Foundations for Paramedic Education

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SPRINGER BRIEFS IN EDUC ATION

Amy E. Seymour-Walsh

Foundations
for Paramedic
Education

123
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Amy E. Seymour-Walsh

Foundations for Paramedic

Education

123
Amy E. Seymour-Walsh
College of Medicine and Public Health
Flinders University
Adelaide, SA, Australia

ISSN 2211-1921 ISSN 2211-193X (electronic)

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Acknowledgements

I would like to acknowledge the kindness and support of my colleagues and stu-
dents at the Prideaux Centre for Research in Health Professions Education at
Flinders University. The values you strive to embody have made me feel so richly
blessed to work alongside you for the last six years. Without your academic gen-
erosity and kindness to spur me on, the research behind this book would have
ground to a halt. One of my supervisors, Prof. Tara Brabazon, first planted the seed
to disseminate this content in the form of a book, and I am thankful to her for this
catalyst and encouragement.
I am ever-grateful for the Australian Resuscitation Outcomes Consortium
(AusROC) who awarded me a Ph.D. scholarship under an NHMRC grant. This
financial support enabled me to develop much of the content of this book during my
Ph.D. research.
And finally for my husband, who doesn’t ever seem to think that these things are
beyond me. I am especially thankful for you, my dear.

v
Contents

1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... 1
International and Terminology Nuances in Prehospital Services
and Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
University Students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Volunteers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Non-emergency Transport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Diploma Students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Graduate Paramedics (Paramedic Interns) . . . . . . . . . . . . . . . . . . . . . 5
Qualified Clinicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
The Institutional Context of Paramedic Education . . . . . . . . . . . . . . . . . 6
In These Pages… . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Case Examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Chapter Reflections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2 Theory of Learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Cognitive (Knowing) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Cognitive Limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Cognitive Load Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Behavioural (Doing) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Retrieval for Learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Social (Being) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
The Learning Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Experiential Learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Simulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Professional Identity and Expectation . . . . . . . . . . . . . . . . . . . . . . . . 25
Conceptualisations of Learning Guide Assessment . . . . . . . . . . . . . . . . 26
Bringing It All Together . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
For Reflection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

vii
viii Contents

3 Skill Teaching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
What Is a Skill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Authentic Skill Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Initial Skill Instruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Separation of Cognitive and Manual Dexterity Components
of the Skill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....... 35
Separation of the Cognitive and Physical Components
of the Skill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Skill Retention and Atrophy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Bringing It All Together . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
For Reflection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
4 Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 43
Authentic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 44
Validity and Reliability . . . . . . . . . . . . . . . . . . . . . . . . . . .......... 44
Development of an Assessment Tool: A Worked Example
and Critique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
A Delphi Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Limitations of the Delphi Process . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Is There Any Such Thing as a “Validated Tool”? . . . . . . . . . . . . . . . 49
Choosing to Apply It . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Use and Interpretation of an Assessment . . . . . . . . . . . . . . . . . . . . . 55
After It’s Applied . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Point-in-Time Competence and Ongoing Competence . . . . . . . . . . . . . . 58
Programmatic Assessment for Learning . . . . . . . . . . . . . . . . . . . . . . 58
How Might Students Approach a Practical Assessment? . . . . . . . . . . . . 61
“Treat It Like a Real Job and You’ll Be Fine” . . . . . . . . . . . . . . . . . 62
The Stakes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Maslow’s Hierarchy of Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Bringing It All Together . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
For Reflection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
5 Feedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
The Purpose of a Feedback Conversation . . . . . . . . . . . . . . . . . . . . . . . 68
Feedback as a Tool for Mutual Understanding . . . . . . . . . . . . . . . . . 71
Feedback as a Tool to Reinforce Sound Practice . . . . . . . . . . . . . . . . 72
Strategies for Feedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Feedback Templates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Crafting a Conversation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Contents ix

Frequency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Benchmarking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Planning a Path Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Bring It All Together . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
For Reflection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
6 Teacher Identity, Role and Purpose . . . . . . . . . . . . . . . . . . . . . . . . . 83
Complexity of Education for the Health Professions . . . . . . . . . . . . . . . 84
Clinical Practice Is Complex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Education Is Complex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Educator as Clinician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Education for a Finite or Infinite Problem? . . . . . . . . . . . . . . . . . . . . 88
Finite and Infinite Problems: Complexity in Clinical Skill
Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Educator Role Perception: Finite or Infinite? . . . . . . . . . . . . . . . . . . . 90
Adaptive Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
The Basis of a Pull Towards Finite Approaches: Standardisation . . . . 92
The Global Education Reform Movement (GERM) Drives
Standardised Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Is There a Place for GERM in Medical Education? . . . . . . . . . . . . . . 94
Implications for Pre-hospital Education and Assessment . . . . . . . . . . . . 96
Bringing It All Together . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
For Reflection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
7 Student Identity Development and Vulnerability . . . . . . . ........ 99
Personal-Professional Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Professional Identity Development: Individual and Corporate
Identity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Student Wellbeing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Students Can Be Vulnerable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
… On Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
… During Internship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Students Can Be Impressionable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Belonging and Othering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Resilient Paramedics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Education as a Speciality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
For Reflection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
x Contents

8 What Is Your Clinical Education Philosophy? . . . . . . . . . . . . . . . . . 113

Teaching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Feedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Why Do We Need to Think About Our Philosophy in Health
Professions Education? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
List of Figures

Fig. 1.1 The four axes of symbiotic clinical education. In sustainable,

meaningful education systems, the student’s presence within the
relationship maximises the benefit for both components of each
axis Adapted from Worley, Prideaux, Strasser, Magarey and
March, (2006). “Empirical evidence for symbiotic medical
education: a comparative analysis of community
and tertiary-based programmes.” Medical Education 40(2):
109–116 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 7
Fig. 2.1 Miller’s pyramid (also referred to as Miller’s triangle)
Adapted from “The assessment of clinical skills/competence/
performance” (1990) by Miller, G. E., Academic Medicine 65(9)
p. S63 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 12
Fig. 2.2 Conscious and unconscious competences presented as a ladder
of competence. Movement up the ladder (or steps) challenges
both ability and awareness of ability from ignorance
to mastery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19
Fig. 2.3 The Lewinian experiential learning model Adapted from
“Experiential learning: Experience as the source of learning
and development” by Kolb, D. A., p. 21. Copyright 1984 by
Prentice Hall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 23
Fig. 3.1 Harden and Brunder’s spiral curriculum, adapted from
“What is a spiral curriculum?” (1999) by Harden, R. M.,
Medical Teacher, 21(2), p. 142 . . . . . . . . . . . . . . . . . . . . . . . . .. 33
Fig. 4.1 An analogy for sequential, discrete assessments, where the
learner moves from novice to a final statement of competence
through a series of educational benchmarks and assessments . . .. 59
Fig. 4.2 The braid as an analogy for programmatic assessment for
learning, where assessment performance and regular feedback
engage with the interconnected longitudinal programme
of learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 60

xi
xii List of Figures

Fig. 5.1 Using feedback to support the experiential learning cycle . . . . . . 72

Fig. 6.1 Educators can select a training strategy based on their
perception of a finite (simple) or infinite (complex) task . . . . . . . 91
Fig. 6.2 Possible approaches taken by different educators . . . . . . . . . . . . . 96
List of Tables

Table 2.1 Dreyfus’ Five Stages of Skill Acquisition. . . . . . . . . . . . . . . . . . 18

Table 4.1 Overview of the inferences necessary to move from
observed data to conclusions about a construct . . . . . . . . . . . . . 53
Table 5.1 Educator-centric feedback compared to learner-centric
feedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

xiii
List of Case Examples

Case 1 Learner diversity and schemata . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Case 2 Applying adult learning principles to a classroom setting. . . . . . . 25
Case 3 Designing a skill development plan . . . . . . . . . . . . . . . . . . . . . . . 33
Case 4 Ongoing skill maintenance compliance and patient safety. . . . . . . 38
Case 5 Critiquing an assessment’s validity (part a) . . . . . . . . . . . . . . . . . 51
Case 6 Critiquing an assessment’s validity (part b) . . . . . . . . . . . . . . . . . 54
Case 7 Determining a pass mark . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Case 8 Reforming a program’s assessment schedule (internship) . . . . . . . 61
Case 9 Comparing traditional and contemporary feedback
approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Case 10 Destructive feedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Case 11 Standardising a clinical skill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Case 12 The tension between education and practice . . . . . . . . . . . . . . . . . 87
Case 13 Disruptions to student wellbeing . . . . . . . . . . . . . . . . . . . . . . . . . 106
Case 14 Support for learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108

xv
Chapter 1
Introduction

Abstract This chapter introduces the modern Australasian context within which
paramedic students proceed through their formal education, in addition to inter-
national variations in process, governance and terminology. Paramedic students
follow various paths from novice to professional, and these differences result in
varied interactions between the educational institution and the clinical organisation.
Students may be internal to an organisation (graduate paramedics, student volun-
teers, or paramedics completing professional development activities) or external
(students completing a placement as part of a degree), and different pressures are
placed on the student, the service, and the education body accordingly.

