Watch the video on this site. I trained Kacee on them very quickly. I started her right off with them and, of course, she did ring them a lot and nearly constantly as a puppy. Sometimes she would ring them just to get me to come into that room to play, but those things all passed. I love the bells. I have them at two doors and wouldn't trade them for anything. I can hear them all over the house. I started her off by taking her paw and ringing them, although, they say to use their nose. I didn't think she would like having her nose pushed into them.
She caught on quickly.
Poochie-Bells, The Trusted Dog Potty Training and Housebreaking Tool