ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 66 P6 | DOI: 10.1530/endoabs.66.P6

Improving midwives' recognition of atypical genitalia and differences of sexual development (DSD) through the use of an e-learning module

Danielle Eddy, Elizabeth Crowne & Julie Alderson


Bristol Royal Hospital for Children, Bristol, UK


Background: Confident recognition of atypical genitalia of the newborn and early referral to specialist centres allows for the smooth and successful management of DSD patients. Midwives conduct the majority of newborn infant physical exam (NIPE) yet may not be confident in recognising DSD and talking to families affected.

Aim: To develop an e-learning module for examining newborn genitalia, recognising the significance of differences in genital appearance and how to communicate and support a family with DSD.

Methods: A questionnaire was completed by midwives to assess the need for education around DSD. This revealed confidence in DSD recognition is poor and that there is concern around how to communicate and support families with DSD. The Royal College of Midwives (RCM) was approached with this data and a decision was made to develop an interactive e-learning module to be hosted on the RCM e-learning environment; accessible by all midwives who are registered with the college.

Results: An online and interactive module was co-produced with endocrinologists, a clinical psychologist and midwives and covers the following areas;

• DSD background

• Examination of newborn genitalia

• Recognising the variations of normal genitalia

• Recognising atypical genitalia

• Discussing concerns with parents

• Referring to paediatrics

• Supporting families at times of uncertainty

• Sources of information and support

• DSD quiz

We plan to review the impact of this training module in future through reviewing the results of the end of module quiz and through feedback from participants. It is hoped this module will improve midwives confidence in examining newborn genitalia and give them the practical tools to communicate with and support families affected by DSD.

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