Keywords Emergency medical technician (EMT) Ambulance officer Symbiotic




clinical education International models of paramedic training Paramedic
governance

It’s hard to say what day I became a paramedic. Was it the day I was first employed
by an ambulance service? The day I graduated with a Paramedic degree? The day I
was allowed to practice autonomously rather than under supervision? Or the day my
national registration was confirmed? Becoming isn’t so clear cut, and formal edu-
cation is just one of the means by which becoming occurs.
Pedagogy is often used to describe the method and practice of teaching. While it
is often applied to adult education, its origins are from the ancient Greek paedo-,
relating to children. In the early 1960’s, the term andragogy emerged to refer to
adult education, and this term rose in popularity through the 1980’s. Using a
different word for adult education reminds us that in adult education, many
assumptions must be put aside. As educators, we cannot even be certain about what
learners understand by particular words, because they bring with them vast dif-
ferences of experience which impact their opinions, connotations, values and per-
spectives. We cannot assume that learners bring a clean slate resembling that of
their peers, because they may enter education following previous study or with
workplace experience, and may already know many aspects of the education
content.

© The Author(s), under exclusive license to Springer Nature Switzerland AG 2019 1

A. E. Seymour-Walsh, Foundations for Paramedic Education,
SpringerBriefs in Education, https://doi.org/10.1007/978-3-030-26792-6_1
2 1 Introduction

This book will approach paramedic education with these andragogical consid-
erations in mind.
This book addresses paramedic education for practice as an ambulance-related
clinician, hence the term andragogy will be embraced as the focus is on the edu-
cation of adults for a professional clinical role. Its relevance spans university
teaching and assessment, and into organisation-based in-service training, and while
the examples throughout are embedded within the ambulance context, they are
applicable across health professions education (HPE) more broadly. Before taking a
closer look at some of the different ways in which paramedic education occurs, let’s
briefly look at some key international variations in paramedic education.

International and Terminology Nuances in Prehospital

Services and Education

A single model of paramedic education is made difficult by the variability of types

of students in the pre-hospital system. In Australia and New Zealand alone, there
are many different ways in which paramedic education occurs. The variation in
learning may be categorised by the learner being either external to the ambulance
organisation (for example university student observers) or internal (those employed
by the service to complete training, for example graduate paramedics and interns),
as this is perhaps one of the most helpful ways to distinguish the differences in
benchmarks, expectations, needs and goals. In other systems, even more variation
in paramedic education (and indeed professional title) exist. In Sweden, for
example, ambulance clinicians are either trained as a basic emergency medical
technician (with a high school diploma equivalent), registered nurse (who have
completed a 3-year bachelor’s degree in nursing), or specialist ambulance nurse (a
registered nurse with one-year additional postgraduate training in prehospital care)
[1]. The term “ambulance personnel” is used more often in Nordic regions and may
reflect a workforce with firmer roots in nursing. In some other areas of Europe, a
Franco-German model of care sees an emergency medical system staffed and run
more predominantly by physicians rather than paramedics [2, 3].
While some regions are governed by national professional paramedic registra-
tion, O’Meara, Wingrove and McKeage note that in the USA, there are over 21,000
Emergency Medical Service agencies [3]. Many of these maintain an inseparable
relationship to individual fire and rescue services [4], resulting in variability from
service to service. The National Highway Traffic Safety Administration has col-
laborated with many of these to determine a national standard for the training of
Emergency Medical Responders (EMRs), Emergency Medical Technicians
(EMTs), advanced EMTs, and paramedics for emergency medical services oper-
ating in the USA.
Whether your local terminology refers to EMRs, EMTs, ambulance officers,
paramedics or otherwise, the andragogical principles in this book will hold
International and Terminology Nuances in Prehospital Services and Education 3

relevance, with broad application not only to ambulance-related education, but also
the broader health professions. What this book refers to as paramedic education,
therefore, is also relevant beyond the boundaries of educating paramedics. The term
paramedic is now protected in Australia, but despite a focus on that term, this book
offers insights which may be applied to many types of education in ambulance
professional education and the wider health professions. University academics,
on-road mentors, ambulance service managers and clinicians themselves may all
have different ideas and experiences of their education foci, roles and expectations,
and while nuances exist, these will all be considered within the term paramedic
education.
Not all learners are considered students and not all learners are the same. Some
are formally recognised as students, others are not. Some have ongoing permanent
employment, others have the assumption of employment contingent on their
assessment performance, and others do not. Some undergo rigorous assessments,
and others do not. For some the stakes are high, and for others they are not.
Culturally, within the micro-society of paramedic clinicians which exists within an
ambulance service, different types of students have different levels of perceived
belonging to that group, and varying levels of vulnerability and support from peers
and mentors. Different types of students have different motivations, different levels
of perceived professional identity, different clinical expectations placed on them,
different motivations for completing the training, and different goals. These are
briefly described below.

University Students

University students completing a paramedic degree are placed on ambulances for a

set number of shifts or hours each year. They are typically not employed by the
ambulance service, and they complete their shift as an additional crew member. The
aims and philosophy of such placements varies depending on the student’s approach,
the ambulance culture, and the approach of the crew members they are rostered to
work with. They have no autonomy in their practice, and have varying levels of
engagement in patient care as they and their crew members feel comfortable.
University students may be placed with a different crew each shift, and much
energy may be expended at the beginning of shift to ascertain how the crew works,
how they talk to patients, what they expect of the student, and other often unstated
expectations which may only be gleaned through exhausting attention to non-verbal
cues.
University students may be either Australian residents with a capacity to work in
Australia following their studies, or they may be international students who will not
be permitted to apply for graduate paramedic positions here in Australia. These two
groups of students progress through the same studies and assessments during their
tertiary studies, however they are likely to have very different expectations placed
upon them following completion of their study. Those who gain employment in
4 1 Introduction

Australia will progress through an ambulance service-specific graduate program, or

internship, where they will be mentored, further assessed, and offered specific
support as they move from university student to clinician. Graduates who work in
other countries, however, may have much more limited mentorship. In fact, some
services may consider these graduates the experts of pre-hospital care, and place on
them the responsibility to train and mentor others to become paramedics. An
argument exists, then, that paramedic educators in Australia have a different moral
and ethical duty to international students than to those who can access further
in-service training post-graduation.

Volunteers

Volunteers completing their initial training may be considered like ambulance

employees in reference to the formal support, belonging, management structure and
the uniform they are issued. Unlike external students, volunteer students also
complete service-specific training, such as urgent driving, and earn an independent
authority to practice as a clinician within the health service. They train towards a
nationally recognised industry qualification, usually at certificate IV level. They are
learning as a way to serve their immediate community through the provision of
emergency and non-emergency ambulance coverage, often in rural or regional
settings beyond the reach of career crews. Importantly, this is in addition to their
other professional roles.

Non-emergency Transport

Students learning to work as a transport ambulance officer also earn a nationally

recognised industry certificate. They are generally employed as staff within the
ambulance service, and are therefore paid to complete their training and assess-
ments. Much of their professional work will be in the context of transporting
differentiated patients (patients who already have a working diagnosis), but they
may also attend undifferentiated patients who have been determined to not require
emergency care. These clinicians-in-training may also be called upon to assist or
respond to critical emergencies when emergency crews are unavailable. When they
are required to attend these cases, there may be less support available to them.

Diploma Students

Over the last two decades, diploma-style training has waned in favour of recruiting
graduate paramedics who come, to an extent, pre-trained. Diploma students
International and Terminology Nuances in Prehospital Services and Education 5

engaged in an apprenticeship model of training, often consisting of blocks of

training interspersed with blocks of on-road work as part of a crew (not surplus to
the team). They are employed by the ambulance service throughout their training,
and often come from non-health backgrounds seeking a change. The movement
from this predominantly in-service training to education by means of an external
degree has had implications for the relationship between the health service and
educational institution, specifically regarding the availability of clinical mentors in
supervising work-integrated learning and other experiential learning activities [5].

Graduate Paramedics (Paramedic Interns)

Graduate paramedic students or interns are employed by the ambulance service

following their (self-funded) university studies. They enter the organisation with a
qualification and assumed level of knowledge, but still need to undergo further
training and assessment in local practices and guideline application in order to
obtain an autonomous authority to practice as a clinician within that ambulance
service. Interns don’t always have permanent employment guaranteed beyond the
term of their graduate training. The stakes, therefore, can seem very high for interns
who may feel like they are under constant scrutiny during their training.

Qualified Clinicians

Paramedics who are employed permanently by the ambulance service and who have
obtained an authority to practice may then attend formal education programs. They
may upskill to a higher level of clinical practice, such as intensive care paramedic
for example. Paramedics who do this for themselves may return to university part
time to obtain this post-graduate qualification without the plan of working towards
an increased authority to practice at intensive care level, otherwise they may be
sponsored by an ambulance service to engage in either in-service training or a
combination of formal post-graduate and in-service training in order to earn the new
clinical title. These students still work (generally full-time) in the ambulance set-
ting, in addition to their studies.
Additionally, ongoing education is a requirement for all paramedics as new
protocols and procedures are introduced. This type of education may be a
requirement to become familiar with new equipment or new medication prepara-
tion, or consolidation and re-visiting of knowledge which is rarely used and may be
at particular risk of atrophy. This typically happens with a combination of online
modules to be completed outside of work time, and a follow-up face-to-face group
education session. Competence is either formally or informally assessed, or
assumed following a period of familiarisation, after which clinicians are authorised
to practice the new skill or knowledge, or use the new medication. Many education
6 1 Introduction

and assessment techniques make the assumption that once a quiz has been suc-
cessfully passed, or a piece of equipment has been explained and used once in
training, that it can be maintained, recalled, and applied in a complex and urgent
situation potentially years after training. Flaws in this type of thinking and some
motivators behind it will be explored further in the remainder of this book.
Ongoing training is also now required in order to demonstrate ongoing devel-
opment as a registered professional to the Australian Health Practitioners
Regulation Authority (AHPRA). The individual clinician now becomes principally
accountable for his or her professional currency in order to maintain national
registration and employability.

