Fractured sternal wire causing a cardiac laceration.

Background: Hemopericardium is a serious complication that can occur after cardiac surgery. While most post-operative causes are due to inflammation and bleeding, patients with broken sternal wires and an unstable sternum may develop hemopericardium from penetrating trauma.

Case Presentation: We present the case of a 62-year-old male who underwent triple coronary bypass surgery and presented five months later with sudden anterior chest wall pain.

Efficacy of del Nido cardioplegia in adult cardiac procedures with prolonged aortic crossclamp time.

Objective: Equivalent myocardial protection and clinical outcomes have been shown with the use of del Nido cardioplegia (DC) compared with blood cardioplegia (BC) in adult isolated coronary artery bypass grafting and valve patients. However, its safety and efficacy in cardiac procedures with aortic crossclamp times >90 minutes is still unknown.

Methods: From May 2014 to September 2019, 2506 adult patients at our center underwent cardiac surgery requiring prolonged aortic crossclamp time defined as 90 minutes or longer.

Del Nido Cardioplegia in Ascending Aortic Surgery.

Del Nido cardioplegia offers equivalent myocardial protection and clinical outcomes to blood cardioplegia in adult isolated CABG and valve patients, but the safety and efficacy of del Nido in complex cases with prolonged aortic cross-clamp times is still unknown. 443 patients at our center underwent replacement of the ascending aorta using either del Nido (n = 182) or blood (n = 261) cardioplegia. Two surgeons used del Nido exclusively and 6 used blood exclusively over the study period.

Recurrent Cardiogenic Syncope From Extrinsic Organ Anomaly.

A 40-year-old woman presented with recurrent syncope. She reported multiple (>20) episodes of non-prodromal loss of consciousness, periodically provoked by physical exertion. One episode resulted in a nasal fracture due to the abrupt nature of her syncope.

Scholarship During a Pandemic: Secondary Data Analysis.

The COVID-19 pandemic has disrupted nearly every aspect of life in the United States and around the globe, including significant impacts to higher education, both in its teaching-learning and research missions. With the physical closure of so many college and university campuses, a looming challenge is how nurse researchers can continue to generate new knowledge during a temporary but extended period of social distancing where conducting research requiring physical interaction with participants is impossible. In this Methodology Corner installment, a brief overview of secondary data analysis is provided, and resources for locating potentially useful data are described.

Accuracy and completeness are required: A response to Dreher et al (2019).

The authors of this response outline numerous factual errors and mischaracterizations about their prior work made by Dreher et al (2019). The authors reaffirm their original findings and conclusions and further argue that substantial empirical evidence not reviewed by Dreher et al (2019) support the conclusions reached by Spurlock and Hunt (2008) and Phelan (2012).

Defining Practical Significance Is Hard, But We Should Do It Anyway.

Although it was decades in the making, the urgency to move beyond simplistic rules for interpreting p values is quickly increasing. While p values may never completely disappear from our quantitative analysis tool box, the need to actively consider the practical significance of our statistical findings increases each day. In this Methodology Corner article, the concept of practical significance is reviewed and compared to our evolving concept of statistical significance.

Searching the Literature in Preparation for Research: Strategies That Matter.

Literature searches conducted in preparation for a study differ in both purpose and scope from the literature searches conducted to locate evidence relevant to specific, narrowly defined clinical or educational practice questions. In this Methodology Corner installment, several important considerations are reviewed, including the importance of understanding the scope and coverage of literature databases, the utility of database search fields and controlled vocabularies, search limiters and expanders, and the possible unintended consequences of limiting searches based on the availability of full-text resources. Examples are provided throughout to help nursing education researchers conduct more effective and efficient literature searches.

A National Study Across Levels of Nursing Education: Can Nurses and Nursing Students Accurately Estimate Their Knowledge of Evidence-Based Practice?

Aim: This national study sought to: a) describe the evidence-based practice (EBP) knowledge levels of nursing students enrolled in baccalaureate through doctorate of nursing practice programs; b) examine relationships between objective and subjective EBP knowledge measures; c) describe correlations between educational and demographic factors and EBP knowledge; and d) further evaluate validity and reliability evidence for the Evidence-Based Practice Knowledge Assessment in Nursing.

Background: Rigorous evaluation of students' EBP knowledge across nursing program levels is vital to enhancing education and patient care.

Method: A cross-sectional, correlational design using large-scale survey procedures was used in this study.

Gender Differences and Similarities in Accelerated Nursing Education Programs: Evidence of Success From the New Careers in Nursing Program.

Aim: The aim of the study was to examine the profile of male students in accelerated nursing education programs (ANEPs) focusing on key demographic, educational, and outcome variables and compare male and female students on these variables.

Background: Though ANEPs have proliferated over the last two decades, there has been little study of students enrolled in these programs and, consequently, the role ANEPs could play in enhancing nursing workforce diversity.

Method: This study is a secondary analysis of data collected from 3,502 students who participated in the Robert Wood Johnson Foundation New Careers in Nursing Program from 2008 to 2016.

When "Little Is Known" Is Not Entirely True.

