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Remember how in Fallout 1 idiot NPCs would stand in doorway, blocking your movement and were content to stand there staring at you till the end of time?
THEY FIXED IT! You can gently push them out of the way. Before I noticed the option, I resorted to doing a targetted kick in their bollocks in the hopes they'd at least crumple up and fall out of the way but then people just tried to shoot me. I call it rude. The point is that no longer are you held at the mercy of the AI's rambling decision making process as to when someone will move and that alone is a major advancement.
Pathfinding has been improved somewhat so the people move in fairly efficient paths most of the time. The enemies do still have an unnatural fixation on killing the PC regardless of who is closer or has a bigger gun so combat is still a pretty selfish affair. They sometimes attack my NPCs if they've done enough damage to the enemy but it's still rare enough to be the exception.
Oh yes and there's also children in this one so the towns have a bit more of a "will survive because there's another generation" feel. Also you can shoot them and get a special negative reputation but that's for sickos, I shoot them ONCE and then let my NPCs finish them off, that way I'M not a childkiller...
The other reviews have pretty much said everything that needs to be said. This is a game for the long haul, designed for moderately patient people rather than the type who, to quote a great critic, is "a twitching, Ritalin popping X-Box owner who falls into a narcoleptic coma when they go without killing something for 45 seconds". You have to wait till you get really good guns and a lot of ammo or become a hand to hand legend before you can efficiently go psycho.
The Fallout story is fairly self contained but you'll get a little bit more out of them if you play them in order.