Michael Gove revealed to be using PR-commissioned puff-polls as "evidence"

Eight out of ten cats prefer Michael Gove to Whiskas.

The Department of Education is notoriously bad at answering freedom of information requests, even being put under special monitoring by the information commissioner's office in December last year because of past inadequacies in answering queries. So it's doubly impressive that Janet Downs, a retired teacher and campaigner who is part of the Local Schools Network, not only managed to get an answer from them, but also extract an excruciating confession about what passes for "evidence" in Michael Gove's department.

Querying a claim made in article in the Mail on Sunday titled "I refuse to surrender to the Marxist teachers hell-bent on destroying our schools: Education Secretary berates 'the new enemies of promise' for opposing his plans", Downs asked for the background to Gove's claim that:

Survey after survey has revealed disturbing historical ignorance, with one teenager in five believing Winston Churchill was a fictional character while 58 per cent think Sherlock Holmes was real.

The department revealed that the main claim sources from a survey "commissioned and conducted by UKTV Gold", and that the other surveys referred to include:

That last survey was linked, by the Department of Education, to an article in the Telegraph, rather than the initial survey.

To be clear, five of the six "surveys" cited by the Department of Education in backing up a claim by a cabinet minister were PR-commissioned puff-polls. They were commissioned, not to find out information in a trustworthy and repeatable manner, but to ensure that stories about UKTV Gold, Premier Inn, the Sea Cadets , Bomber Command Memorial and "teacher-set exam revision service" Education Quizzes found their way into UK papers. Some of them may additionally be respectable polling – the Lord Ashcroft poll around Bomber Memorial Command uses a nationally representative sample, non-leading questions, and face-to-face interviews, for instance – but it's the sort of thing which normally rings alarm bells.

The last cited survey isn't a survey. It's a pamphlet on "Freedom, Aspiration and the New Curriculum" from think-tank Politeia. While it agrees with Gove's conclusion, it is hardly a primary source (an ironic distinction to have to make in a discussion about history teaching).

If this the sort of information which is revealed when the Department of Education responds to freedom of information requests, it's becoming clearer why they so rarely do it.

Photograph: Getty Images

Alex Hern is a technology reporter for the Guardian. He was formerly staff writer at the New Statesman. You should follow Alex on Twitter.

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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide