This code could mean:
Alignment tools are available, however they are not usually needed if the old synchronizer is marked carefully before removal, many tech's keep a small bottle of white touch up paint in their tool box for this purpose.The sensor / synchronizer assembly needs to be 54 degrees Counter Clockwise from the front of the engine NOT 54 degrees clockwise.
Has there been any work done to the truck Before this problem starter? Like timing, cam shaft,
Things to check If the camshaft synchronizer And the camshaft position sensor were BOTH replaced right.