Bridging the Gap: Why Female Representation in Healthcare Simulation Matters

Simulation within healthcare training plays a vital role in the safe and effective development of clinical skills, emergency responses and high-stakes decision making. It also strengthens clinician confidence and therefore improves patient outcomes. Safe and effective healthcare is for everyone, so why has training been allowed to default to gender and sex biases for so long?

Historically, training aids such as anatomical models and manikins largely default to male characteristics. Schwieters, Morris & Craig (2023) highlight how female patient simulators, among others, are less likely to be capable of procedure training on sensitive areas compared to male simulators. They advocate for greater diversity for the betterment of decision-making, and disparities in patient care and outcomes.

There are quantified differences in the performance of healthcare providers stemming from the male gender bias. Disparities effecting women rise in early clinical management such as symptom assessment, initial diagnosis, diagnostics, and communication regardless of experience level (Pujol-Martinez, Castelló & Tejado, 2025).

This lack of gender representation meaning women are negatively impacted and are not receiving care grounded in sex-specific research.

Healthcare simulation shapes core competencies long before clinicians encounter real patients. When training tools default to male physiology or omit female characteristics entirely, they reinforce long-standing biases in medical education and clinical practice. From underrepresentation in clinical research to disparities in diagnosis, treatment, and emergency response, female patients have been treated within a male “norm."

The evidence shows that representation matters. CPR manikins without female anatomy contribute to hesitation and reduced bystander intervention. Un-diverse training scenarios leave clinicians less prepared to recognise and respond to real-world female health needs. Controlled, adaptable, repeatable simulation has an opportunity to correct these imbalances — but only if the tools themselves reflect the diversity of the patients’ clinicians will treat.

• Stocking female patient simulators enables more representative scenario design.
• Educators can better reflect real patient populations across acute care, assessment, and emergency response training.
• Female simulators such as Lisa help bridge the gap between evidence and practice, supporting equitable training without compromising clinical fidelity.

Ultimately, improving female representation in healthcare simulation is not about adding variety — it is about improving outcomes. By aligning training tools with the realities of patient care, simulation centres can help ensure that tomorrow’s clinicians are prepared to deliver safe, effective, and equitable care for all patients.