The Institutional Context of Paramedic Education

Paramedic education spans two main institutions: the education and research
institution (the university or training college), and the health service institution (the
ambulance service). Historically, one was considered a place of knowledge input,
and the other a place of knowledge application and clinical care. Modern HPE
theories have come to reflect that in the most sustainable design, the two are not
segregated, but rather they are complimentary. Paul Worley’s model of symbiotic
clinical education presents these two institutions in relationship with each other, and
the student is placed in the centre of that relationship [6]. Getting the best of both
worlds, the student moves from the teaching centre to the clinical setting and back
again, constantly challenging and refining their knowledge, attitudes, skills and
experience.
Symbiosis is a term taken from ecological principles of mutual benefit, and is
used in this model to connect otherwise siloed stakeholders of the health system. It
consists of four axes or key relationships: the institutional axis refers to the teaching
institution and the health service; the clinical axis refers to the relationship between
the clinician and patient; the social axis refers to the relationship between the
government and the community; and the personal axis refers to the individual’s
values and ethical standards as they relate to the professional expectations of the
clinical role. These four relationships are depicted in Fig. 1.1.
This model was developed in reference to tertiary medical student education and
resulted from research into longitudinal rural placements compared with
metropolitan hospital-based students, therefore some limitations of this model exist
when considering paramedic education. Tertiary paramedic students do not tend to
have clinical exposure hours intertwined within their didactic teaching sessions at a
co-located university. Tertiary paramedic students undergo placements on full shifts
as an additional crew member on an ambulance.
These and other differences between ambulance and medical education impact
the integration of the teaching institution and the health service institution as aspects
The Institutional Context of Paramedic Education 7

Health Service Professional expectaƟons

Clinician Community

Student
Government PaƟent

Personal values University or training college

Fig. 1.1 The four axes of symbiotic clinical education. In sustainable, meaningful education
systems, the student’s presence within the relationship maximises the benefit for both components
of each axis Adapted from Worley, Prideaux, Strasser, Magarey and March, (2006). “Empirical
evidence for symbiotic medical education: a comparative analysis of community and tertiary-based
programmes.” Medical Education 40(2): 109–116

of this symbiotic clinical education model, however the model offers helpful
challenges to our conception of paramedic education, and ways in which we may
improve it.
A clinical expert brings a priceless contribution to education: thousands of
patients, hundreds of accident scenes, myriad skills in countless circumstances, and
years of reflection on reforming and refining procedural and psychological practice
within the professional role. The resources that a clinical expert brings to educating
tomorrow’s paramedics are essential. Making such resources available to paramedic
students, however, is an educational speciality and not a clinical one. However, a
paramedic’s clinical qualification and a stated desire to teach is sometimes all that is
needed in order to be appointed to the educator specialist role. Clinical educators
enter into education on the basis of their clinical proficiency, to alleviate the
demand to work night shift, due to a practice-limiting injury, or because it is
perceived as a natural career progression. In this book, the specialist educational
skills required in clinical teaching and assessment are argued. It will assist clinicians
and curriculum designers to consider the complex environment within which
education occurs.

In These Pages…

The diversity of students within a pre-hospital health system is demonstrated by

variance in professional goals, employment contract, ongoing employment stability,
wage, stakes, risks and motivations. All education in ambulance practice should
therefore avoid homogeneity in its approaches and assumptions, but recognise the
individual learners’ perspectives.
This book on paramedic clinical education will incorporate all of these aspects.
Clinical education doesn’t stop with the novice learner; it is of just as much rele-
vance to ongoing education. Whether we consider ourselves learners or not, lifelong
8 1 Introduction

curiosity breeds lifelong learning, and that will compel our profession forward. The
first chapter will reflect on the nature of learning, before moving on to skill
instruction for pre-hospital practice. Assessment and its assumptions will be con-
ceptualised, before the role of feedback is explored. Particular vulnerabilities
relating to students will then be explored, with reference to the development of
professional identity.

Case Examples

Realistic case examples will be presented within each chapter, and will conclude
with a series of reflective questions for the educator. The case studies address
tertiary teaching, in-service continuing development and on-road supervision
examples. By all means, adapt them to your local context as much as possible.
Answers to these questions may change over time, or evolve in response to
deepening understanding of pedagogical theory. There is often not one right or
wrong answer. They are intended to allow you to consider your own thoughts,
assumptions and experiences, and to bring these to light in the cases. If you are part
of a group of paramedic educators, I encourage you to commit your own responses
to paper, and then meet up regularly with your team mates and allow the diversity
of the group’s responses to challenge your thoughts, and in turn to allow your
perspective to gently challenge theirs.

Chapter Reflections

These questions are not tethered to specific cases, and will encourage you to
consider the concepts of the chapter more broadly. These questions may also inform
5–10 minutes of your regular paramedic educator development meetings.

References

1. Abelsson, A., & Lindwall, L. (2012). The Prehospital assessment of severe trauma patients
performed by the specialist ambulance nurse in Sweden–a phenomenographic study.
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 20(1), 67.
2. Dick, W. F. (2003). Anglo-American vs. Franco-German emergency medical services system.
Prehospital and Disaster Medicine, 18(1), 29–37.
3. O’Meara, P., Wingrove, G., & McKeage, M. (2018). Self-regulation and medical direction:
Conflicted approaches to monitoring and improving the quality of clinical care in paramedic
services. International Journal of Health Governance, 23(3), 233–242.
References 9

4. Liao, M., & Mackey, K. (2016). EMS delivery models, provider levels, and scope of practice.
In EMS Essentials: A Resident’s Guide to Prehospital Care, F.A. LeGrand Rogers, Timothy
Lenz, Editor. 2016, Emergency Medicine Residents’ Association: Dallas, USA, pp. 21–27.
5. Simpson, P., & Thyer, L. (2016). Fitting together the pieces: Using the jigsaw classroom to
facilitate paramedic WIL. In The Gold Sponsor of the ACEN 2016 Conference was Intersective,
Supporting Work-Integrated Learning in Australia.
6. Prideaux, D., Worley, P., & Bligh, J. (2007). Symbiosis: a new model for clinical education.
The Clinical Teacher, 4(4), 209–212.
Chapter 2
Theory of Learning

Abstract In Theory of Learning, the reader will consider the very nature of
learning. Educators may consider learning to be a development in cognition, a
change in behaviour, or something which manifests within a society of professional
expectation and practice, and this all starts to build a philosophy or conceptuali-
sation of learning and teaching for the educator. Such a conceptualisation, however,
is often tacit. Therefore, this chapter seeks to bring the nature of learning to light,
with consideration to current andragogical principles and research. Educational
theories such as cognitive load theory, and experiential and situated learning, are
explained and applied. The reader is guided to consider their personal assumptions
about learning and how it is measured.

Keywords Cognitive learning Cognitive load theory Knowledge retrieval




Behavioural learning Experiential learning Social learning Simulation

As educators we all have some understanding of what learning is, and how it is
demonstrated. But if someone asked you to describe what learning is, how would
you put it into words? If we read a study in an educational journal which compares
two different methods for teaching skills, and concludes that one is measurably
better than the other, this reveals a lot about the authors’ conceptualisation of
learning. It may reveal that practical knowledge is demonstrated by an action which
is externally observable, and a change in that practical knowledge is attributed to
learning. Measuring competency on a checklist which provides a numerical score at
the end demonstrates the assumption that learning can be reliably converted to a
number (quantified) for the sake of comparison. When we teach and assess, whether
it be formative or summative assessment, we apply assumptions about education
and learning. If she didn’t hold that equipment properly, she had faulty learning…If
he failed his exam, he mustn’t have studied enough… If they can’t state the
receptors that drug works on, they mustn’t understand (and so on). Our assump-
tions about what learning is and how it is demonstrated during practice and
assessment are manifold and often hidden.

© The Author(s), under exclusive license to Springer Nature Switzerland AG 2019 11

A. E. Seymour-Walsh, Foundations for Paramedic Education,
SpringerBriefs in Education, https://doi.org/10.1007/978-3-030-26792-6_2
12 2 Theory of Learning

Learning is commonly defined as a change in behaviour, and this has an obvious

cognitive element because memory and recall is required, but this definition focuses
on performance. The underlying conceptual understanding isn’t always necessary
for correct performance. Conceptual understanding is unarguably important for
expert skill application and adaptive practice, however, as is experience and
reflection. Correct skill application and appropriate skill application are therefore
not synonymous. A medical skill can be performed technically correctly in a patient
who doesn’t need the procedure, or who needs another procedure more urgently,
making it inappropriate and conceptually and professionally incorrect.
In acknowledgement that there is more to learning than an observable change in
behaviour, this chapter will consider cognitive, behavioural and social aspects of
learning, and challenge educators to look beyond knowledge and actions, but to
move towards the social aspects of becoming a health professional within a context
of practice.
Consider Miller’s pyramid. It appears in many books pertaining to clinical skill
teaching, and sometimes risks doing so tokenistically. First published in 1990, it has
become a staple in medical education. On one hand, its message is easily under-
stood, but there is also great depth and insight present for the developing clinician.
There are four levels to Miller’s pyramid, as depicted in Fig. 2.1: the student knows
when they have knowledge; they know how when they are competent; they show
how when they perform; and they do through action.
The different stages of development represented in the pyramid inform different
types of assessment. For example, multiple choice questionnaires are easy to pro-
duce and mark, and while they may assess foundation level knowledge, this
strategy cannot assess the more evolved applications and habitual practice of
knowledge and learning. Such tests may assess knowledge but not competence,

