The apprenticeship model of teaching procedural skills in regional anesthesia may no longer be effective because of the increasing number of peripheral nerve blocks currently performed. A time-based training program is restrictive, and this is compounded by limitations in duty hours and time pressures concerning operating room efficiency. Forty percent of residents do not fulfill the recommended minimum number of blocks required upon graduation. In this review we discuss the issues with the current apprenticeship model of teaching; how simulation addresses some of these issues, and why the future of regional anesthesia education will be modeled on an experiential competency-based paradigm as opposed to the traditional time-based model.