“Pointing and calling” – promoting mindful attention
In this post, I have provided several examples from different perspectives to highlight the broad applicability of the Japanese safety technique, Shisa Kanko. The concept of Shisa Kanko could be metaphorically extended and applied in various areas of parenting and other aspects of life and work.
For a typical example, in Japan, on high-speed trains, the driver has a routine to follow. They don’t silently check the speedometer or glance at signals. They point at each gauge, engage with it conversationally and say what they see aloud – “Speed 100… Signal clear… Doors locked.” This allows for confirming the speed both visually and audibly. It’s also a way of letting others know about the actions that have taken place.
A demonstration of this can be seen in this video.
Shisa Kanko (pronunciation – shee-sah Kahn Koh)
Shisa Kanko is a Japanese safety technique called “Pointing and Calling “By physically pointing and verbally confirming each step, the driver turns an automatic routine into a conscious act. It’s deliberate and has been found to reduce errors. It’s a way of shifting from unconscious behaviours to conscious ones, and from implicit cognitive processing to making it explicit. This technique is highly effective and has been extrapolated to other industries such as aviation and healthcare.
The rationale
When we say something out loud and pair it with a physical gesture, we engage multiple senses such as sight, sound, and movement. This causes the brain to slow down and pay closer attention. It’s like shining a spotlight on what matters most and can be seen as the Buddhist application of mindfulness.
Application in Parenting
One of the most common issues parents face nowadays is behavioural problems. Unless parents take the time to help children understand clearly what is desirable and what is not, children might not understand, which can lead to frustration.
Behavioural modification: Point-and-tell can be a very useful technique. Instead of just saying “you did a good job,” you could reframe it as, “I saw you sharing your pencil with your friend. That was very kind of you.” This way, the child will understand that sharing is a desirable behaviour and kindness is a virtue. If you say “good job,” you’re not being specific about exactly what you’re encouraging.
Remembering tasks: I find it helpful when coaching children with ADHD who struggle with forgetfulness. I suggest creating a checklist of tasks and advising them to physically ensure they see and talk aloud what they are doing. For example, if the goal is to avoid a child losing things in school, before entering the car or leaving the classroom to go home, he/she needs to go through a checklist that might look like: hat, school bag, water bottle, etc. However, it’s not just about talking aloud; it’s about physically ensuring that these are physically in place. This deliberate practice ensures that the behaviour we are targeting is resolved efficiently. This approach later becomes an effortless, automatic practice for tackling complex tasks.
Clinician’s Perspective
Even the best systems can fail when we’re distracted or in a hurry. By pointing to each step and saying it aloud, we reduce mistakes and improve safety. Hence, it becomes a cognitive safety net.
In healthcare, we often rely on checklists and protocols. Before every hospital procedure, calling out the patient’s name and asking for their date of birth, address, and the procedure/ clinical care they are scheduled for helps ensure mindful attention. It confirms that the right patient receives the correct care.
Checklists are also available for each procedure, which detail the personnel responsible for each task, the equipment needed, backup plans, and a running commentary on the plan for the patient. This helps make unconscious actions more conscious and promotes mindfulness in daily tasks.
Positive reinforcement – As a supervisor, this is a beneficial technique to reinforce positive behaviour. When someone mentions that we might keep adrenaline ready during a routine intubation, I would mindfully comment on that. Thank you for suggesting that. Having adrenaline on hand in case the patient deteriorates is an excellent idea. This comment then allows the trainee to know that this is something to think about in similar situations in the future, reinforcing and validating this behaviour.
Sharing mental model – During rounds, I would review several X-rays and images for patients. For an experienced eye, interpretations are often automatic and unconscious. With experience, many of these images can be interpreted with high accuracy just by looking.
However, relying on unconscious cognitive processes also risks missing findings, and being deliberate about interpreting investigations is very helpful. This might mean deliberately talking aloud thoughts to my team members and pointing to what I see. It might go like this: the lung fields appear normal, the heart border looks normal, the rib cage is normal, and the costo-phrenic and cardio-phrenic angles are normal. There is no suggestion of pneumonia, pneumothorax (air around lungs) or pleural effusion (fluid around lungs). There is no mediastinal mass. This approach allows me to be deliberate and share my mental model with others.
Enhancing communication: explaining and sharing my thoughts is something I do during my ward rounds. I pull up each investigation and the charts and describe them in detail to the parents. That way, the parents clearly understand the investigation results as they are visually seeing them, and it also brings clarity to my team and me. Just glancing over the results may lead to errors.
For example, when explaining the complete blood examination to the patient, I might point to the investigation and say, ‘This is the section looking at the body’s response to infection.’ This part examines whether the body has deployed the soldiers to fight infection and inflammation. That way, things that I know in my unconscious are brought to consciousness and it also allows me to make interpretations in the context of the patient and communicate its relevance mindfully.
This simple act promotes clarity and can be applied across all workplaces. It moves the discussion from vague statements to specific evidence. It also trains the eye and mind to work together—because when you point, you commit. You’re saying, “This is what I see, and here’s why.”
Simulation education involves training by replicating real scenarios in artificial settings. It focuses on building habits that last and become reflexive. When you point and speak, you’re not just completing a task—you’re ingraining awareness into muscle memory. It transforms passive observation into active participation.
When I run simulation sessions for trainees, I focus on this principle. During a neonatal resuscitation drill, for instance, I ask participants to point to the oxygen flow meter and state the reading aloud, or to point to the monitor and verbalise the Rhythm and the heart rate that they see, so that meaningful interpretations are made and actions taken.
Conclusion
From Japanese train drivers to parenting, clinical work, teaching or daily routines, there is value in implementing the principle of Shisa Kanko. This deliberate act helps us to slow down, take notice and act with intention. And this clarity keeps us safe, consistent, and connected.
So next time you’re about to rush through a task, consider pausing, pointing and verbalising. Make it deliberate. Over time, this habit builds precision and mindfulness. It’s not about slowing down for the sake of it—it’s about making every observation deliberate and mindful.
Suggested resources
https://www.flightsafetyaustralia.com/2018/01/point-it-call-it-get-it-right/
https://www.kevinmeyer.com/the-point-of-pointing-and-calling-a-personal-rediscovery/
Disclaimer
This article is intended for informational purposes only. It is not a substitute for professional advice, diagnosis, or treatment. The ideas shared here are general in nature and should not be acted upon without consulting an appropriate expert, such as your clinician and coach. Any actions taken or interpretations made based on this content are solely at the reader’s discretion, and the author assumes no responsibility for outcomes.