Shoulder dystocia is a rare obstetric emergency which can be managed using the HELPERR mnemonic. Midwives should recognise the signs and understand the principles of managing shoulder dystocia. Step-by-step images to illustrate the HELPERR mnemonic can enhance knowledge and understanding of this logical sequence of actions.

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Background: Participants representing rural and regional health care providers, employees, and consumers were involved in a continuing education (CE) conference focused on envisioning tomorrow's health. The 1993 attendees were taught a process of envisioning health care 5 years into the future. The 1993 projected outcomes were reviewed with 1998 realities. Method: Continuing education participants (N = 417) generated their design for a healthy future by responding to six story scenarios. Stories (2,502) related to quality of health care were analyzed in a three-step process. Results: Findings from the concept analysis of stories obtained at the 1993 CE conference revealed a conceptual model for a desired health future for 1998, with four major concepts, five goals, and five guiding principles. Conclusions: Visioning in a CE environment creates valuable direction for an improved health care future. A CE conference provides the seeds and opportunities for dialogue and partnership by people responsible for implementing action plans that potentially would create a healthy community.