When starting their 3rd year rotation in OBGYN, most of my medical students have never witnessed an actual obstetric delivery.
During their orientation Skills Lab, I include a vaginal delivery module that starts with the 5-Minute Vaginal Delivery.
While necessarily superficial, the video allows for exposure to the basic childbirth reality, without becoming tedious.
Following the Vaginal Delivery video, I show them the Immediate Care of the Newborn video. Then we move to the manikins.
I favor low-fidelity manikins for getting the students oriented. I remove the plastic vulvas and plastic abdomens, so they can see the fetus (doll) moving through the pelvis. They place some under-buttocks drapes, use a towel to control the delivery, check for a nuchal cord, and then deliver the baby with me or another faculty manually pushing the baby out.
I have them clamp/cut the cord, then dry the newborn. They practice suctioning the airway. Finally, they wrap the newborn.
During the one-on-one training (actually, it is usually 3-4 students per faculty with each manikin) the faculty gives more detailed instruction not covered by the video. Among the frequent questions is, “Why was an episiotomy performed?” (Answer: This was the patient’s second baby. She had an episiotomy with her first, believed that if she didn’t have another, she would have a bad tear, and was requesting an episiotomy be performed. I told her I didn’t think she needed one, and if she did tear, it would be a small tear, but the patient was insistent and I obliged her rather than fight about it.) Left alone, I wouldn’t have performed the episiotomy.
Time allowing, I like to give the students a brief test (“Status Check”). The test is one page, and has the answers on the back. They are told the test does not count, but is merely to make sure that everyone has “gotten it.”