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Virtual Patients: Occupational accident international

This Virtual Patients lesson is relevant for medical students and professionals working in health care. In this lesson, you are welcome in the Workers hospital in Santiago de Chile. You will learn how Mr. Valdez suffers from a severe occupational accident, and how he is treated. An international team of doctors consists of a head physician from Chile, a German orthopedic surgeon, and a Brazilian physiotherapist. During the medical treatment, the team realizes the big differences between the Chilean, Brazilian, and German occupational health systems. How many workplace accidents happen each year worldwide?

Accidentally his hands got pulled into a folding machine. Given notes made in the intermediate care unit, what would be your choice for emergency surgery? Revascularisation of both hands is an option. Extensive information is given about the anatomy of the hands. An expert comment explains the differences between the health systems.  The course after the surgery is presented. Unfortunately, after ten days the team decides to take off his right hand at a certain level, so avoiding sepsis. After two weeks Mr. Valdez is allowed to go home. He is referred to physiotherapy, learning how to use a multifunctional adapter on the right hand. However, he is very depressed, he cannot even get dressed by himself, he feels dependent on the family, and suffers from phantom pain. In Germany, severe phantom pain is considered when analyzing the degree of incapacity to work. But in Chile, only if the reduction in earning capacity is bigger than 40% the worker gets a benefit. The team proposed to use his second toe from the left foot, attaching this toe to the left hand. The result is much better functionality. He returns to his factory as a driver with restricted tasks.  Compensation systems are compared between the countries.

The lesson contains 21 cards, which guide you through the various phases. The cards provide descriptive texts, an overview of the three health systems, anatomical details, expert comments, questions, and feedback. After submitting an answer to a question, feedback is given. After passing all cards, you will get a red or green mark (enough correct answers). If you are following a regular course in Munich, a tutor can give comments. The lesson is given in English and Spanish.

General information about Virtual Patients & Work

The series of medical cases for medical students and physicians-in-training for Occupational Medicine has been developed by the Institute and Clinic for Occupational, Social and Environmental Medicine at the LMU university (Munich, Germany), in this case with the help of various institutes and experts from Chile and Brazil. The cases, developed in 2006-2013, are still present-day in many countries, and useful for education. Nevertheless, cases might be not up-to-date or valid everywhere, for example regarding diagnostic procedures, risk assessment tools, therapeutic interventions, or figures like incidence rates. Differences may be caused by differences in time periods, contextual conditions, or populations. Discussion about such aspects in a group, with a colleague, or with a teacher, is an essential part of the learning experience.

Practical. Clicking the link below connects to the Casus website. Make an account going to ‘Register’. Use your e-mail address as LOGIN, fill in a personal password. When registration is completed, LOGIN again, select if needed the English language (see, under your name, ‘Options’, ‘Language). Go to ‘Player’, you see ‘Courses available’, select ‘Virtualpatient-Work.Net – English course’. Select this case. You can complete a case once, changing answers after completing is not possible.


English, Spanish

Original Authors:

Katja Radon, Laura Wengenroth

Original affiliation, ownership:

Clinical centre of the University of Munich Institute of Occupational and Environmental Medicine, Munich, Germany. Collaboration with experts in Chile and Brazil.

Year of publication:


Charge for use or free:

Free of charge


Target group(s):

graduate students, OSH experts; or in training

Usefulness for non-OSH-expert professionals:

More or less useful for non-OSH-expert professionals in health care or other sectors; or in training

Time demand to complete the lesson or course:

1 – 1.5 hour


The lessons can be attended and completed online for free. No material may be copied. During the session, some private data will be stored. The learning materials can only be used if the user accepts these conditions prior to attending the online lesson.

Intellectual property and copyright:

Before downloading, changing, disseminating and/or using the lessons and courses, please look carefully at the conditions given by the authors or owners of the materials related to copyright or creative common conditions or other conditions for the downloading, changing, further dissemination and kind of use of the materials (non-commercial vs. commercial).

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