Good discussion Fullauto.
What is missing?
Non violent resolution, avoidance and shooting while moving backwards are a start, the first 2, would not make much of a game, subsequently not much fun, unless you like acting and critics. Shooting while moving backwards is great practice, but generally not allowed in most games, just like shooting while on the ground with some part of your body forward of the muzzle, this is done for safety reasons, someone might fall, or jerk the trigger while shooting, while sitting on the ground, with their feet forward and blow a foot or a toe off, even though, you should be able to draw and shoot if you get knocked down and practice it. No matter how much sense it makes, no body wants to get sued.
Whether We like it or not, Idpa, and Uspsa are offensive not defensive, as they both require, termination of the target, every scenario is defensive in nature, but the solution is termination in every instance. The things that they provide the competitors that are positive, are gun handling under stress and movement, sight alignment and trigger press ( accuracy ), target recognition, and instant response, BUZZER go's off, must act. It also allows for equipment testing, firearm, holster, sling, and clothing, but not all good equipment is allowed. Pocket holsters? Fanny packs? Ankle holsters? Purse holsters ( man or woman ) etc...
Things I like that can be used but rarely are, targets with balloons behind them that have to be broken in order for the target to fall, target must fall to count. I used this idea with standard targets ( Milpark ) borrowed from Clint Smith, who uses this type of target at Thunder Ranch, but it is a box target, and they cost like 5 bucks apiece, I take a standard target, and punch holes an inch to 2 inches apart, starting at the top of the head, spaced about 6 inches apart vertically, all the way to the crotch, but centered on the spine, install cable ties through the holes horizontally, then run a string vertically from top to bottom connected to the cable ties in a loop,the string is attached to a 1x2" or 2x4" stick with a staple to connect it, just loose enough that a 4" to 6" balloon can be pushed between the string and the target and that will keep the target up until busted. These balloons should be placed at the head position, sternum position, or pelvis position. This is to emulate, 2 shots to the body that did not work, so go to the head, if that does not work, take out the support structure, the pelvis, bad part, you have to hit each of these points accurately, if your missing, you could be doing things tactically correct, but not hitting the balloon. I've had competitors run out of ammo doing this.
Short answer realism, long answer, it is always up to the course designer to be challenging, or just design stages that are fun, the competitors will always push for fun, if the course is too challenging and too few shots are fired, they will get bored. Realistically most stages should be 3 shots or less and under 7 yards, and I think you should have 2 stages like that at every match, but the other 2 - 4 should be less predicable. I have run tactical matches for years, I always tried to stress 1 skill per stage, weak hand shooting, up close and personal, extended distance, hard core target recognition, and using cover as a requirement of each stage, this is not a recognized or affiliated match, so I don't have to answer anyone about course design, except the shooters who play. We use the do right rules, if the competitor tries to game it, he or she can be called on it. Realists like it, gamers don't.
We can't all afford to go to the cool ranges once a month for training, so the local matches are our practice ground, use them to your benefit, and shoot them within the rules for the best effect for personal defense.