Curriculum reform is a topic seen in research for decades, and nursing education has not been excluded in this call for reform (Benner, Sutphen, Leonard, & Day, 2009; Diekelmann, Ironside, & Gunn, 2005; Dracup, 2011). The issue in nursing education relates to the lack of guidance in how to proceed with this radical change process (Benner, Stuphen, Leonard, & Day, 2010). The purpose of this quantitative research study was to examine the extent to which accredited baccalaureate nursing programs utilized the elements of an academic plan as defined by Lattuca and Stark (2009) when developing or revising curricula. Utilizing this academic plan as a guiding framework, this study further identified the extent to which defined factors, external or internal, influenced curriculum decision-making. This study identified the differences that existed in decision making related to factors based on institutional characteristics. Data were collected using a researcher-designed survey sent via Survey Monkey to 715 deans/directors/chairs of accredited baccalaureate nursing programs nationwide. The data were analyzed and revealed that the element of purpose was most utilized followed by content. The learner, although moderately utilized, was the least utilized element in curriculum decision-making. Analysis further identified a significant difference in the area of content utilization between public and private institutions and no significant differences based on accreditation type. There were differences noted between groups in the use of content related to both number of full-time faculty and number of students graduating annually. This study reiterated the point that nursing education is in need of change and that content has been the major factor utilized when planning curriculum. The data support the research in that nursing education is content saturated and content driven. Given this, efforts must continue to change nursing education in substantial manners. Healthcare today mandates the need for nursing education that is dynamic and fluid and can meet the changing needs of the consumer. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]