Medical Education Content Required for Kernicterus Risk Recognition


Antônio Ledo Alves da Cunha 1 , Maria Amélia Sayeg Campos Porto 1 , Gláucia Macedo de Lima 1 , *

1 Institute of Pediatrics and Child Care Martagão Gesteira, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

How to Cite: Ledo Alves da Cunha A, Amélia Sayeg Campos Porto M, Macedo de Lima G. Medical Education Content Required for Kernicterus Risk Recognition , Iran J Pediatr. 2015 ; 22(2):163-170.


Iranian Journal of Pediatrics: 22 (2); 163-170
Published Online: June 30, 2012
Article Type: Research Article
Received: April 02, 2011
Accepted: December 16, 2011


Objective: The objective of this study was to define the minimum academic content required for pediatricians to recognize the risk of kernicterus.
Methods: A questionnaire was developed on the basis of American Academy of Pediatrics guidelines seeking to develop a consensus for pediatricians in training on the theoretical content about neonatal hyperbilirubinemia. To validate the instrument, we used the Delphi consensus method. The 14 invited experts interviewed, eminent Brazilian researchers of neonatal hyperbilirubinemia, analyzed the questions posed in accordance with the literature and validated the instrument
Findings: An assessment instrument, the Student Questionnaire (SQ), was developed on the basis of indicators of risk of neonatal hyperbilirubinemia obtained from the literature. A panel of academic experts, composed of the leading researchers of neonatal hyperbilirubinemia in Brazil according to research rankings of the Brazilian government’s Lattes Platform, was assembled for consensus validation of the assessment instrument. Validation of the SQ was achieved after two rounds of the Delphi technique. Finally, the SQ itself was validated with the medical education content required for recognition of kernicterus risk.
Conclusion: The consensus among experts stressed the need to identify the primary epidemiologic risk factors for significant hyperbilirubinemia associated with neonatal jaundice and to characterize risk of bilirubin encephalopathy according to the literature. The minimum capacity required of physicians in training is that they have the insight to consult the reference material specific to each clinical situation in which hyperbilirubinemia may be involved. The present study emphasized the need for knowledge of the four variables related to management of neonatal jaundice: gestational age, birth weight, infant age, and total serum bilirubin. This validated questionnaire can be a useful tool to prepare pediatricians to recognize the possibility of bilirubin encephalopathy in neonates and prescribe intervention as necessary.




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