Effective partnerships between universities and industry facilitate health-profession students’ learning and work readiness. However, developing sustainable industry engagement in academic curricula remains challenging. This study utilised Social Exchange Theory (SET) to explore the benefits of and barriers to industry engagement within health-profession preparation programs. A realist evaluation framework was used to consider factors that impacted experiences and outcomes for academics and clinicians who engaged in the development and delivery of curriculum for a new health professional preparation program in speech pathology. A sequential mixed-methods design was adopted to explore factors influencing clinicians’ motivation to engage with the university, using an online survey (n = 18) and focus group (n = 5). Clinicians rated “personal development” and contributing to the “future workforce” as the highest personal benefits. “Sharing knowledge” was the highest team benefit, and “staff satisfaction” was the highest employer benefit. Time and workload were perceived barriers. Academics (n = 2) and clinicians (n = 3) who collaborated in learning and teaching experiences also participated in a post-engagement focus group. Three Context Mechanism Outcome configurations were shown to facilitate engagement outcomes: engagement as opportunity, partnership, and work readiness. In accordance with SET, the nature of exchange processes and professional relationships contributed to positive engagement outcomes for clinicians, academics, and enhanced health-profession education.