Paying it Forward in Haiti: Physiatrist Shares Ultrasound Knowledge with Those in Need
By: Cliff Gronseth, M.D.
May 22, 2019


What if ultrasound could be used all over the world to detect
life-threatening conditions? What if we could teach people to teach
ultrasound techniques and carry that knowledge to remote communities?
What if we could save lives using ultrasound—NOW?

These were some of Dr. Cliff Gronseth’s 2:00 am thoughts that inspired him to share his in-depth ultrasound knowledge with those in need; those who without his guidance and expertise, would not have access to this life-saving technology. Dr. Gronseth is a physiatrist in Boulder, Colorado and calls himself an ultrasound champion. He has an intense passion to teach the power of ultrasound and an ambition to save lives around the world using ultrasound; technology he believes is underutilized. Through the Now You Are the Group’s Interest (NYAGI) Project, a non-profit organization that he founded, Dr. Gronseth is empowering others in some of the most underprivileged countries in the world to learn and use ultrasound technology to help save lives.

In late January 2019, a NYAGI Project team of volunteers traveled to
Haiti to teach the fundamentals of ultrasound to local physicians and
nurses. The teaching emphasized maternal care, but also covered
trauma assessment and musculoskeletal scanning as well as a few
other specialties. In partnership with several organizations in Haiti, the
NYAGI team worked side-by-side with local clinicians to equip them
with basic ultrasound skills as well as to train other community-based
health care providers.

“The goal is to empower the local providers; to
give them the knowledge and the tools to both do
ultrasound and to teach others… to pass it forward.”

He believes in providing education and hands-on training to give practitioners the confidence to not only perform ultrasound on their patients, but to teach ultrasound to their peers. “Today you will learn things that are new, and we want you to teach the rest of Haiti,” Dr. Gronseth told his students as they began their training at Grace Children’s Hospital, who hosted the event.

Unlike many medical aid projects, the focus of this trip (and 2 previous trips to Nepal) was to teach, rather than diagnose and treat. This builds capacity and empowers communities in impoverished areas to take their health care into their own hands. “The idea is to train health care providers on the fundamentals of ultrasound: how to operate the ultrasound machine, locate body parts, and get good image quality,” said Gronseth. During the 5-day trip, the participants went quickly from theory to instructor-led scanning to independent scanning of patients with little to no coaching from the NYAGI team. “The NYAGI team helped us provide incredible training. They are committed, passionate people as well as very highly-skilled trainers on this technology,” said Dr. Nathaniel Segaren, Medical Director for Projet Santé, Haiti. This approach that includes ongoing self-learning is unique to NYAGI and includes leaving behind 20 donated licenses for 7D Imaging’s NAVTM software suites—one to go into the field with each machine.

Dr. Gronseth believes the best way to learn ultrasound is to perform
ultrasound, so that’s what they did. The first day was devoted to getting
acquainted with the students, evaluating their ultrasound experience,
and introducing them to the ultrasound machines. Some had experience
with ultrasound while others had never seen or touched an ultrasound
machine before. The next 4 days were spent at the hospital providing
hands-on training to the 43 Haitian obstetricians, nurses and midwives
in attendance. The trainees, always eager for more knowledge, even
attended ad-hoc evening informational sessions held by Dr. Gronseth to
further hone their skills and address any challenges or roadblocks from
earlier in the day. “They wanted to learn more. While many had some
knowledge of the English language, we mostly relied on translators and
broken English or French, but communication, teaching and learning
happened,” said Dr. Gronseth.

The NYAGI Project hopes to continue providing training and portable
ultrasound solutions to remote and impoverished parts of the world.
“Ultrasound is a safe, affordable, portable and powerful diagnostic tool,
and it is being rapidly adopted for bedside diagnostic imaging. Our
team’s vision and mission are to bring ultrasound to the world to save
lives now – together,” said Dr. Gronseth. v

About Dr. Cliff Gronseth:

Dr. Cliff Gronseth has been an advocate for the power of ultrasound since first using it 20 years ago. As a physician and educator, he is committed to
bringing ultrasound to save lives to all remote, rural, resource-limited areas around the world. Dr. Gronseth is founder and currently managing partner
of Spine West, a private practice in Boulder, CO, specializing in non-surgical musculoskeletal medicine and ultrasound. He is triple board certified in
Physical Medicine and Rehabilitation, Electrodiagnostic Medicine, and Pain Medicine.