Fig. 2.1 Miller’s pyramid

(also referred to as Miller’s
triangle) Adapted from “The
assessment of clinical skills/
competence/performance” DOES
(1990) by Miller, G. E., (acƟon)
Academic Medicine 65(9)
p. S63
SHOWS HOW
(Performance)

KNOWS HOW
(Competence)

KNOWS
(Knowledge)
2 Theory of Learning 13

performance or action. Miller’s pyramid shows the progression of learning from its
cognitive processes (knowing) through to behavioural processes (performing) and
through to the pinnacle of doing [1]. But let’s not misunderstand what Miller meant
by doing, as others have. He clearly argues that by this very simple term, he means
practicing the skill or knowledge in the authentic clinical setting, underpinned by
professional expectations and guided by the complex considerations of a clinician’s
role. This doing at the apex of Miller’s pyramid is actually being the clinical
professional. This framework challenges the more simplistic notion that learning is
evidenced by a change in behaviour, and impacts how paramedics are taught and
assessed.
If learning is an evolution of being, it is less objectively and quantitatively
definable than some assessment tools tend to accept. For example, Frank Zhu and
colleagues found that two groups of learners who were taught to perform a
laparoscopy with different teaching approaches recruited different areas of their
brains during the skill, despite no measurable difference in the accuracy of the
motor outputs observed [2]. On a skill performance checklist, then, the two different
groups of clinicians perform the same but electroencephalographic (EEG) data
demonstrated different cerebral processes. This study shows that what we see on the
outside (performance artefacts) is not the whole measure of learning: there must be
more to it.
What we understand learning to be will inform our education philosophy and
impact our teaching approach and assessment style. Three frameworks are offered
to help understand our education philosophy: learning as a cognitive, behavioural or
social activity.

Cognitive (Knowing)

Cognitive-centred approaches to learning focus on aspects of knowing: under-

standing, storing and recalling information. Pertinent to these approaches are
cognitive limits and neuronal roles in memory formation and data storage. This
perspective of learning views the brain as a type of computer, using random access
memory (RAM) as an analogy for cognitive limit.

Cognitive Limitation

In 1956, George A Miller (not to be confused with George E Miller who shared
with us Miller’s pyramid), argued that the mind has a limited ability to hold new
information in short-term memory. During his experiment, participants were asked
to recall a series of musical pitches in their memory. Those participants who were
not trained or particularly sophisticated in music (in other words those for whom the
information was new and the task required particular concentration) were able to
14 2 Theory of Learning

hold around 2.5 bits of information before they started to become confused.
A single bit of information is a point at which “two equally likely alternatives” are
possible and one is chosen. For each bit of information, two choices exist: two bits
of information provide four equally likely alternatives; three bits provide eight
equally likely alternatives, and so on. Determining the correct alternative demands
that successful binary decisions are made at each point, and Miller determined that,
on average, 2.5 bits could be held in working memory which translated to around
six different pitches correctly held in their minds until participants became confused
[3]. Miller argued, therefore, that the expected capacity for new information being
held in the mind of a learner is five to nine, or “seven plus or minus two”. Saaty and
Ozdemir, nearly 50 years later, confirmed that Miller’s calculation of “seven plus or
minus two” is indeed a limit, a channel capacity on our ability to process infor-
mation” [4]. According to Tobias Dantzig’s observations with crows and their
apparent ability to count, this may even be an instinctual function rather than an
intellectual one; a type of numerical sense for numbers “that is primitive and
predates true counting” [4].

Cognitive Load Theory

Short-term memory and its limitations are therefore pertinent to learning. By pre-
senting too much new information, the student’s ability to hold it all in their mind
may be exceeded, and confusion ensues. This idea has taken greater shape through
cognitive load theory. Sweller, Van Merrienboer and Paas [5] reinforce that not
only the volume, but also the type of cognitive load impacts learning, and suggest
three classifications of cognitive load: intrinsic, germane and extraneous.

Intrinsic Cognitive Load

Intrinsic load is dependent on the difficulty of the content. It is unavoidable, finite,

and determined by the teaching content. Teaching a paramedic student the chemical
processes in an allergic asthma cascade, for example, demands that a certain amount
of information be learnt regarding cellular responses to inflammatory mediators,
roles of different types of cells, and pharmacological action of sympathomimetic
agents such as adrenaline and salbutamol. This is content which must simply be
memorised. It isn’t intuitive, so it can’t be reasoned, it must simply be learnt. To the
learner, this demands a set level of intrinsic cognitive load. The load for such
complex processes is much greater than just learning one part of the system, for
example just learning the action of sympathomimetic agents on bronchial smooth
muscle in allergic asthma.
When we are teaching, there is little we can do about the complexity of the
content. However, as a student progresses through their study and builds their
Cognitive (Knowing) 15

knowledge in longer-term memory, the same amount (or complexity) of content

becomes easier as it connects and builds on established understanding. This relates
to germane cognitive load.

Germane Cognitive Load

Germane cognitive load refers to the construction of schemata, or structures and

patterns of thought and knowledge used to organise, reference, and connect con-
cepts or content. The organisation of knowledge within a schema enhances
streamlined retrieval [6] and allows information to be compressed and stored more
effectively [7]. Continuing on with the computer-as-brain analogy, this process is
similar to both sorting computer files into logical directories. The key is organi-
sation for efficient retrieval and associations with other relevant information.
Fitts [8] referred to this concept over 60 years ago, arguing that the
“stored-program data processing system”, works to perform tasks by retrieving the
smaller process (subroutines) that make up the larger routine. Thus, information
may be chunked into parcels of suitable complexity so that they may not overwhelm
the intrinsic cognitive load, and be retrieved as parcels (if organised efficiently) to
build into highly complex processes.
Germane cognitive load in the development and reorganisation of schemata is
not only required in the storage of knowledge, but also its retrieval. This retrieval
and restructuring of existing schamata, Jeffrey Karpicke and Henry Roediger argue,
is critical to longer term knowledge retention. Their research demonstrated that
students who were taught content once and had to retrieve that information in a test
situation outperformed students who learned the same information three times over
with no retrieval in testing [9, 10]. Karpicke and Roegider argue that “repeated
retrieval practice enhanced long-term retention, whereas repeated studying pro-
duced essentially no benefit”.
Constructivist learning theory seeks to engage the learner to build new knowl-
edge using what they already know, hence the educator helps the student adapt
existing and new schemata in learning. A constructivist approach to teaching, then,
is cognizant of the germane cognitive load that a learner is experiencing.

Extraneous Cognitive Load

Extraneous cognitive load relates to the way in which knowledge is presented to the
learner, therefore it is the component of total cognitive load which is most available
to be influenced by the educator. Information may be broken into smaller parcels
and time given to students to process, mentally digest, and consolidate these
smaller, more manageable parcels. Or it may be presented in a way which is
tethered to a case presentation so that a student may recall an illness script for that
particular demographic, disease, or presentation, thus aiming to assist with effective
organisation of content. An illness script refers to the attachment of particular
16 2 Theory of Learning

patients and experiences to case types, which become arranged in knowledge

networks [11]. Practice allows such illness scripts to be challenged, supplemented,
and refined, and this process further embeds knowledge and experience to allow
clinician reasoning to become more and more informed and efficient. Extraneous
cognitive load is impacted by the education environment, class culture,
educator-student relationships, teaching pace, and presentation modality.
The total cognitive load is the sum of these three sub-types of cognitive load.
Paramedic practice is known to be highly cognitive demanding due to its com-
plexity. Patient data are collected from a variety of potentially conflicting or
incomplete sources, and provisional diagnoses must be made quickly within a very
small clinical team (typically two clinicians) [12]. If qualified, experienced para-
medics experience such complexity, how do we address that which is experienced
by the learner?
The cognitive aspect of learning is fundamental, hence it forms the foundation to
Miller’s pyramid. The student can then move from knowing to knowing how, which
is the beginning of a transition from knowledge to practice. Gilbert Ryle, however
argues that knowledge how and knowledge that are two conceptually and philo-
sophically different things, and that knowledge how can’t be taught [13]. He argues,
rather, that knowledge how requires intelligence which is separate from learning a
series of rules. This is reconciled in part by the modern distinction of routine
expertise and adaptive expertise: routine expertise requires a high level of skill, and
it allows experts to readily identify relevant information and avoid distractions by
irrelevant, biasing information [14]. Routine experts have a sharp and effective
attention for what is pertinent to the task at hand. Adaptive expertise, on the other
hand, is required in order to masterfully approach a new, unprecedented or unfa-
miliar situations. It may use the same knowledge bank as routine expertise, but is
applied in a novel, unteachable way. Thus, skilled practice (doing) which demands
adaptive expertise requires more than a simple cognitive approach (effective
memory and recall) to learning. Adaptive experts embrace complexity and
innovation.

