch as the land they stand on shrinks, see how illness and government policies reduce your populations and hear testimonies from those impacted.

On this particular day, the participants are senior leaders in the University of Toronto's Faculty of Medicine, including department chairs, administrative leaders and members of the dean's executive team. However, the blanket exercise is being used frequently throughout the Faculty of Medicine as a way to not only convey the poorly understood history of Indigenous nations within Canada, but also the intergenerational trauma that has been caused by colonialism. This includes the claiming of traditional Indigenous lands by settlers as well as the impacts of and the .

“It’s important for us to understand the history and trauma of Indigenous Peoples in Canada, not only in light of our commitment to the Truth and Reconciliation Commission recommendations, but as health professionals who work with Indigenous populations,” says Professor Trevor Young, dean of the Faculty of Medicine and vice-provost, relations with health care institutions.

The Rehabilitation Sciences Institute included the blanket exercise as part of their back to classes offering for students. The institute’s director, Professor Angela Colantonio, called the exercise “transformational.”

Department chairs and senior leaders in the Faculty of Medicine participate in the blanket exercise (photo by Liam Mitchell)

Dr. Lisa Richardson, co-lead of Indigenous Medical Education in the MD Program, says that blanket exercise is an important educational tool that helps individuals draw an emotional connection to the lessons they learn. 
 
“Students can understand experientially  – in a mild way – some of the emotional trauma Indigenous Peoples have faced and are continuing to face,” says Richardson. “This isn’t like a typical lecture, where you’re hearing statistics and talking about social determinants of health. As the blankets are removed, the issues are being visualized in front of you.”

Dr. Lindsay Herzog, a family medicine resident based at Mount Sinai Hospital, has used the blanket exercise to help other residents understand the historical context for Indigenous health issues. She discovered the exercise in the final months of medical school while taking an elective course in urban Indigenous health.

“While I wasn't exactly sure what the elective would involve, the description highlighted concepts of Indigenous health and developing a greater understanding of Indigenous culture,” says Herzog. “Given the lack of my medical training education in this area and the fact I would soon be entering family medicine residency, I felt this could be a worthwhile experience, so I signed up for it.”

The course encouraged engagement with Toronto’s urban Indigenous population through a variety of community events, one of which was participation in the blanket exercise at ��˾��ֱ��'s .

“Looking back now, I’m so grateful to have had this experience at the time that I did, and I couldn’t possibly have known the way the blanket exercise would continue to weave itself through my future medical training,” says Herzog. “I have since been lucky to have the opportunity to help facilitate the blanket exercise for the family medicine residents at Mount Sinai, at the department of family and community medicine undergraduate education faculty development workshop day, as well as for the second-year medical students at ��˾��ֱ��.”  

The exercise is an important way, she says, for health professionals to connect with their Indigenous patients.

“By understanding a person’s history and their culture, we gain a deeper understanding of that person and we become sensitive to how such concepts may relate to one’s interaction with the health-care system and their overall health,” she says.

But, it’s not just health-care professionals who would benefit from participating in the blanket exercise.

“We have a duty to learn more; not just as health professionals working to best care for our patients, but as Canadian citizens. It is our responsibility to learn, to understand, and to contribute to reconciliation.”