SHISA KANKO

Errors are never intentional. A worker does not act to cause damage. Any decision he makes is contextual. It makes good sense to him. If it did not make good sense to him, he would not go ahead with it. He wouldn’t have gone ahead if he knew the outcome would be harmful.

“If the end brings me out all right what is said against me won’t amount to anything. If the end brings me out wrong, ten angels swearing I was right would make no difference.” Abraham Lincoln.

Humans are assumed to be rational. But to be rational, he would need all the possible information and have knowledge of every possible outcome at every moment. Because time doesn’t stand still and the environment keeps changing, it is impossible to have all the information and knowledge to make the correct decision. His context keeps varying and the worker responds to make best sense of it and take the best action – he is not acting to cause harm. He is acting to finish his task.

In this situation, something that slows a worker down and allows him to engage more of his brain will help him make an informed decision and reduce errors should excite you and me.

I was standing by the panel in the CCR preparing to discharge cargo at the Keiyo Sea Berth. The berth master came up beside me.

“Ready Chief?”

He began to run his forefinger on the mimic. He started from the cargo tank valve and moved along the bottom lines, across the bulkhead masters, to the pumps in the pumproom and through the pump room risers to the deck main and then to the manifold. He turned to look at me with a thumbs up! Soon we were discharging

On the ship _gawa, we would stand around discussing the day’s work. After the meeting, we stood in a circle with our left hands pointing to the centre of the circle. Our right arm in a fist with the thumb outside would be next to our right ear. We would bring our right hand with the forefinger opened and pointed out vigorously down to meet our left as we shouted, “Safety First”. Thrice.

This was an exercise to point everyone’s attention to safety. But without any background, I thought it theatrical. I was self-conscious when I did this and avoided it when I could. 

This is something you would also see if you travelled by train in Japan. And that is where it all started. You could watch what I am talking about here:

Anecdotally the practice began in the early 1900s. A train driver thought he was losing his vision. He feared he might miss a signal and so began to call out the colour of the signal light as they approached it. His fireman would repeat what he said to confirm the colour. Someone saw this and adapted it to the Railway safety manual.

I reached out to Dr. Nikhil Bugalia. He shared some material that helped me understand this better.

What was happening with the berth master or after the safety meeting or in the railways was not arbitrary - it was deliberate, well thought out and proven.

The ergonomic laboratory of the Japanese Railway Technical Research institute studied this practice. The gave a simple task to the test subjects. They showed them a colour on a screen. Th subjects had to press a button matching the colour on screen, from among the five buttons in front of them.

1. The first group had to press the button that matched the colour
2. The second group had to call out the colour and then press the button
3. The third group had to point to the colour and then press the button
4. The fourth group had to call out and point to the screen before they pressed the button

The researchers measured the error rates. The error rates of the first group was 2.38 (per 100) while that of the last group was 0.38. The results were very clear: error rates dropped by 85% if you pointed and called before pressing the button.

This method engages the brain better because it involves a persons’ eye, ear, mouth, hand and brain. This is like practicing mindfulness as each step in the task is reinforced by engaging the brain better. Page 11 of this report (https://www.rtri.or.jp/rtri/pdf/annual/annual2010_e.pdf) shows the effects of pointing and calling - deliberate actions, improvement in memory and vigilance. Mindful meditation, anyone?

Even if one wasn’t as enthusiastic as the Japanese, the increased awareness from even a half-hearted practitioner would improve safety. In 1996, the train conductors of the New York subway enthusiastically adapted this technique and within 2 years there was a 57% drop in accidents.

We often compare ourselves to the airline industry. The Airline industry seems to be looking at Shisa Kanko. While it is hard to imagine comparing shipping with the railways, the fact that aviation is looking at this should encourage some of us. Anything that is proven to reduce accidents by 85% should be worth a look.

https://www.flightsafetyaustralia.com/2018/01/point-it-call-it-get-it-right/

Shigeru Hira-san in his book ‘The Psychology of Error’ wrote “It seems it’s difficult to get foreigners to do it”. People outside Japan may find it silly to be doing something like this. But if this is something that is going to find its way into a cockpit, we might as well get there and make our ship a more mindful one.

 Sources:

• https://www.atlasobscura.com/articles/pointing-and-calling-japan-trains
• https://www.japantimes.co.jp/news/2008/10/21/reference/jr-gestures/#.Xt0SYTozbIV
• https://aviationweek.com/business-aviation/adding-japanese-shisa-kanko-techniques-modern-cockpits
• https://www.safetysynthesis.com/
• https://www.skybrary.aero/index.php/Toolkit:Systems_Thinking_for_Safety/Principle_2._Local_Rationality
• https://www.liquefiedgascarrier.com/pressure.html