About the NYAGI Project:

NYAGI is a nonprofit 501(c)(3) charitable organization dedicated to increasing diagnostic ultrasound accessibility and education around the world.
NYAGI’s vision is to improve healthcare by using diagnostic ultrasound in areas with limited resources.

About 7D Imaging:

7D Imaging develops ultrasound education solutions featuring high-resolution imagery and point-of-care reference guides to accelerate learning and enhance ultrasound use. The goal is to reduce the “steep learning curve” to mastering ultrasound and to help providers scan with greater confidence by providing ongoing immediate access to relevant information.

Special thank you to AAPM&R who sponsored this story in their monthly newsletter, PHYSIATRIST / May 2019.

Teaching was outstanding!

Great day of ultrasound training – cool technology with applications for every day primary care – I am a primary care doctor who has been looking to learn ultrasound and Dr. Gronseth’s ultrasound course was a great way for me to get into the ultrasound world and learn skills that I can immediately take back to the office to improve patient care. Teaching was outstanding! They delivered on their promise to teach me and get me going in the right direction.

Christopher Trojanovich MD MPH

I loved it.

The amount of probe time makes the program great for all skill levels. I felt, as a novice, the structure allowed me to quickly confirm what I already knew, but still allowed me to focus on new/advanced topics that I wanted to learn. The instructors were great in providing PEARLS and ways to improve/learn new ultrasound skills using the NAV program.

Mitchell Frydenlund

I gained so much knowledge...

"I gained so much knowledge in diagnostic ultrasound. I left the course with enough tools and confidence to start experimenting with the ultrasound on my own.

Dr. Cliff Gronseth has figured out an education method that is effective and non-intimidating.   He is an excellent instructor as are the instructors he brings along."

Antoinette Vastenburg, PT

I had an excellent experience.

"I completed the hands-on ultrasound training course and had an excellent experience. Dr Gronseth is an excellent teacher and has extensive ultrasound experience and expertise that he shares with enthusiasm. The mskNAV software that he developed is exceptional. This course is definitely worthwhile and I highly recommend it."

Chester Dreiman, MD FACP

Excellent resource.

The mskNAV software is an excellent resource for residency programs or the independent practitioner learning ultrasound. It's extremely thorough and user-friendly.  It includes scans of all the required structures and additional ones that are clinically relevant.  Provides excellent MRI and illustrated anatomy correlations. Walks you through scanning protocols and injections.  It gave me everything I needed to establish a strong foundation in MSK ultrasound.


Our fellows love it!

mskNAV is fast, intuitive and very helpful for teaching ultrasound.

J. Stumbo

Sports Medicine Program Director

Learn injections instantly

On several occasions I’ve needed to learn how to do a specific injection on the spot. I opened mskNAV, quickly reviewed the injection module and then performed the injection successfully. Highly recommended. An important reference in my office. One of a kind learning tool.


An Amazing Program...

This is an amazing program, not only for those looking to get better at US, but for those who are learning anatomy, injections and anything MSK related. If you are using this app for a supplement to a fund of knowledge or learning from scratch it gives great content for both. I hop on before I do an injection for a quick refresher to look at my landmarks and positioning.

Randall Johnson

For our Fellows and Residents.

We have been using this program for our fellows and residents for the last year and a half. It's outstanding.


Worth every penny.

I love this app.  As a teacher and learner it is fabulous.  I used it for my ARMDS certification and in teaching fellows.  MSK US is hard to learn from a photo in a book.  The videos are great and I love how you can tag anatomy.  I even use it to educate patients.  I would highly recommend this if you are learning MSK US or in a teaching role.


A great asset to anyone learning ultrasound.

The mskNAV software was recently incorporated into our regular didactic schedule and has been more than impressive. Great for both the learning center as an adjunct to skills workshop and in the clinic for a quick review of both diagnostic and procedural skills.


PM&R Resident Physician

An important tool in my office

I have been using mskNAV for several years now.  It definitely helped me when I was first learning ultrasound.  Currently, I use the program for patient education and to review or quickly learn ultrasound guided injections.  On several occasions, I’ve needed to learn how to do a specific injection on the spot. I opened mskNAV reviewed the injection module for 1-2 minutes and then successfully performed the injection for the first time.


The CME is nice!

Tremendous amount of useful information. Excellent resource. And the CME is nice!


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