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No, it applies to saves, not to the flat checks.
On a critical failure, the target's allies can still cause minimal damage to allow flat checks to end the condition. And you or your allies dealing damage to the target causes flat checks to end the condition as well.
On normal failure, in addition to the flat checks caused by enemies or allies dealing damage, the target gets to make a new save each round.
This is probably why the spell doesn't have the Incapacitation trait. Even if it lands, it doesn't stay long on BBEG boss enemies.
I would expect so. I haven't seen it in action myself.
But from a GM's perspective, I would expect it to work best on a battle where there are a number of enemy creatures that the party is facing. Landing Confusion on one of them would do horrors on my enemy's action economy.
On a regular fail and the Confused condition with a save to end the ability at the end of each round, my choices are:
* Leave the creature to its confusion. Effectively taking it out of significant threat to the party for a round or two.
* Have other enemy characters trying to slap them back into sensibility - causing damage in the process and more importantly, wasting actions.
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The effect is more limited if it is a boss fight with mooks or a solo boss fight.
Solo boss fight, the party will take care of removing the condition. Probably before the boss's turn even comes up.
Casting Confusion on a mook doesn't really matter. The main threat of the combat is the boss anyway. The mook did its job by wasting actions of the party - the actions spent casting Confusion on a mook.
Another good use would be in the boss fight with mooks, if you cast Confusion on the boss and land it. The boss may end up spending its own actions nuking mooks. The action cost of the enemy team for mooks to slap the boss back to their senses is easier to swallow. And the boss will have higher saves and will shake off the effect faster unless they crit-failed to begin with. Also once the mooks are gone, we are back into the scenario of solo boss fight. Though it is now a much easier battle with all of the mooks gone.
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Yes.
Confusion can be effective. I have seen it in play, and it can be very effective.
Not only does it give Stunned 1 on a save, which is useful on its own, but the confused creature treats everyone as an enemy and picks its targets randomly among all creatures it is aware of.
This might make it spend 2 or 3 actions Striding towards a PC or one of its allies.
It might, as Finoan said, attack or even kill, one of its own allies. Also, while Confused, the creature cannot use Reactions and this can be pretty amazing, especially on something like a Hydra with multiple Reactive Strikes. On top of that, it can only use offensive *cantrips* for spells, meaning that the confused monster (or PC) can't AoE or use a powerful effect on its target to try and get around the confusion. It also can't use special abilities. IE: No basilisk stone attempts, no dragon breath weapons, no special 2 or 3 action attacks.
Also, even with ending on a DC 11 flat check, there is no assurance that the enemy will roll 11+ on its first try. It could last a very long time,
Confusion is not a bad spell in any way.
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A big deal that determines how good confusion is in the moment is if that foe uses Strikes, or likes to use special abilities.
Confusion *only* allows for Strikes and offense cantrips to be used.
If the foe is a Knight of Abendego who wants nothing more than to do basic Strikes that have unique NPC bonus damage, Confusion will be less effective because of how that foe is built.
If the foe is instead some archer with a "rain of arrows" style ability and weak basic shots, then Confusion is a much better prospect.
Worried about getting Swallowed Whole? Maybe Confusion could prevent it.