Interprofessional education (IPE) is widely used to prepare health-professions learners for collaborative practice, yet evidence that educational gains translate into negotiated professional roles and shared medication decisions in clinical settings remains fragmented.To integrate quantitative and qualitative evidence concerning interprofessional pharmacy education, role negotiation, and translation from educational outcomes into collaborative medication decision-making in practice.A mixed-methods systematic review was undertaken using PRISMA 2020 reporting principles, design-sensitive quality appraisal informed by the Mixed Methods Appraisal Tool, and a convergent integrated synthesis approach. Three complementary search routes were executed on 14 September 2026 across PubMed-indexed and publisher-indexed scholarly records. Eligible primary studies published from 2017–2026 involved pharmacy learners, pharmacists, or identifiable pharmacist participation in medication-related interprofessional work and reported educational, role-negotiation, collaborative-practice, implementation, or practice-translation outcomes. Quantitative and qualitative evidence were synthesized separately before integration. Findings were transformed only where their constructs could legitimately be aligned. Fifty-eight records were surfaced across the executed searches; 13 duplicate appearances were removed, leaving 45 unique records. Twenty-five were excluded during relevance screening and 20 primary evidence units were retained for detailed mixed-method evidence mapping. The evidence was weighted toward proximal educational outcomes such as collaborative attitudes, confidence, teamwork, role understanding, and perceived competence. Fewer studies examined sustained professional enactment, and direct evidence connecting IPE with objective medication-related patient outcomes was sparse. Qualitative practice evidence indicated that translation was conditioned by role clarity, professional identity, communication, organisational control, workload, leadership, resources, and relational work. Interprofessional learning can strengthen capabilities relevant to collaboration, but educational improvement should not be treated as evidence that collaborative medication decision-making has been achieved in practice. Translation depends on how roles are negotiated and supported within clinical organisations. Evaluation should therefore distinguish educational outcomes, enacted interprofessional roles, and practice-level medication decision-making rather than collapsing them into a single measure of IPE success.