Behavioural (Doing)

The movement from knowing to knowing how is the first step towards clinical
practice. Cognitive concepts (knowing that) lay a foundation for applying concepts
(doing) through knowing how. A typical assessment of whether a student knows
how to approach practice is through giving them an opportunity to show how they
apply their knowledge. Recalling Miller’s pyramid, though, this is a leap of two
levels: knowing (cognitive) to knowing how (cognitive aspects of performance) to
showing how (performance). The term Miller uses to summarise knowing how is
“competence”, however competence as a concept is defined very differently by
other models of practice application.
Another random document with
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 Sy moeder veeg haar gesig af, van die trane en die sweet.
Bewende sê sy:
—Moenie jammer wees nie, dis nie die moeite werd nie.
—Hoe so? sê Paula verbaas.
—Hulle wil nie van hul dogter skei nie, en daarom glo hul dat hul
haar so danig liefhet.
Paula vra:
—En Alida self?
—Ek het haar nie eens gesien nie. Sy kruip weg—of wel, hulle
steek haar weg. Haar ouers was nie voorberei op my besoek nie.
Hul was verbaas. Marcel moet belowe dat hy in Chamberie sal bly,
dat hy sy betrekking moet neerlê as dit nodig is. Ek het wel goed
gesien dat ’n Marthenay meer na hulle sin sou wees.
—Ba! sê Marcel, en sy oë skiet vonke.
En mevrou Kibert vertel van die vernederende onderhoud wat sy
moes deurstaan. Marcel wil dit nie erken nie, maar hy voel baie pyn,
en dit maak hom ondankbaar; hy laat haar nie uitpraat nie:
—U kon nie behoorlik u woord doen nie—dis seker. U hou nie van
hulle nie en u het dit nie weggesteek nie. U verag die wêreld en u
weet dit nie.
Hy het ’n houding van geringagting aangeneem; trots maak sy
wond nog erger. Sy antwoord hom met sagtheid en diepe droefheid:
—Jou vader het my dié verwyt nooit gemaak nie. Maar, dis waar,
ek verdien dit. Dog ek is tog alte oud om te verander, en die mense
het my nie ontsien nie.
Marcel is kwaad; hy skaam hom, maar hy verlaat die kamer
sonder die woord wat hy gesê het, terug te neem of te versag.
Paula het al die tyd roerloos en spraakloos bly staan. Nou sluit sy
haar bedroefde moeder in haar arms en soen haar met innige liefde.
—Moenie huil nie, ma. O, hoe verag ek daardie mense. En Marcel
is onregvêrdig. Dit was verkeerd van hom om u soiets te sê. Ek is vir
hom ook kwaad.
En oor haar donker oë frons sy haar winkbroue. Haar ma droog
haar trane af en sê:
—Nee, Paula, ons moet niemand verag nie. En wees geduldig met
jou broer. Sien jy nie dat hy smart het nie? Loop soek hom.
 VIII.
PLANNE.

