Equifinality
Equifinality, the ability to attain the same final state from many different initial conditions, is featured more prominently and is increasing in importance because the regulatory landscape is becoming more complex as it seeks to address and accommodate dynamic change and associated variability in health systems. In the past, when regulators were the only mechanism to protect the public, student nurses were primarily women who completed high school, and there were few nursing shortages, regulatory systems tended to be linear and isolated (Allsop et al., 2004).
In many countries, the level of academic preparation varies, yet the license-to-practice examination is set at the same level. In the United States, nurses who have completed a 2- year associate-degree program, a 3-year diploma program, or a 3- or 4-year baccalaureate degree and those who have entered nursing with an existing degree in a related discipline and then exited with a masters qualification all take the same NCLEX® examination upon which states base their licensing decisions.
The concept of equifinality also applies to governance and legislative issues. Carlton (2006) demonstrated equifinality when he identified that data from legislative mapping exercises often indicated variability across jurisdictions both in terms of the powers allocated and the approaches taken.
Perhaps as a result of a lack of dialogue, however, there are few examples of jurisdictions seeking to compare and contrast the approaches being used across the full range of their responsibilities. This is unfortunate since the lack of such scrutiny may lead to needless reinvention of already identified approaches or the application of suboptimum solutions.