I was delighted when this came out, enjoyed it alot when I was younger. There are some nice mods out there as well that improve the graphics and add more ships, check out the Forums.
For me the game works out of the box. There was a mouse lag issue but that was caused by Nvidia driver and not the game, the latest drivers seem to have fixed this now. Other than that, I have noticed there is about a 20% chance of the game crashing when you start a mission. Saving before missions stops this being to much of a pain however.
Otherwise, gameplay it has several campaigns for Romulan, Klingon and Federation as well as free form campaigns for all three plus Borg. You travel around the map doing missions, earning enough points so you can upgrade your starship with new equipment or get a better starship. Combat is slower paced and more tactical, focus more on manuvering, shield positioning and weapon recharge rotation.
For people that like star trek or space combat simulators I can recommend.