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Instructional Decision Making (IDM) is a complex ‘mental dialogue’ of determining learning goals, instructional activities, flow and sequence of content, instructional tools, and resources, and modifying these decisions as needed. The paper synthesizes empirical evidence on types of Instructional Decisions (IDs) and factors that influence IDM, drawing literature from EBSCOHOST and Taylor and Francis published between 2010 and 2022. Findings suggest instructors navigated personal, instructional, organizational, and societal circumstances to make IDs. Understanding of IDM advocates for moving instructor professional development away from prescribing instructional methods to developing instructors’ IDM skills. Support and incentivization must be made available for instructors to make evidence- and context-informed IDs.