
China Train-of-Trainer (TOT) Programme
Background and Initiative
In the 2015 Quality of Death index published by the Economist Intelligence Unit, China ranked 71 out of 80 regions. Since 2015, APHN has held the Mandarin Hospice Summit yearly collecting opinions from prestigious palliative care experts in China. The team learned that the Ministry of China had issued a notice in 2017 about palliative care pilots. A second circular was issued in 2019 in response to the policies of the Healthy China 2030 Outline. Based on the promotion of relevant policies in recent years and the collected opinions from the Chinese prestigious palliative care experts, and because of the lack of systematic palliative care structure and fundamental training in China, APHN decided to develop and introduce systematic training to healthcare workers in China, focusing on cultivating palliative care trainers.


Objective and Delivery
There’re three main objectives of this programme:
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To help participating hospitals build sustainable palliative care services
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To train generalists in palliative care for the provision of locally adopted train the trainer
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To nurture palliative care champions for outreach programmes
The China training program was launched in mid-2021 as an online program due to the pandemic. It was successfully completed in October 2022 after 40 hours of fundamental teaching and 40 hours of clinical case discussion sessions with support from 30 plus volunteer faculty from 5 regions. The faculty mentored trainee hospitals in palliative care and the program ended with a mini-graduation where three selected hospitals shared their experiences at the Mandarin Hospice Summit 2022 organized by the APHN.
Click the play button to see the graduation clip
Outcome and conclusion
The programme has successfully trained a total of 102 trainees including 46 doctors, 38 nurses and 17 social workers who are from 22 hospitals and institutions in mainland China, across 7 provinces and 2 municipalities. This is by far the largest number of participants we have ever had in the same batch of training.
Hebei - 1 hospital
Jilin - 1 hospital

Beijing - 8
hospitals
Shanghai - 4 hospitals
Jiangsu - 2 hospitals
Sichuan - 3 hospitals
Liaoning - 1 hospital
Henan - 1 hospital
Yunan - 1 hospital

This China training on palliative care has produced positive results, with a 13% increase in the number of outpatient services, a 3% increase in dedicated beds, a 16% increase in weekly outpatient units, and a 94% increase in monthly average patients admitted to palliative care units. More institutions have added dedicated beds and some trainees have taken on leadership roles or provided training to other institutions. The training materials have become reference textbooks.
What's next?
We are in the progress of preparing more in-depth and targeted training programmes based on all the survey results and mentoring notes to better support palliative care workers in China. There has also been various request from the demonstrating hospitals in China to run the bedside and face-to-face training.

Our Passionate Faculty
A core team of 30+ experienced palliative care experts from Singapore, Malaysia, Hong Kong, Taiwan, and Mainland China as volunteer faculty for the training program.
Cynthia Goh Sector: Singapore
Chun-Kai Fang Sector: Taiwan
Yuen Kowk Keung Sector: Hong Kong
Yingwei Wang Sector: Taiwan
Shirlynn Ho Sector: Singapore
Neo Han Yi Sector: Singapore
Amy Chow Sector: Hong Kong
Theresa Tze-Kwa Lai Sector: Hong Kong
Chia-Chin Lin Sector: Hong Kong
Ning Xiao Hong Sector: Mainland China
Qin Yuan Sector: Mainland China
Emily Yap Sector: Malaysia
Fong Yi Leong Sector: Malaysia
Helen Chan Sector: Hong Kong
Annie Kwok Oi Ling Sector: Hong Kong
Poon Yin Sector: Hong Kong
Dai Xiao Yan Sector: Mainland China
Lee Chung Seng Sector: Singapore
Aw Chia Hui Sector: Singapore
Chen Ru Yi Sector: Taiwan
Lu Xin Yan Sector: Taiwan
Susan Xu Zhi Zhen Sector: Singapore
Chia Gerk Sin Sector: Singapore
Zhang Shi Yin Sector: Taiwan
Joanna Chan Gui Xian Sector: Macao
Sha Rui Sector: Mainland China
Jade Lam Sector: Hong Kong
Helen Chiu Sector: Hong Kong
Magaret Suen Sector: Hong Kong
Enoch Lai Sector: Taiwan