Studies have raised concerns about the reliability of traditional clinical perceptual voice evaluation. References, training, and the analysis-by-synthesis method were proposed to improve this reliability. However, no study has directly compared the effectiveness of these methods. This study compared two training programs that are based on an anchors method and a paired comparison method. The aim of the programs was to improve the ability of naive listeners to detect subtle differences in breathiness. This study found that trained listeners showed significant improvement after training. Equivocal results were found as to which of these training methods was more effective. However, it is suggested that listeners should be trained before they use the analysis-by-synthesis method. The findings of this study provided more information on developing the theoretical framework proposed by Kreiman et al, in particular the "nature" of the internal representations of voice quality. An exemplar-based approach for processing breathiness is proposed.