This Critical Realist review recognises the challenges facing nurse educators and practitioners if they are to help ensure the discipline remains responsive to future healthcare needs; not least the growing demand for qualified nurses. Drawing upon professional opinion, reports, quantitative, qualitative and mixed methods research, the paper thematically presents international evidence examining the factors which affect the nature of practice learning experiences for nursing students; reflecting the wide range of social, environmental, educational, intrapersonal and interpersonal variables related to the practicum as a key event within pre-registration nurse education programmes. Worryingly, the work highlights numerous examples of negative student experiences associated with nursing placements, but also outlines some features related to more positive student learning in clinical settings. In addition, and congruent with the principles of Critical Realism, the paper identifies a field of investigation associated with practice learning that appears worthy of further investigation due to an apparent paucity of published work. Finally, the author briefly highlights his own research activity currently underway to extend the body of knowledge in this area and in so doing contribute to addressing student retention and staffing issues within nursing.