“Tapper and Listener” the course of Health Care Knowledge from Physician to Patient

By Akash Prabhune, Research Associate – ICTPH


We may have played this game in our childhood where we tap on the school desk the beats of certain song and one of our friend tires to identify the song.  In 1990 Elizabeth Newton a PhD student of Psychology from Stanford, experimented with some of her friends the same game of “tappers and listeners”. They played with over 25 well known songs. Each tapper was asked to pick a song and tap out the rhythm to a listener (by knocking on a table). The listener’s job was to guess the song, based on the rhythm being tapped. They played this game over 120 songs and of those 120 listeners were able to guess only 3 songs (2.5%), while the tappers in the beginning of the game overestimated that 50% of the songs can be guessed correctly. The observations of this experiment were applied in fields on business management, mass communication and teaching.

This experiment brings in light the most important aspect of human psychology and communication. The tappers who were tapping the desk were reciting the song back in their mind hence for them whatsoever they were tapping on that wood was making sense. On the other hand the listeners who were unaware of the song, the task of identifying the song from the taping was harder than breaking the Enigma code. Most of the time the “tapper” or the one who dispenses the knowledge has that playback running in his mind and hence for him the inability to perceive the knowledge due to inefficiency of the “listener” or the receiver of the knowledge. On the contrary for the “listener” the “tapper” is inefficient to dispense the knowledge.

In Medical field the “tapper” is the physician and the “listener” is the patient. For the physician it is required to explain to the patient in detail about his condition, possible treatment options, the best the physician can offer him and most important the instruction regarding medication and diet. This conversation between the physician and the patient is the milestone of the relationship the duo would cherish. If either of two fails to convey or perceive the information correctly, it is the patient who will suffer ultimately. In case of chronic diseases management the most commonly faced problem of poor adherence to the treatment regime and loss to follow up can be attributed to this “tappers and listeners” phenomena. The physician is over confident about his method of information dissemination while the patient perceives only a fraction of the information and fails to understand the value of the disseminated information. Multiple studies, attempts have been undertaken to overcome the problem of poor treatment adherence and poor follow up, and on close observation of the literature it can be inferred that the reasons provided by the physician for poor adherence and follow up amongst patient vary to a great extent than those given by the patient. This symbolizes the gap in the communication between the two parties.

Multiple steps are being implemented globally like electronic media alerts, printed brochures and leaflets, utilization of the mass media and many other and the results are improving globally. When we look at this holistically the efforts put together to increase adherence and follow-up and much more than the output. But very less efforts are made to ensure that the flow of information form the physician or any other source to the patient is clear. Efforts are needed to ensure that the patient is able to understand and analyse the information regarding his condition, medications, diagnostic tests, nutritional requirements.

There’s a gap in the literature and clinical practice, a new approach needs to be undertaken to ensure the flow of knowledge from the physician to patient is leakproof.

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May 2017
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