In 2020, TraumaSim launched the Manniskin—a groundbreaking, silicone overlay designed to convert the traditionally male-featured CPR manikin into a realistic female form. This launch coincided with Restart a Heart Day, a global initiative aimed at raising awareness around sudden cardiac arrest (SCA) and the importance of bystander CPR and AED use.

Our motivation was simple: people don’t save lives if they’re not prepared, and people aren’t prepared if they’re never trained to recognise or respond to cardiac arrest in a woman.

Back then, we were responding to some truly confronting statistics:

• Over 30,000 Australians suffer cardiac arrest each year, and only 1 in 10 survive.

• Studies from the US and Europe revealed that only 39% of women receive bystander CPR, compared to 45% of men.

• Researchers concluded that one of the barriers was discomfort: people hesitate to touch or apply chest compressions to a woman, fearing inappropriate contact or being unsure of correct hand placement.

We asked ourselves: How can we expect someone to confidently act in a real emergency if they’ve never seen or practiced CPR on a body that looks like a woman’s?

A Bold Step Toward Realism in Training

The Manniskin was our answer.

A female-presenting, high-fidelity silicone skin—complete with breasts, realistic facial detail, lashes, hair, and pigment variation—designed to fit existing CPR manikins like Little Anne. Within seconds, a traditionally gender-neutral training session could now reflect the very real diversity of people who collapse in our streets, homes, and workplaces.

Our goal wasn’t shock—it was representation, empathy, and preparedness. Because cardiac arrest doesn’t discriminate by gender, but it seems bystander action still does.

How Has It Been Received?

Now, years later, we reflect: has anything changed?

The answer is complex.

Some trainers have embraced the Manniskin with genuine passion. They tell us how students take the training more seriously. They talk about breakthroughs in classroom conversations—questions about bias, about assumptions, and about real-world scenarios. They say it’s helped them train with empathy, challenge discomfort, and prepare students better for saving lives.

But there’s also been pushback. And it’s worth examining.

We’ve heard that:

• “It’s too realistic.”

• “The breasts don’t fall naturally to the side.”

• “It’s too confronting to use in public courses.”

• “Young male students will laugh or make jokes.”

• “Gender doesn’t need to be shown in CPR training.”

• “The silicone collects dust.”

• “My students don’t like the face—it’s too lifelike.”

These aren’t just technical critiques. Many of these reactions reveal deep discomfort—not with the product itself, but with what it represents.

So we have to ask again: Have we really moved the needle on female CPR statistics if we can’t even look at a female form during training?

Confronting the Double Standard

We don’t shy away from innovation. We expect debate. But when realism in female anatomy is seen as “distracting,” “inappropriate,” or “unnecessary” in training, while male-featured torsos remain the unquestioned standard, we are forced to confront a persistent double standard.

Do we subconsciously accept the male body as neutral and professional, while the female body is seen as sexual or taboo—even in life-or-death training?

Are we unintentionally reinforcing the very bias that causes hesitation in a real emergency?

Where To From Here?

We still believe in the Manniskin. In fact, we believe in it more now than ever. But we also recognise that a product alone can’t shift an entire culture. That takes conversations, courage, and a willingness to be uncomfortable—because someone’s life may depend on it.

So we ask you, as a trainer, educator, or responder:
If your students feel uncomfortable with a female-presenting manikin… what will they do when a real woman collapses in front of them?

Has your training addressed that?
Have we as an industry addressed that?

And most importantly—have we improved the stat that started it all?

Join the Conversation

We welcome your feedback, your stories, your questions—even your concerns. Because change doesn’t happen without friction. But neither does progress.

The Importance of Realistic Training in Combat and Medic Scenarios: Current Warfare vs. Historic Warfare

Warfare has evolved, and with it, the challenges faced by medics on the battlefield. Today’s combat zones require more than previously taught—they demand targeted training to handle the complex and devastating wounds that are often encountered in peer or near-peer warfare. As conflict landscapes shift, the need for realistic, immersive training has never been greater, especially in preparing medics to respond to traumatic injuries in high-stress environments.

In previous conflicts, such as Iraq and Afghanistan, irregular warfare dominated, and the injuries that soldiers and medics encountered reflected that environment. Blast injuries from improvised explosive devices (IEDs), gunshot wounds, and injuries from urban combat were common, and the training aids developed for those scenarios, while effective, are not fully suited to the nature of today’s battles. The current conflict in Ukraine and other peer warfare settings has introduced new challenges, including severe blast injuries, catastrophic hemorrhaging, and complex trauma, necessitating new approaches to training.

Responding to Modern Combat Needs: Realism in Training

To address these needs, TraumaSim has worked closely with military personnel engaged in the current European conflict, including the Australian Defence Force, Special Operations Medics, and international defence personnel. This collaboration has led to the development of new, highly realistic training aids designed specifically for modern warfare. One such product is the Combat Trauma Thigh, a simulation model with dual bleeding sites, replicating both arterial and venous bleeding. This model incorporates severe blast wound profiles, fractured bone complications, and realistic trauma visuals medics are likely to encounter on the battlefield. By training with these tools, medics can learn to handle the immediate life-threatening challenges associated with haemorrhaging complex injuries.

Another crucial addition is the Combat Trauma Moulage Kit, which includes six wearable simulation wounds designed to mimic the most common and devastating injuries seen in modern combat. The kit features realistic wounds such as shrapnel injuries, evisceration, compound fractures, and neck wounds, all equipped with bleeding capability. Some of these wounds are designed with pockets for wound packing—a vital skill for hemorrhage control in the field. The kit also includes stage blood and extra moulage supplies, allowing medics to enhance the realism and complexity of their training scenarios. These products are designed with a focus on rapid application and reusability, ensuring that medics can continually practice and reinforce the critical skills required for saving lives in combat.

