Medication-error disclosure requires more than recognition that an error occurred. Pharmacists and pharmacy learners may need to interpret ethical obligations, communicate transparently with patients and families, respond professionally to harm, manage their own emotional response, and function within institutional systems that support disclosure and learning. To integrate contemporary evidence relevant to preparing pharmacists for medication-error disclosure and post-harm response, with particular attention to ethical preparation, communication practice, second-victim experiences, and professional or institutional support. An integrative-review approach was used to bring together heterogeneous educational, observational, qualitative, review, and implementation evidence. Search concepts addressed medication-error disclosure, pharmacy education, patient-safety communication, second-victim experiences, and professional support. Evidence was evaluated according to design-relevant methodological features and integrated without assuming equivalence between educational outcomes, practitioner attitudes, staff experiences, patient perspectives, and organizational interventions. Direct pharmacy evidence was identifiable but dispersed across pharmacist disclosure attitudes, student simulation, broader medication-safety education, second-victim experiences, and support preferences. Simulation-based studies generally indicated improved confidence, knowledge, attitudes, or observed communication behaviors, although transfer to real disclosure encounters was rarely demonstrated. Patient and family evidence emphasized openness, timeliness, explanation, acknowledgment, support, and forward-looking communication. Post-harm evidence showed that healthcare professionals and learners may experience substantial emotional and occupational effects and that support preferences extend from peers and supervisors to structured institutional programs. The evidence did not support treating these domains as one undifferentiated communication competency. Preparation for medication-error disclosure in pharmacy should connect ethical reasoning, communication performance, response after harm, and access to organizational support while retaining the distinct educational and evidentiary requirements of each domain. Current evidence supports integrated preparation more strongly than it supports any single standardized educational intervention.
