Extensive research has highlighted the crucial role of fire safety training for hospital staff in guaranteeing patient safety during fire emergencies. However, training in such a complex environment can present significant challenges due to the hospital’s architecture, patients’ presence, and diverse needs. Although previous fire safety training programs in New Zealand hospitals have incorporated scenarios designed and played by hospital staff, they still lack the realistic element of smoke spread impressions and potential challenges that staff face during patient transfers between different departments in the event of fire evacuations. Various technological simulations are used to conduct this training and overcome this challenge. This paper explores the technological simulations available in today’s market for conducting fire safety training in hospitals while assessing their realistic efficiency in ensuring overall patient safety during fire emergencies. This study employs a constructive interpretivism framework to analyse 36 relevant research papers rigorously. Specifically, it delves into the efficacy of three simulation tools – Virtual Reality (VR) and Augmented Reality (AR) for training hospital staff in fire safety. The study then evaluates each method based on the key factors of safe egress in hospitals to determine how the approach promotes patient safety during fire emergencies and current gaps. The practical implications of each simulation tool are also thoroughly examined. This study provides insights into the impact of simulation systems on patient safety during fire emergencies. The findings of this study can be useful for academics, fire professionals, trainers, and hospital staff to identify and mitigate the risks associated with fire emergencies.