Overall statement or summary of the article and its findings:

The objectives of the study are well defined and clear. The main aim is explained in the Abstract. This section is adequately structured responding to all sections of the document. The objectives and the questions that the researchers will try to answer are set out in the last paragraph of the Introduction. The Introduction section is very well structured and proposes a solid theoretical framework, with relevant and current bibliography. In the second paragraph, in the first sentence "The modality of immersive simulation has been embraced in Physiotherapy and nursing education" . This field has been extensively studied in recent years in relation to clinical simulation. Please, consider adding some reference in this line, for example: Dunsmuir, Atkinson, Lang, Warhurst & Wright, 2017. The authors provide valuable information on the topic of study and refer to researchers in the field.

The way in which the sample is recruited is appropriate for the object of study. It is a representative sample of the universe under study. In addition, the selection process is detailed as well as compliance with ethical criteria. The intervention is also detailed. The clinical confidence measurement instrument is validated and correctly referenced. In this case, it has been modified to include one more question and this is adequately explained. The instrument used to evaluate the performance or competencies acquired is a digital tool that is also validated and referenced. The authors include sample items of each measure used in addition to the complete questionnaire in an attached file.

The data analysis is appropriate for the object of study. In addition, to the assessment of improved student confidence, it includes the correlation with academic performance, objective measure based on the APP assessment instrument and differences between the groups analyzed.

The results obtained are detailed in an orderly and concise form. The authors explain the meaning of the evaluated data and correlate the level of confidence with academic performance.

In the Discussion, the authors discuss the results obtained and suggest ideas based on them. They also make specific comparisons with previous studies that have obtained equivalent results. The authors include the limitations, among others, of students' previous experience in the clinical setting. In this line, please consider including any study that has related these variables: Experience and Academic Performance and Confidence or Habituation, for example: Lubbers, & Rossman, 2017. The document includes suggestions for future researches along these line, and a Conclusions section, summarising the most important findings of the study.

The tables presented offer sufficient data for a correct interpretation of the results. They are not repetitive and facilitate the reader's comprehension.

Overall strengths of the article and what impact it might have in your field:

The object of study is relevant to the field of application. Subjective and objective variables are evaluated, and an attempt is made to look for significant correlations. In this case, the perception of improved self-confidence and academic performance. The results obtained indicate that although student confidence increases in each simulation block, it decreases again when they have to face a new scenario. However, this is not related to academic performance. These results can be used to broaden variables, so that in future studies they will try to relate to the objective of improving the experience of students in facing evaluation through simulated scenarios. For example, stress (objective and subjective), coping styles used by students or certain personality factors that can impact academic performance and the learning process itself.

This is a very good job. It is well thought out, well structured and the methodology is correct. The results are relevant and oriented towards process improvement.