In die tuin van Maupas, waar die rose reeds verwelk, in die
skaduwee van die kastaiingboom, waarvan die blare al geel word,
kyk Marcel Kibert en Jan Berlier na ’n landkaart van Afrika wat op die
klip-tuintafel oopgevou lê.
—Dis die pad wat ons moet neem, sê die kaptein, en hy wys met
sy vinger op ’n lang streep rooi kruisies dwars oor die
Saharawoestyn.
Met jeugdige geesdrif vra Jan:
—Is dit nou seker dat die kommando sal gaan?
—Ja, en ons sal twee jaar wegbly, ten minste as ’n mens vooruit
sou kan sê hoelank so ’n lang en gevaarlike tog wel sou kan duur.
Ek het in die stad die kommandant gesien. Met honderd of
tweehonderd man gaan ons op pad. Maar ek vrees dat ons nie
wegkom voor ander jaar nie. En met ernstige stem lê Marcel haarfyn
uit hoe alles sal gereël word. En met breë gebare verduidelik hy sy
woord oor die onbekende land, so wyd uitgestrek en eentonig,
ondeurgrondelik en geheimsinnig soos die see.
Jan luister, en sy gesig neem ’n uitdrukking aan van aandag en
manlike erns. Hierdie mooi, fyn jonkman, altyd vol lag en grappies, ’n
liefling van die vroue van wie ’n mens by die eerste oogopslag sou
sê dat hy net deug om te „flirt” en mooie meneertjie te speel in die
voorkamer—hy toon, as hy eenmaal in sy natuurlike element en voor
’n ernstige onderneming geplaas word, dat hy ’n manlike geaardheid
besit, ferm en vol durf. Marcel, wat hom beter ken, het dit altyd
geweet; en as hy van Jan hoor praat as van ’n voorkamersoldaatjie,
dan sê hy altyd: Julle ken hom nie.
Mevrou Kibert kom uit op die stoep van die huis.
—Stil! sê Marcel, en lê sy vinger op sy lippe.
—Weet sy nog nie dat ons gaan nie? vra Jan, fluisterend.
 —Nee. Sy sal dit altyd nog te vroeg hoor.
Sy kyk die tuin in, maar sien die twee jonkmans nie. Sy dink dat sy
heeltemal alleen is, haal haar bril af—sy het dit gebruik by een of
ander handwerk—en veeg langsaam haar oë af met haar sakdoek.
Sy is moeg en leun op die houttralie waartussen, soos ’n verwelkte
versiering, die ontblaarde ranke van die blomme gevleg is. En in
gedagte laat sy haar droefgeestige blik gaan oor die welbekende ou
landskap.
Die dalende aand verf pers en rose tinte op die teer-yle lug. Die
frisheid van die lug kondig die nadering aan van die najaar. Die
landskap rondom laat dink aan die teer-bekoorlike glimlag van ’n
sterwende meisie wat nog terugdink aan die lewe. En dit lyk of die
kaal lande en bome en wingerd, nadat hul alles gegee het wat hul
gehad het, nog meer sou wil gee. Onnuttig nou, het die landskap
nog net sy skoonheid behou. Die bosse is half beroof van hul
misterie, en die sterwende aandstrale lê flouerig, dog amper te
swaar op hul geel-groen blare. Langs die muur laat ’n paar rose hul
alte sware blaartjies opehang, en die sagte aandwindjie laat hul
neerstryk op die grond. En bo-op die bult, swart geteken teen die
goud van die aandlug, trek twee osse stadig-stadig in die ploeg—
voorbereidende die oes wat nog moet kom. Oor die kalme afsterwe
van die natuur sweef so die voorspelling van ’n herlewing.
’n Vallende kastaiing, bo uit die bome, laat Marcel opskrik. En as
hy sy liewe ou moeder aankyk, soos sy daar leunende staan, haar
gedagtes vol van haar klompie kinders oor die hele wêreld versprei,
dan is dit of hy meteens besef hoe groot haar liefde moet wees; en
hy voel ook die bygelowige vrees, wat ons somtyds so kan bekruip
en pynig as ons dink aan die swakheid van die wat ons liefhet.
—Arme ou moedertjie! Hoe baiemaal het u al gebewe vir my lewe.
En dit sal weer moet gebeur. Die landkaart hier voor my, onverskillig
en spraakloos, berg die geheim van u toekomstige smarte. Vir die
melk van u bors, wat my gevoed het, vir die lewe wat u lewe my
gegee het, vir my gelukkige kinderjare en jongelingskap—o, wees
daarvoor geseën. Ek het u lief. Maar, as ek wil weggaan, vergewe dit
my!
 Die beeld van ’n blonde meisie kom voor sy gees. Na die weiering
het hy Alida Delourens nog nie weer gesien nie. Verskeie male het
hy al die tralies oorgeklim wat die eikebome van Chenée skei van
die pad. Daar, in die skaduwee, het hy vir haar gewag. Wetende dat
sy hom liefhet, wil hy, tot elke prys met haar praat en haar ewige trou
belowe. Die roem wat hy in verre lande sou behaal, en
geduldoefening, sou haar eindelik wel aan hom gee. Maar of dit nou
toeval was of iets anders, sy het nooit daar na die bos gekom nie.
Sal hy so moet weggaan? Binne weinige dae sal sy verlof om
wees—hy het geweier om verlenging daarvan aan te vra—en dan
moet hy teruggaan na Algiers, met Jan Berlier en sy kommando. Hy
maak allerhande onmoontlike planne, hy herkou op sy onmag soos
’n jong, ongeduldige perd op sy stang.
—Ek wil nou loop, maar eers wil ek jou ma gaan groet.
—Wag nog ’n bietjie, sê Marcel. En meteens tot ’n besluit
komende, sê hy, fluisterend:
—Kyk hier, ek wil met mejuffrou Delourens praat. Wil jy my help?
Daar bestaan ’n innige vriendskap tussen die twee jonkmans, iets
broederliks en rustigs, gebore uit wedersydse vertroue en
ooreenkoms van aard en strewe. Maar hul hartsgeheime deel hul nie
mee aan mekaar nie. Dit verwonder Jan dus dat sy vriend syne nou
so openbaar, al het hy dit al lank agtergekom. As beskeie toeskouer
het hy die spul so aangekyk. Hy ken Marcel se wilskrag en trots; die
groot hartstog boesem hom belang in, al vrees hy vir die wanhoop
wat daarop kan volg—dis so iets anders as sy eie oppervlakkige
vryerytjies vir tydkorting. Hy weet waaraan hy dit moet toeskrywe dat
sy vriend meteens so ’n lus gekry het om met die kommando na
Afrika te gaan, dat hy so ’n opgewonde verlange het na roering en
werk.
Jan maak of hy van niks weet nie, en sê:
—Waarom gaan jy nie self na Chenée nie? Dis die eenvoudigste.
Marcel kyk hom deur en deur en antwoord:
—Jy weet waarom ek nie kan nie.
 En na ’n oomblik stilte laat hy volg:
—Maar ek wil haar darem sien.
—Om met haar weg te loop? sê Jan, met ’n glimlaggie.
Hy wil nog probeer om daar ’n grappie van te maak, maar ’n
stuurse antwoord is al wat hy kry.
—Kyk in haar oë, en jy sal nie meer so praat nie . . . . Ek moet
haar absoluut sien voor ek weggaan, miskien om jarelank weg te bly.
Haar geluk sowel as myne is daarmee gemoeid. Was daar van myne
alleen sprake, dan sou ek met my smart kan weggaan, sonder om
om te kyk. Maar sy moet gerusgestel word omtrent haar toekoms, sy
moet verstaan dat die toekoms behoor aan dié wat volhou. Sy sal
my vrou word, as sy wil. Ek wil haar net vra om moed te hou en te
wag.
—Dis die hoogste eis, sê Jan. Hy het nie ’n alte hoë dunk van
Alida haar moed nie.
—Dis die gemaklikste.
—Ja, vir jou, wat heeldag besig gehou sal word met gevare en
hinderpale om te oorkom. Maar sy . . . .?
—As sy my nou liefhet? sê Marcel eenvoudigweg en daar is iets in
sy stem wat alle gedagte aan eiewaan verban.
—Ja, sê Jan, en hy dink by homself: Sy weet nie wat liefde is nie.
Isabella Orlandi trou met meneer Landeau omdat sy graag wil skitter.
Alida Delourens sal met meneer Marthenay trou uit swakheid, en
omdat haar ma begeer om nog eendag ’n adellike kleinseun te sien.
Die jongmeisies van ons dae weet nie meer wat ’n groot liefde
beteken nie, en niemand leer hul dit nie.
Maar hardop durf Jan dit nie te sê nie. Op die breë, ope voorhoof
en in die ernstige oë van sy vriend sien hy die tekens van ’n siel deur
liefde geroer.
—Wil jy haar absoluut sien?
—Absoluut!
 —Jy is al so tuis by die famielie Delourens. Jy kan maklik met die
dogter praat. Ek sou my suster gevra het om dit te doen as sy nog
daarheen kon gaan na die . . . . weiering.
Hy moet sy trots oorwin om die laaste woord te kan uitspreek. En
met ’n sekere minagting hef hy sy hoof op as hy sê:
—So ’n weiering is onregvêrdig. Ouers het geen reg om hul gesag
so te laat geld tot bevrediging van hul eie vooroordeel en selfsug, en
om uit ydelheid die hart van hul dogter te breek nie. Niemand het
soveel eerbied vir ouerlike gesag as ek nie, maar dan moet wysheid
en rede dit lei. Paula het Alida in die kerk gesien, sy was bleek en
kwynend. Ek moet haar sien. Daar is geen troueloosheid in nie, geen
plan om haar met minder eerbied te behandel as ek haar verskuldig
is nie. Dit wou ek jou net sê voor jy my antwoord.
—Dis goed, sê Jan. Na ’n oomblik nadink sê hy verder:
—Ek wil jou eie woorde herhaal, Marcel: Kyk in haar oë, dink aan
die eerlike blou oë, en vra jouself af of sy sal uitloop om jou êrens te
ontmoet.
Marcel staan spraakloos, dan sê hy:
—Dis waar. Ek wil daar nie meer aan dink nie: ek sal weggaan
sonder haar te sien.
Geen ander klag kom oor sy lippe nie. Maar sy vriend word
aangedaan deur dié eenvoudige woorde. Alhoewel hy dink: dis ook
maar beter dat hy weggaan sonder haar te sien, kry hy so jammer,
dat hy tog ’n plan maak:
—Kyk, laat die saak aan my oor: ek sal jou sê as jy haar kan
ontmoet. Sy sal jou sien sonder dat ek haar vooraf iets sê. Dit sal
dan aan jou lê om te hou wat jy het. Dis nie ’n alte mooi manier nie,
maar dié Marthenay vererg my en die Delourens-klomp is windsakke
—daarom ontsien ek nie om hul ’n bietjie te fop nie.
—Jy wou my moeder nog groet, nie waar nie? Kom, ons gaan
binne-toe, sê Marcel.
Mevrou Kibert en Paula sit nog aan hul handwerk, in die
aandskemer. Die moeder se oog verhelder toe sy haar seun sien
