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Thousands of students enroll in Massive Open Online Courses~(MOOCs) to seek opportunities for learning and self-improvement. However, the learning process often involves struggles with confusion, which may have an adverse effect on the course participation experience, leading to dropout along the way. In this paper, we quantify that effect. We describe a classification model using discussion forum behavior and clickstream data to automatically identify posts that express confusion. We then apply survival analysis to quantify the impact of confusion on student dropout. The results demonstrate that the more confusion students express or are exposed to, the lower the probability of their retention. Receiving support and resolution of confusion helps mitigate this effect. We explore the differential effects of confusion expressed in different contexts and related to different aspects of courses. We conclude with …