The issue of the competencies of patient therapeutic education (PTE) practitioners is central to the development of training programs in this field. However, until now, no framework in this field based on direct observation methodology was available in France. Based on this observation, INPES conducted a project (2010, 2011) to propose a shared reference framework that could be used by professionals and training institutions. Following a literature review and the definition of a representative sample, interviews to analyze practices and case studies were conducted. The survey was carried out among approximately one hundred stakeholders in France and five European countries. The prototype framework was the subject of extensive consultation. The final document synthesizes key situations related to VET, the activities involved, and the competencies to be implemented. It consists of three frameworks concerning: (1) VET practice, (2) the design and coordination of a VET approach, and (3) the design, management, and promotion of VET policies and programs. The guidelines, developed based on the practices of ETP stakeholders, reflect the current reality of the situations encountered. They capture the diversity and richness of the ETP field. The resulting documents can be used in various contexts and for different purposes, particularly to structure the initial and continuing education of relevant stakeholders, with a focus on competencies. [Author’s abstract]