binnekom; maar Paula kyk nie op nie.
—Ek kom groet, sê Jan.
—Wag jy nie tot Marcel gaan nie? Gaan jy nou al weg? vra
mevrou Kibert. Want sy hou van die lewenslustige jonkman en
vergeet dat hy somtyds so ligsinnig kan wees. Sy is hom ook
dankbaar dat hy—beter as sy self durf of kan—aan Marcel afleiding
besorg van die droefgeestigheid wat hom druk soos ’n sware rou en
waarvoor sy ’n soort van vrees koester.
—In drie dae tyds gaan ek aan boord, mevrou. My verlof is gouer
om as dié van Marcel.
Paula lig nou haar hoof op. Jan lees in haar donker oë iets van ’n
verwyt, en haar bleekheid verraai dat sy pyn ly. Maar baiemaal is ’n
mens in twyfel oor wat daar spreek uit ’n oog of selfs uit ’n blos op ’n
jeugdige wang. Dis van die snelle en vlugtige uitdrukkings wat vir
ons ’n geheim bêre, wat ons nie graag deurgrond as dit lyk of sulke
uitdrukkings ons ongunstig is of selfs ook maar verleë maak nie.
Hierdie meisie met haar ernstige gesig en bedaarde bewegings, met
haar skuwe bevalligheid, getuiende van groot beslistheid, trek hom
aan en stoot hom af tegelyk. Hy wil haar so graag op ’n lughartige,
vriendskaplike manier hoor praat; maar nou werk haar
terughoudendheid verlammend op hom. Haar toejuiging en agting
sou hom kan verhef en sterk maak; maar hy begryp dat hy dié agting
alleen kan verdien deur groot dinge te onderneem en ’n hoë inbors
te besit; en hy voel ’n inwendige vrees vir wat hy noem „die hoë
dinge.” Hy is veral bang om homself ernstig af te vra waarom sy so
’n dubbelsinnige indruk op hom maak. Hoe baie menselewens gaan
daar nie verby, drywende op die twyfel, sonder die geheim te wil
deurgrond van die verwante gevoelens wat aan hul hele lewe ’n
ander koers sou gegee het, maar waarvoor die meeste mense al
vooruit bang is!
Mevrou Kibert stap ’n entjie saam met Jan, buiten-toe. By die
treedjies fluister sy snel in sy oor:
—Kyk tog ’n bietjie goed na Marcel as hy later ook by julle
kommando kom. Ek vra jou om dit vir my te doen, Jan.
 Hy is aangedaan deur die vertroulike woorde van die ou vrou:
—Ek beloof u dit mevrou, hy is soos ’n ouer broer vir my.
Hy kyk nog ’n keer om en bewonder die fier sy-gesig van Paula in
haar rouklere; sy staan op die stoep, maar sy kyk nie na hom nie,
haar oë is in die verte gevestig—en die rosetinte van die najaar
verbleek op die berge . . . .
Dieselfde aand gaan Jan op Chenée eet, waar hy Isabella Orlandi
ontmoet. Dis kort voor haar troudag, maar nog nooit is sy so
baldadig gewees, en gee sy so min om fatsoenlike maniere nie, as
nou. Ondertussen doen meneer Landeau sy voordeel met die
seldsame opgang van die geldmark; hy maak baie geld deur
toepassing van die moderne misleidingsmiddel, en hy vry so uit die
verte, deur in sy briewe kortliks maar duidelik te laat blyk hoe goed
hy aangaan—hy ken wel die krag van sulke mededelinge.
Dis aand geword; en Isabella gaan by Jan sit op ’n sofa, agter ’n
party varings en palme.
Jan het ’n vrou nodig om sy plan vir Marcel ten uitvoer te bring.
Die plan is eenvoudig om Alida tot ’n wandeling uit te lok—op ’n
afgesproke uur—na die eikebos, waar sy dan meteens vir Marcel
Kibert sou aantref. Maar hy kan Alida nie vra om alleen met hom uit
te gaan nie, hy moet ’n betroubare bondgenoot hê. Jan kyk skuins
na Isabella, en dink:
—Hierdie een miskien, maar kan ek op haar reken?
Hy het nie ander keus nie, dus moet hy maar probeer:
—Wat dink jy van hom, sê hy, terwyl hy ’n hoofbeweging maak na
die kant van Marthenay, wat voor mevrou Delourens ’n vertoning
staan te maak, terwyl die arme Alida, om hom nie te sien nie, in ’n
boek sit en prentjies kyk, sonder ’n blad om te slaan.
Isabella lag:
—Wie, Marthenay? Hy is Alida se meneer Landeau. Elke een het
haar eie.
—Wil jy my help om hom ’n streek te speel?
 —Ja, seker! Dit sal ons weer laat dink aan die blommefees se
slag.
—Nou ja, kom môreagtermiddag om vieruur hiernatoe—ek sal dan
hier wees.
—As jy hier is, kom ek ook; dit spreek vanself.
—Alida is ’n bietjie bleek die laaste dae, jy sal aan haar sê: „Jy
moet afleiding hê, ’n bietjie meer in die buitelug gaan, jy bly te veel in
die huis.” Ons neem haar na die eikebos, en, op ’n teken van my,
laat ons haar daar alleen. En as jy dan iets sien, sal jy dit vir jouself
hou?
—Maar ek begryp van die hele affêre niks nie.
—So moet dit ook wees.
—Sê my ten minste wie ek sal sien.
—Nuuskierige Eva! kan jy ’n geheim bewaar?
—As jy my dit vertel, ja.
—Die geheim is nie myne nie. As ek dit vertel, is ek ’n verraaier.
Sy kyk die jonkman aan met haar wellustige, skone swart oë:
—My liewe Jan, ek is nie veel werd nie, en jy reken my vir nog
minder as ek is. Om jou plesier te doen, sal ek gevare tart . . . . en
selfs welvoeglike maniere.
—Veral „welvoeglike maniere” as jy nie omgee nie.
—Maar seker. O, as jy wil, volg ek jou tot die end van die wêreld.
—Sonder iets te besit? vra hy, met ’n twyfelagtige glimlaggie.
Sy antwoord met ’n mat laggie, wat haar wit tande laat sien.
—Met net so min as hier op my hand is.
’n Rilling loop oor Jan se lyf, by die gewaagde onbeskaamde
woorde, en hy voel ’n soort van verdriet in teenwoordigheid van die
skone, verleidelike liggaam. Voordat sy haar in haar huwelik werp,
soos in ’n aaklige afgrond, het sy daar ’n soort van baldadige plesier
in om op die rand daarvan te baljaar.
 Hy is stil, maar sy merk wel wat ’n mag sy nog oor hom uitoefen.
Sy waag dit om boweop nog sy hand te neem en in Italiaans te sê—
om haar onbeskaamdheid half te bemantel:
—Ek hou van jou.
Jan dink nie meer aan Marcel nie. Maar omdat sy so seker lyk van
haar oorwinning, voel hy hom tot teenstand geprikkel, want in die
grond van sy natuur is hy fyngevoelig, trouhartig en byna
teruggetrokke. En so gee hy tog nie die antwoord wat sy verwag nie:
—So, dus sal jy meneer Landeau laat staan om vir my te neem?
Sy vind hom ’n bietjie onnosel, en sê dat hy maar net in skyn iets
durf waag, dat sy danige durf net alles grootpraat is. Dog hy behaag
haar om dié rede nog meer. Op die grond van haar wellustige hart
voel sy selfs ook nog ’n weifeling, omdat die bederf nog maar begin
—dis die oorblyfsel van haar kinderlike onskuld, en sy voel
aangedaan deur die onverwagte eerbaarheid van Jan. Maar oor dié
opwelling is sy gou weer heen, en haar antwoord is:
—Ek sal niks laat staan nie. Ons sal ons nie laat hinder deur die
ou veertigjarige man van my nie.
En sy laat weer die dubbelsinnige laggie hoor.
Hy begryp haar en kan nie help om ’n kleur te kry nie. Dit erg haar.
Deur die plante, van agter die sofa, kan hul Alida sien binnekom. Sy
stap oor die vloer met starende gevestigde oë of sy in haar slaap
loop. Sy het ’n rok aan van wit kamerdoek: dit staan goed by haar
blonde haar. Eén oogopslag is vir Isabella genoeg om die rok in alle
besonderhede op te neem. Jan het haar kwaad gemaak, en sy sê:
—Dis duur goed wat sy dra, en kyk hoe volmaak is die snit
daarvan. Sal jy my net sulkes kan gee, meneertjie, as ek met jou sou
trou?
—Wat, uit my klein salaris? sê hy.
—Ja, ek hou nou eenkeer van goed wat mooi is.
—Al wat blink, is nie goud nie.
—Reg so, daar is ook nog diamante en ander edelgesteentes.
 Half minagtend sê hy:
—Ja, elke een draai sy rug toe aan die lewe en probeer dit te
vergeet. Jou ma het haar hond, Pistache, my oom het sy rose, en jy
het jou klere. Die liefde moet maar sukkelend agteraan kom.
—Dit lyk my jy word nou soet, Jan.
Jan begin nou weer oor sy plan vir môre:
—Dus sal jy jou mond hou as jy môre iets gewaar?
—Ek sweer! Is jy nou tevrede? Kom vertel my nou wat dit is.
Hy weifel eers nog, maar sê dan:
—My vriend, Marcel Kibert, het iets te sê aan Alida. Hy sal vir haar
wag in die eikebos.
—So, so! sê Isabella, vol belangstelling. Maar daarby is ons nie
nodig nie.
—Luister: Alida weet daar niks van nie. As sy weet, sal sy nooit
gaan nie.
—So ’n stommerik!
—Sy is ’n bangerige en teruggetrokke kind.
—Ja, te nougeset. Maar sy is ryk, sy kan vir haar ’n man uitsoek.
Dis in hierdie tyd ’n seldsame voorreg. Hoe sou sy nie die voorkeur
kan gee aan kaptein Kibert nie, in plaas van aan die lawwe,
verwaande Marthenay? Ek hou self ook baie van die kaptein—
amper so veel as van jou. Net, hy maak my bang. Ek verwag altyd ’n
knor van hom.
—As jy dit nou verdien?
—Ek verdien dit. Knor jy my—maar nie te hard nie. Marthenay is
onnosel; en as ’n mens onnosel is, dan is hy dit vir ’n lang tyd.
Mevrou Delourens dink dat die twee nou lank genoeg alleen gesit
het. Sy kom nader en vra:
—Is Alida nie by julle nie?
 —Sy het uit die kamer gegaan, mevrou; maar daar kom sy net
terug.
Sy gaan weg van hulle; en Jan sê haastig, om nou ’n end aan hul
gesprek te maak:
—Jy moet weet dat mevrou Delourens haar dogter nie van haar
weg wil laat gaan nie.
—Ag, sê Isabella. Dan sal die arme Alida met meneer Marthenay
moet trou. Sy het net so veel wilskrag as ’n hoender in ’n reënbui.
En op komieke toon voeg sy daarby:
—Laat ons die ongeoorloofde liefde steun. En wat sal jy my gee
vir die hulp?
—Vra, en ek sal gee.
Sy kyk hom skelmrig aan, om hom te oorwin:
—’n Soen van jou lippe, meneer.
Jan is weer in haar mag, en voleindig haar sin:
—Op joue, juffrou!
Hulle lag albei half verleë, en ming dan met die ander mense in
die kamer.
 IX.
AFSKEID.

