In so far as there is an outward and visible sign in this sacrament, it must be seen in the context of coming before the priest and making ones confession to God. The priest, on the authority given to him in ordination, assures the penitent of the absolution offered through the reconciling work of Christ on the cross of Calvary.
The arrangement which prevails in the Anglican Communion leaves much to individual responsibility and self-discipline, and everyday matters are taken care of in the practice of general confession and general absolution. But if these is anyone who 'cannot quiet his own conscience' by self-examination and self-discipline, then the opportunity of the sacrament of penance is offered. This is summed up in the fairly well-known phrase - 'All may; none must; some should'.