Background: The utilisation of simulations in learning can prepare nursing students for real-world clinical practice. However, studies have also shown that students face difficulties relating simulations to reality and performing in front of others. Aim: To explore nursing students' learning experiences in simulation and propose ways to optimise learning in these environments. Methods: The research employed a qualitative case study involving observation and interviews of 12 third-year nursing students using simulation. A general inductive approach comprising a thematic data analysis was used. Findings: Five themes were identified to describe students' learning experience in simulations: perception of reality, comfort with role-playing, response to perceived failure, expectations of the simulation, and personalities of those within the students' simulation group. Conclusion: There are complexities related to what the learner personally brings to the simulation that influences what they notice in the simulation, how they respond, and their reflection on the learning, all of which are identified by Tanner (2006) as central to the process of making a clinical judgement. If not considered, these complexities may result in performance anxiety and learner disparity. (C) 2021 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.