The Skills Modules developed by Professional Organizations, ABOS, AAOS, AANA provide a recommended format for the required implementation into Resident education. Each ABOS Module provides a format for setting up a practice station, equipment needed, estimated budget, recommendations for learner assessment & proficiency benchmarks, as well as suggested readings, references. Each module includes powerpoints,videos and PDF’s-all in English. The San Marcos residents speak Spanish and there is no budget for the equipment and translation needed to implement. Each year of residents teaches one of the 17 modules, translates as best they can, and comes up with cost effective equipment to replicate the modules shown on the videos. So far we are amazed at the enthusiasm, creativity & professionalism powered by their desire to learn–shown by all of the residents in the implementation of each module.