The Shift from Historic to Modern Warfare Training

The injuries medics face today are significantly different from those seen in previous conflicts. However, many of the skills learned in historic warfare, such as hemorrhage control, casualty stabilization, and rapid assessment, remain vital. The key is adapting these skills to the new wound profiles seen in peer warfare—something that realistic training aids make possible. Tools like the Combat Trauma Thigh and the Combat Trauma Moulage Kit offer an unparalleled level of realism, ensuring that medics are exposed to the types of injuries they will most likely face.

This level of authenticity is essential not only for skill-building but for inducing the psychological preparedness needed to perform under the extreme pressure of combat. Training with realistic, uncomfortable simulations allows medics to become desensitized to the chaos and trauma they will encounter, building mental resilience and ensuring that they can maintain composure in high-stress environments. By immersing medics in simulations that mimic the noise, unpredictability, and feel of the battlefield, these tools help cultivate the confidence needed to make split-second decisions that can save lives.

Clinical simulation is an ever-evolving space and the team at TraumaSim feel passionately about educating our future Healthcare professionals. Drawing on our clinical nursing experience and simulation education, we set out to review, revamp and ultimately deliver new clinical simulation tools to the healthcare education arena. Concentrating on specialised wound care and the importance of pre-exposure and in-depth understanding of wound stages, led us to engage with some of the industries most experienced individuals, ensuring we are delivering hyper realistic and effective simulations wounds.

Why do we need simulation tools when educating our future nurses? Not only is pre-exposure important but the education environment itself needs to be an engaging and immersive space. Realistic simulations and effective visuals, assist students to engage more deeply and have an experience that lends itself to improved knowledge retention. Refining clinical skills such as wound assessment, cleaning, dressing and suturing in a controlled environment, allows for confidence building and a space where critical thinking and problem solving can be built. Allowing students to practice on realistic wounds helps learners perfect the technics needed before being faced with vulnerable patients.

Specialised wound profiling, treatments and advancements within the dressing space have ensured continual development of our healthcare professionals is needed. TraumaSim set out to review our clinical simulation wounds to ensure we are at a standard that matches this evolving space. Using contacts within the medical and specialised wound arena, we sought feedback on our clinical wounds, we asked for critical comments on colours, visuals, wound depth, slough, bone and flap inclusions, infection verse healing and all other factors related to wound assessment. Following their constructive feedback, we began the process of adjusting moulds and painting techniques to match the recommended improvements. We believe we have delivered the most medically realistic simulation wounds on the market.

TraumaSim has also moved to deliver specialised wound ranges, allowing for wound progression and student learning across the various stages of wound breakdown and assessment. We now offer Pressure injury, Ulcer and Skin Tear ranges, as well as Surgical and other various clinical wounds to aid in the simulation exposure of training professionals. Valuing diversity and inclusion, TraumaSim offers a myriad of skin tones with the ability to customise the wounds to match your existing manikins’ tones.

*New Ranges Now Available

Silicone Wound Kit – Clinical Full Range

Clinical Pressure Injury Range

Clinical Rash and Hives Range

Clinical Skin Tear Range

Clinical Surgical Range

Clinical Ulcer Range

Clinical Various Range

*NOTE: New images are coming soon

Allowing trainees, the space to perfect their skills and gain the confidence needed to interact with patients and interdisciplinary teams, is a crucial aspect of healthcare education. Fortifying emotional preparedness, within the graphic environment of wounds, is another a vital concept of simulation training. TraumaSim feels you will be able to meet these important goals when combining our clinical simulation wounds into your education space.

Over the last 10 years there has been a discernible change in the way that companies are approaching first aid training and emergency response testing.

Mining, Oil & Gas, Agri-Business, Rail, Air and Road transport companies have begun to demand simulated realism in their first aid training and response testing to ensure their responses are actually effective. In some cases fear of legal liability is driving the change.

Traditionally such companies had relied on simply having staff trained to a national first aid standard to meet their legal obligations. Such training is usually conducted in an inert environment where students are sheltered from the visual reality of the wounds or injuries they are being trained to treat. However, students if successful receive a first aid certificate, which may mean the company that employs them has met their legal workplace requirement for a trained first aider. But what is not known by the company or their staff that may have to rely on them when the time comes is whether or not the student can actually cope in a real situation?

Similarly, legal requirements to conduct on-site safety response training are usually just a drill. Generally, a great time for social catch ups as people go through the motions of the drill response. But would people act as per the drill if and when they were actually required to do so?

Many companies seem to have been asking the same questions as there has been a noticeable trend change towards more realistic first aid training and event testing simulations. The causes of these trend changes are varied and range from:

• Fears of complacency regarding site safety and practices;
• Remoteness of operations;
• The increased presence of ex-military who were trained to a higher standard of simulated realism;
• Emerging research that simulated realism can reduce post event mental health risks;
• The growing perceived legal risk to Directors.

Making Simulations Affordable

For over a decade TraumaSim has been providing services to the military, paramedic and emergency services in high end simulated injuries and trauma. However such services were often out of the price range or budget of some companies.

Therefore, TraumaSim spent two years researching and developing pre-made, rapid application yet realistic common wounds or injuries that Company OSH staff or Training companies could use themselves.

These reusable wound simulations can enable staff or trainers the flexibility to develop and conduct their own realistic training or events. The product range is growing, the details of all of them and our other services can be found on our website.

These are incredibly easy to use, to see how watch the short video on our LinkedIn TraumaSim page, which also shows some scenario examples.

Liked in many other sectors of training, there is a definite trend away from tick and flick training to demanding that people are actually competent to perform at the required level when needed.

Happy to discuss your thoughts?