Dis ’n dag later, en alles gebeur soos voorsien was:

Isabella Orlandi en Jan Berlier lei Alida Delourens na die eikebos,
waar Marcel haar afwag. By die draai van ’n paadjie staan Alida
meteens voor Marcel. Die twee verlaat haar daar en wandel verder
onder die bruingekleurde najaarsblare.
Alida is verskrik en lê haar hand op haar bors. Haar eerste
gedagte is om te vlug, maar sy voel haar bene knik en haar asem is
weg.
—Wag, asseblief ’n bietjie, sê Marcel met ’n ernstige en haastige
stemsuitdrukking—wat hy nouliks as sy eie herken. Vergeef my
waagstuk; ek gaan weg na Algiers, en ek het die moed nie gehad
om dit te doen voor ek jou eers gesien het nie.
—O! sê sy, bleek en bewend. Wat sal ma daarvan sê?
Die gedagte aan haar ma maak Marcel jaloers; hy frons sy
winkbroue, dog gaan voort, op dieselfde sagte manier:
—Alida, ek wil jou vertel dat ek jou liefhet. Paula sê dat jy my ook
liefhet. Is dit so? Ek wil dit uit jou eie mond hoor.
Hy sien hoe sy beef en met albei hande aan haar hals vat, net of
sy wil verstik. Al die bloed is weg uit haar wange, en haar oë is
gevestig op die dooie blare op die grond, maar sy sien niks nie.
Die eiketakke ritsel in die windjie met ’n droefgeestige geluid. Die
rosegloed van die lug, deur die regop stamme van die ou bome,
kondig al die end van die dag aan.
Soos ’n sag-tere klag kom die woorde oor haar lippe:
—Ek kan jou dit nie sê nie.
Dis die aanvallige en reine bekentenis van haar tingerige siel.
 Bewoë tot in die binneste van sy hart, kyk hy nou met ander oë na
die vreesagtige kind, soos sy daar op enkele treë afstands van hom
staan, met ’n wit tjalie oor haar skouers, soos ’n geesverskyning
onder die hoë gewelf van die laning. Die lang ooghare lê half oor
haar hemelblou oë. Agter haar, tussen die takke deur, sien hy die
son laer sink, soos ’n groot brand, waarteen die swart boomstamme
skerp afsteek. En deur die blare priem vurige, wrede strale van goud
en bloed.
—Alida, sê hy, as jy my liefhet soos ek vir jou, beloof my dan dat jy
my vrou sal word.
Eindelik kyk sy op in die fiere gelaat van die jonkman. Sy sien dat
hy deur haar gely het, en daar kom trane in haar oë.
—Ek kan nie . . . . Marcel . . . . My ouers . . . . Verder kan sy nie
kom nie; haar trane verkondig wat sy wil sê.
Hy kom nader en neem haar hand. Sy trek dit nie terug nie.
Met ferme, oortuiende stem sê hy verder:
—Moet jou nie ongerus maak nie, Alida, jy sal hulle toestemming
verkry. Hou maar moed, en wag. Die tyd sal alles reg maak. Ek vra
jou net om geduldig te wees. Wat my betref, ek sal groot dinge verrig
om jou te kry. Ek gaan met ’n kommando na die binneland van
Afrika. Met my oorwinninge sal ek jou ook wen.
Vrees vir sy lewe verraai haar liefde vir hom:
—Nee, nee, ek wil dit nie hê nie. Jy moet jou lewe nie so blootstel
nie. O, as jy . . . . my liefhet, sal jy nie gaan nie.
—Ek sal gaan omdat ek jou liefhet, Alida.
—Jy ken my nog nie. Ek is banghartig. Ek is bang vir alles. Ek is
maar ’n armsalige wesentjie. O, wat ’n hoofpyn het ek!
Die hand wat hy nie vashou nie bring sy aan haar voorhoof en
haar bors.
—Hoe swaar voel my hart! fluister sy.
 —Alida! sê hy hartstogtelik, moet vir niks bang wees nie! Ek het
jou lief, ek sal jou beskerm!
Hy buig hom vooroor en raak met sy lippe die handjie aan wat hy
vashou. Die kus laat haar bewe. Sy sê, met ’n suggie:
—Laat ons binne-toe gaan, dis verkeerd wat ons doen.
—O, nee! Ek het jou so lief. Is ek dan nie jou verloofde nie?
Sy sê weer:
—Dis verkeerd.
Hulle kyk mekaar in die oë. Die kleure verbleek aan die aandlug;
’n blou waas skuiwe tussen die boomstamme deur en oor die
grasperke. Dis die geheimsinnige uur wanneer dit lyk of alles huiwer
vir die naderende dood. Die dag draal nog, maar dis ’n swakkerige
daglig, mat en sag wegkwynend. En die voetpad wat hom onder die
bome verloor, word afwisselend rooskleurig en violet.
Die ondergaande son spieël hom af in die oë van die meisie—die
hele droefgeestigheid van die sterwende Natuur.
Nog nooit het hy so ’n besef gekry van haar tingerigheid nie. Nog
nooit het sy so sterk die kuise behoefte gevoel om haar te steun op
sy jeugdige krag nie. Nogtans, as hy haar nadertrek en vooroorbuig
om haar ’n kus te gee, stoot sy hom saggies weg met haar hande en
sê, vir die derde maal:
—Nee, jy mag nie, dis verkeerd!
Die vreesagtige deugsaamheid, wat tog nie haar liefde kan
verberg nie, vervul hom met eerbied en ontroering.
—Alida, sê hy nog ’n keer, sweer my dat jy my vrou sal word.
Maar haar antwoord is weer dieselfde:
—Ek kan nie. My ouers wil nie.
Dit verbaas hom dat hy nog maar nie verder gevorder het as dit,
van die begin af van hierdie onderhoud, waar hy so vurig na verlang
het en waarvan hul toekoms sou afhang. Beslis neem hy weer die
woord, sterk in sy liefde en seker dat hy haar sal oorhaal:
 —Alida, Alida, ek gaan weg, miskien vir ’n paar jaar. Maar wat
beteken twee of drie jaar as ’n mens iemand liefhet? Liefde duur vir
altyd. Ek wil jou woord hê om met my mee te neem; dit sal ’n
beskermende hand oor my hou en dit sal my moed gee. Alida, ek het
jou meer lief as my eie lewe, of liewer, ek het my lewe nie lief sonder
jou nie. Moeilikhede is niks as ’n mens liefhet nie. Sweer my dat jy
jou hart vir my sal bewaar solank as ek weg is, en hierdie handjie,
wat jy my gegee het, en wat so yskoud in myne lê.
Maar sy is onder ’n verbod, en sy bly roerloos en spraakloos
staan. Sy het nooit in haar lewe iets uit haar eie gedoen nie. Sy weet
nie of sy ’n eie wil het nie. Selfs haar liefde het haar oorrompel en
pynig haar op ’n manier wat haar oordrewe en ongeoorloof lyk.
So sien hy haar staan, bleek en swak; al wat hy wil is om haar te
beskerm teen die slae van die noodlot. Maar terwyl sy nog maar
swyg, sê hy weer:
—Alida, ek het jou lief. Dit word laat, jy moet binne-toe gaan. Die
lug word al koud. Sal jy my laat vertrek sonder ’n woord, sonder
enige hoop?
Dis die aangrypende uur van die dag wanneer dit lyk of alles ’n
oomblik in gedagte bly staan, alvorens in die nagskaduwee te
verdwyn, te sterwe. Die laaste lig van die westerhemel val nog op
die reine engelgelaat, op die goue hare; en haar wit tjalie steek af
teen die donkerte onder die bome. Sy bly so staan: spraakloos en
roerloos. Terselfdertyd dink sy aan die onmoontlike stryd teen haar
ma en die onmoontlike huwelik met meneer Marthenay. Sy weet nie
wat ons van ons lewenslot kan maak as ons die moed het om dit te
lei met ’n hand wat nie beef nie. Die liefde maak die deure van die
lewe wyd ope vir haar. Verskrik durf sy nie binnegaan nie. Wat het sy
tog misdrewe teen die Heer dat Hy haar keus van haar alleen laat
afhang? Waarom is haar pad tog nie gelyk en gemaklik nie? En so
verlam die vrees haar, dat sy geen keus kon doen nie.
Waarom praat hy nie van sy smart nie? Dit sou haar so aandoen,
dat sy die verlangde belofte sou gee. As hy dan sou probeer om
haar, soos vantevore, nader te trek na hom, sou sy hom nie weer
afstoot nie, sy sou eindelik haar hoof neerlê op ’n dapper bors.
 Maar hy wil hê dat sy, in antwoord op sy aansoek, haar uit haar
eie moet gee. Hy wag nog maar daarvoor, en namate dit langer duur,
soveel te meer bejammer hy die arme wankelmoedige kind. Nee, dis
nòg skamerigheid, nòg natuurlike teruggetrokkenheid wat oorsaak is
dat sy nie praat nie. Die omstandighede is te ernstig dan dat sy sou
aarsel om te praat as sy voel dat sy moet. Die moeilikhede wat hulle
skei, is maar net die struikelblokke van ydelheid en selfsug, wat
gemaklik te oorwin is. Sy het hom lief, en tog bly sy stil.
Hy voel dat hulle weë alte veel verskil. Fier en verontwaardig rig
hy hom tot sy volle lengte op teenoor haar. Om haar te kan groet,
oorwin hy egter sy trots en hy sê, met toegeeflike ontferming:
—Nee, Alida, beloof maar liewer niks nie. Jou woord wat jy aan
Paula gegee het vir my, gee ek jou terug. Jy is te swak om lief te hê.
En terwyl hy die klein, koue hand loslaat, wat hom nie versit nie,
sê hy nog daarby, duidelik en ferm:
—Dag, juffrou, ons sal mekaar nooit weer sien nie.
Sy sien hoe hy haastig verdwyn in die laning, waar die skaduwees
van die invallende nag al rondsluip. Hy kyk nie om nie. Nou is hy nie
meer te sien nie, en sy soek hom nog met haar oë. Die boomblare
bewe in die aandwindjie. Een van die blare gaan los, en raak Alida
haar hare in sy val. By dié aankondiging van die winter voel sy die
dood om haar heen en in haar. Soos twee huppelende, vrolike
skimme verskyn Isabella en Jan weer. Hulle kry haar beweegloos
staan op dieselfde plek waar Marcel haar verlaat het. Hulle wil met
haar praat, dog sonder ’n woord loop sy huis-toe om haar verdriet te
verberg. Sy dink daar nie aan om Jan Berlier in vertroue te neem nie
—hy sou haar nog uit haar ongeluk kan red. Sy is in haar kamer,
bêre haar gelaat in haar hande, en ween. Maar selfs in haar verdriet
dink sy nie aan stryd nie; sy gee haarself oor aan die wrede noodlot,
wat in haar oë onvermydelik is.
Alida het weggevlug, en Jan en Isabella kyk mekaar verwonderd
aan:
—Ek begryp daar niks van nie, sê hy.
 —Ek verstaan, sê sy. Dis nog ’n bange! Ons is almal eners in ons
dae: Ons wil geniet, maar niks waag nie. Ek weet net van een wat vir
liefde tot aan die end van die wêreld sal gaan in ’n rok van ’n paar
dubbeltjies.
—Wie?
—Paula Kibert.
Voordat sy die naam nog uitgespreek het, sien hy meteens in
gedagte die fiere sy-gesig, die reine gedaante van Paula in haar
rouklere. Isabella merk wel wat daar in sy gedagtes omgaan. Jaloers
kom sy nader en sê, op haar mees vleiende toon:
—En die loon vir my medepligtigheid? Het jy dit al vergeet?
Sy bied haar lippe aan. Hy onthou nou weer wat hy beloof het; en
terwyl ’n mistigheid die tinte van die aand bedek, gee hy haar, daar
onder die bome, haar betaling . . . .
Marcel kyk eers om as hy naby Maupas is. Hy sien Chenée onder
in die donkerte, terwyl op die berge bo nog die glans van die aandlig
lê. ’n Lang vlokkige wolk, soos ’n verskeurde doek, sweef op halwe
hoogte die bergwande verby; die strale van die son, wat al onder is,
giet daar ’n fyn rose tint oor, so teer, dat dit lyk soos ’n blou geaderde
berggodin, half verberg in gaas en neteldoek.
Hy skep behae in sy selfpyniging, en hy kyk, tot die opkruipende
skaduwee oor die toppe gaan, die heerlikheid uitwis en die skat van
kleure laat verbleek. Dit lyk vir hom of hy makliker asemhaal in die
versomberde natuur. Met ligter stap gaan hy die bos deur; die bome
is al half ontblaar, en deur die takke sien hy bloedkleurige wolkveë.
Die uile—soos onheilspelende geeste van die aand en die najaar—
roep mekaar met noodkrete, soos die doodsangstige hulpgeroep van
slagoffers, wat die hart van ’n late verbyganger laat stilstaan.
By die hek van Maupas ontmoet hy sy suster; sy was ongerus en
het kom kyk of hy al aankom. Sodra Paula hom sien, weet sy wat die
uitslag is van sy tog.
—Ag! sê sy eenvoudig.
Een woord van hom verklaar die saak.
 —Sy is bang vir die lewe: sy en ek is nie van één soort nie.
Sy neem sy arm en wil hom soen, dan sê sy meteens, bewend:
—Luister!
—Dis maar die uile—die bome is vol van hulle.
—Laat ons gou weggaan. Hulle maak my bang. Die boermense sê
hul kondig die dood aan.
Hy maak ’n beweging van onverskilligheid met sy arm . . . .