As an integral part of end-of-life care, palliative care places high demands on the comprehensive competencies of nursing staff. Medical nursing assistants, as the frontline personnel directly involved in patients’ daily care, play a crucial role in ensuring patients’ quality of life and dignity at the end of life. However, current palliative care training programs for medical nursing assistants generally suffer from a lack of systematic content, insufficient clinical relevance, and weak practical components, making it difficult to meet actual clinical needs. This paper identifies the primary issues in current training programs and analyzes key factors affecting course quality from multiple perspectives, including instructors, trainees, and teaching mechanisms. Based on this analysis, it proposes targeted improvement strategies across three dimensions — curriculum optimization, teaching model reform, and evaluation system refinement — with the aim of providing guidance for enhancing healthcare assistants’ palliative care service capabilities.