Research in nursing education often involves addressing problems and topics of interest to scholars from numerous fields outside of nursing-and to nurse educators from around the globe. Although it is sometimes true that little is known about a given topic of interest to nursing education researchers, often more is known about the topic if researchers consider evidence with extradisciplinary and international origins. In this Methodology Corner article, a framework for evaluating the applicability and transferability of study findings is presented alongside examples of how the framework can be operationalized to expand the evidence base from which nursing education researchers can draw when designing studies of their own.

A Guide to Guidelines for Nursing Education Researchers.

This installment of the Methodology Corner discusses the important role of research and quality improvement project reporting guidelines in the development of a field's evidence base. Several prominent guidelines, all with relevance to nursing education researchers, are described. Research and quality improvement reporting guidelines can be useful to researchers and quality improvement leaders long before the dissemination stage of a project and should be consulted from the earliest stages of a project.

A Global Approach to Promoting Evidence-Based Practice Knowledge: Validating the Translated Version of the Evidence-Based Practice Knowledge Assessment in Nursing Into Spanish.

Background: Government and professional organizations have issued a call for evidence-based practice (EBP), prompting the development of competencies and expectations for knowledge, skills, and attitudes. However, EBP is still inconsistently implemented. To advance the science of nursing globally, educators and leaders need to use consistent, rigorous evaluation methods to assess the EBP knowledge of students and clinicians.

What's in a Name? Revisiting Pilot Studies in Nursing Education Research.

Pilot studies are a commonly described type of study in the nursing education literature. Although nursing education researchers continue to label small, single-site, hypothesis-driven studies as pilot studies, the consensus in other fields as to what constitutes a pilot study has changed over time to focus more narrowly on issues of feasibility and acceptability of study interventions and interactions. Nursing education researchers are encouraged to adopt more modern definitions of pilot studies that substantially reduce (or eliminate) the focus on inferential statistical testing while increasing the focus on practical and procedural aspects of study design and implementation.

Statistical Power in Nursing Education Research.

Nursing researchers have been encouraged for decades to address the validity of their statistical conclusions in part by accumulating evidence from studies that are capable of correctly identifying relationships between variables when those relationships are truly present. However, it has been noted that only a fraction of nursing studies appear to have undertaken power analyses to help mitigate the risk of Type II statistical conclusion errors. This Methodology Corner article reviews some of the major aspects of power analysis procedures and reiterates recommendations that researchers who plan to use inferential statistical analyses also conduct a power analysis to guide decision making about target sample sizes to increase the validity of study findings.

Genome-wide association analyses based on a multiple-trait approach for modeling feed efficiency.

Genome-wide association (GWA) of feed efficiency (FE) could help target important genomic regions influencing FE. Data provided by an international dairy FE research consortium consisted of phenotypic records on dry matter intakes (DMI), milk energy (MILKE), and metabolic body weight (MBW) on 6,937 cows from 16 stations in 4 counties. Of these cows, 4,916 had genotypes on 57,347 single nucleotide polymorphism (SNP) markers.

The Single-Group, Pre- and Posttest Design in Nursing Education Research: It's Time to Move on.

Studying the effectiveness of educational interventions is centrally important to building the science of nursing education. Yet, the design most commonly used in the study of nursing education interventions-the single-group, preand posttest design-provides limited evidence to support claims of intervention effectiveness. In this Methodology Corner installment, the limitations of the single-group, preand posttest design are outlined and a review of the requirements for establishing stronger arguments for causality is presented.

The Purpose and Power of Reporting Effect Sizes in Nursing Education Research.

Like many other fields and subfields within the social sciences, education, and medicine, nursing education research has a long history of giving p-values associated with common statistical tests a position of primary importance in interpreting study findings. Global, transdisciplinary efforts are underway to diminish the role p-values play in making judgements about the significance of study findings by changing the threshold p-value used to pronounce statistical significance, through the use of Bayesian statistics, and through efforts to report effect sizes alongside p-values. In this month's Methodology Corner installment, the focus is on effect sizes and their role in enhancing the value and utility of nursing education research studies.

The genetic and biological basis of feed efficiency in mid-lactation Holstein dairy cows.

The objective of this study was to identify genomic regions and candidate genes associated with feed efficiency in lactating Holstein cows. In total, 4,916 cows with actual or imputed genotypes for 60,671 single nucleotide polymorphisms having individual feed intake, milk yield, milk composition, and body weight records were used in this study. Cows were from research herds located in the United States, Canada, the Netherlands, and the United Kingdom.

Beyond p < .05: Toward a Nightingalean Perspective on Statistical Significance for Nursing Education Researchers.

During the past decade, substantial concern has developed among scholars from a variety of disciplines about the common use and interpretation of p-values, used to indicate the statistical significance of inferential statistical analyses reported in quantitative studies. These debates have highlighted a widespread misunderstanding of p-values and the more limited role they should take in informing study conclusions and policy decisions. In this month's "Methodology Corner," I provide an overview of this debate, describe the limitations of statistical significance testing, and suggest that the nursing education research enterprise would benefit from following a more Nightingalean approach to statistical analysis, where the practical importance-the meaningfulness-of study findings is emphasized.